pimozide
Brand names: Orap
Pimozide (Orap) is a medicine that helps control tics in people with Tourette's Disorder. It works by affecting certain chemicals in the brain.
Drug Pricing (NADAC)
Generic Price
$1.22/unit
Generic Available
Yes (1 manufacturer)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Pimozide is used to treat motor and phonic tics in people with Tourette's Disorder.
Common side effects
Parkinson-like symptoms (tremors, stiffness), Restlessness, Muscle stiffness
Key warnings
Pimozide can cause changes in your heart rhythm (QT prolongation).
How It Works
Pimozide belongs to a class of drugs called antipsychotics. It works by blocking dopamine, a chemical in the brain. By blocking dopamine, pimozide helps to reduce tics.
How to Take It
Take pimozide exactly as your doctor tells you. The usual starting dose for adults is 1 to 2 mg per day, divided into smaller doses. Your doctor may increase the dose slowly every other day. Children usually start with a lower dose, and it is increased slowly every 3 days.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if pimozide will harm your unborn baby. Talk to your doctor about the risks and benefits of taking pimozide during pregnancy and breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store pimozide tablets at room temperature, away from heat and light.
Side Effects (from patient reports)
Based on 374 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 463 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
463
Death-Related Reports
79
Hospitalization Reports
173
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INTERACTION | 76 |
| 2 | DRUG INEFFECTIVE | 46 |
| 3 | PARKINSONISM | 42 |
| 4 | WEIGHT INCREASED | 37 |
| 5 | SOMNOLENCE | 33 |
| 6 | HYPOTENSION | 29 |
| 7 | NEUROLEPTIC MALIGNANT SYNDROME | 29 |
| 8 | DYSTONIA | 28 |
| 9 | OFF LABEL USE | 28 |
| 10 | TOXICITY TO VARIOUS AGENTS | 26 |
| 11 | ATRIOVENTRICULAR SEPTAL DEFECT | 23 |
| 12 | CONDITION AGGRAVATED | 23 |
| 13 | ELECTROCARDIOGRAM QT PROLONGED | 23 |
| 14 | DYSMORPHISM | 22 |
| 15 | FOETAL EXPOSURE DURING PREGNANCY | 19 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Pimozide can cause changes in your heart rhythm (QT prolongation). This can lead to serious heart problems. You should have an ECG (heart test) before starting pimozide and regularly during treatment. Do not take pimozide with other medicines that can also affect your heart rhythm.
Known Drug Interactions
Table 10: Effects of Aprepitant on the Pharmacokinetics of Other Drugs CYP3A4 Substrates Pimozide Clinical Impact Increased pimozide exposure Intervention Aprepitant is contraindicated [see Contraindications ( 4 )] . Table 10: Effects of Aprepitant on the Pharmacokinetics of Other Drugs CYP3A4 Substrates Pimozide Clinical Impact Increased pimozide exposure Intervention Aprepitant is contraindicated [see Contraindications ( 4 )] .
Mechanism: Aprepitant stops the body from breaking down pimozide, which can cause pimozide to build up to dangerous levels in the blood.
What to do: Do not take these two medications together because the combination is unsafe.
Pimozide Clinical Impact: Concomitant use of citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of citalopram alone [see Clinical Pharmacology (12.2) ]. Intervention: Citalopram is contraindicated in patients taking pimozide [see Contraindications (4) , Warnings and Precautions (5.2) ]. Intervention: Avoid concomitant use of citalopram with drugs that prolong the QT interval (citalopram is contraindicated in patients taking pimozide) [see Con...
Mechanism: Citalopram increases the amount of pimozide in your blood, which can lead to dangerous heart rhythm problems.
What to do: This combination is not allowed and must be avoided.
Colchicine (in patients with normal renal and hepatic function) Use With Caution Antipsychotics: Pimozide Contraindicated Pimozide: [See Contraindications ( 4.2 )] Quetiapine Lurasidone Quetiapine: Quetiapine is a substrate for CYP3A4, which is inhibited by clarithromycin.
Mechanism: Clarithromycin prevents the breakdown of pimozide, which can cause the drug to reach dangerous levels and potentially affect your heart rhythm.
What to do: Do not use these medications at the same time because this combination is strictly prohibited.
pimozide ↑ pimozide Co-administration is contraindicated due to potential for serious and/or life-threatening reactions such as cardiac arrhythmias.
Mechanism: Darunavir increases the level of pimozide in the body, which can cause the heart to beat in a dangerous way.
What to do: Do not take these two medicines together because of the high risk of life-threatening heart rhythm problems.
Intervention: Escitalopram is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [ see Dosage and Administration (2.7) , Contraindications (4) , and Warnings and Precautions (5.2) ] Pimozide Clinical Impact: Concomitant use of racemic citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of racemic citalopram alone [ see Clinical Pharmacology (12.3) ]. Intervention: Escitalopram is contraind...
Mechanism: Escitalopram raises the amount of pimozide in your blood, which can cause dangerous heart rhythm issues.
What to do: You should not take these two medicines together.
Common Questions
Can I take pimozide for any type of tic?
What should I do if I experience side effects?
Can I drink alcohol while taking pimozide?
How long does it take for pimozide to start working?
Will I need regular check-ups while taking pimozide?
Can I stop taking pimozide suddenly?
Are there any foods I should avoid while taking pimozide?
Can pimozide interact with other medications I'm taking?
What if pimozide doesn't seem to be working?
Is pimozide a cure for Tourette's?
What are the common side effects of pimozide?
Does pimozide interact with other medications?
What drug class is pimozide?
Is pimozide safe during pregnancy?
Related Medications in Typical Antipsychotic
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for pimozide
The FDA label for pimozide (sold under brand names such as Orap) classifies it as a prescription-only medication in the Typical Antipsychotic class. Pimozide is used to treat motor and phonic tics in people with Tourette's Disorder. Official labeling lists 4 commonly reported side effects, including Parkinson-like symptoms (tremors, stiffness), Restlessness, Muscle stiffness.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 374 voluntary reports. The database also lists 24 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $1.22.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 25, 2017
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages