- What is Nuplazid (pimavanserin), and how is it used?
- What are the side effects of Nuplazid (pimavanserin)?
- What is the dosage of Nuplazid (pimavanserin)?
- What drugs interact with Nuplazid (pimavanserin)?
- Is Nuplazid (pimavanserin) safe to use while pregnant or breastfeeding?
- How does Nuplazid (pimavanserin) work?
What is Nuplazid (pimavanserin), and how is it used?
What are the side effects of Nuplazid (pimavanserin)?
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Nuplazid is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis.
Nuplazid is contraindicated in patients with a history of a hypersensitivity reaction to pimavanserin or any of its components. Rash, urticaria, and reactions consistent with angioedema (e.g., tongue swelling, circumoral edema, throat tightness, and dyspnea) have been reported
Nuplazid should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of torsade de pointes and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval
Common Adverse Reactions:
What is the dosage of Nuplazid (pimavanserin)?
The recommended dose of Nuplazid is 34 mg, taken orally as two 17 mg strength tablets once daily, without titration.
Nuplazid (pimavanserin) is available as 17 mg strength tablets. The white to off-white, round, coated tablets are debossed on one side with a “P” and “17” on the reverse side.
Nuplazid can be taken with or without food.
What drugs interact with Nuplazid (pimavanserin)?
Class 1A antiarrhythmics:
Class 3 antiarrhythmics:
Strong CYP3A4 Inhibitors:
Strong CYP3A4 Inducers:
Is Nuplazid (pimavanserin) safe to use while pregnant or breastfeeding?
There are no data on Nuplazid use in pregnant women that would allow assessment of the drug-associated risk of major congenital malformations or miscarriage. In animal reproduction studies, no adverse developmental effects were seen when pimavanserin was administered orally to rats or rabbits during the period of organogenesis at doses up to 10- or 12-times the maximum recommended human dose (MRHD) of 34 mg/day, respectively. Administration of pimavanserin to pregnant rats during pregnancy and lactation resulted in maternal toxicity and lower pup survival and body weight at doses which are 2-times the MRHD of 34 mg/day.
There is no information regarding the presence of pimavanserin in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Nuplazid and any potential adverse effects on the breastfed infant from Nuplazid or from the underlying maternal condition.
How does Nuplazid (pimavanserin) work?
The mechanism of action of pimavanserin in the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis is unknown. However, the effect of pimavanserin could be mediated through a combination of inverse agonist and antagonist activity at serotonin 5-HT2A receptors and to a lesser extent at serotonin 5-HT2C receptors.
In vitro, pimavanserin acts as an inverse agonist and antagonist at serotonin 5-HT2A receptors with high binding affinity (Ki value 0.087 nM) and at serotonin 5-HT2C receptors with lower binding affinity (Ki value 0.44 nM). Pimavanserin shows low binding to sigma 1 receptors (Ki value 120 nM) and has no appreciable affinity (Ki value >300 nM), to serotonin 5-HT2B, dopaminergic (including D2), muscarinic, histaminergic, or adrenergic receptors, or to calcium channels.
Nuplazid is indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Nuplazid is not approved for the treatment of patients with dementia-related psychosis unrelated to the hallucinations and delusions associated with Parkinson’s disease psychosis.
Multimedia: Slideshows, Images & Quizzes
Parkinson's Disease: Symptoms, Causes, Stages, Treatment
Discover the symptoms, causes, stages, and treatment options for Parkinson's disease. Learn more about the stages of Parkinson's...
Parkinson's Disease Quiz: Test Your Medical IQ
Parkinson's disease is common among neurodegenerative disorders. Do you know how it works? The causes? The symptoms? Take the...
Related Disease Conditions
Parkinson's disease is a slowly progressive neurological disease characterized by a fixed inexpressive face, a tremor at rest, slowing of voluntary movements, a gait with short accelerating steps, peculiar posture and muscle weakness, caused by degeneration of an area of the brain called the basal ganglia, and by low production of the neurotransmitter dopamine. Most patients are over 50, but at least 10 percent are under 40.
Wolff-Parkinson-White syndrome is a condition in which abnormal electrical pathways in the heart cause arrhythmias. Symptoms of Wolff-Parkinson-White syndrome include: tachycardia, dizziness, palpitations, fainting, and shortness of breath. Wolff-Parkinson-White syndrome is a common cause of paroxysmal supraventricular tachycardia. Wolff-Parkinson-White syndrome is caused by mutations in the PRKAG2 gene.
Parkinson's Disease: Eating Right
Eating a well-balanced and nutritional diet is very beneficial to people with Parkinson's disease. With a proper diet, our bodies work more efficiently and it is especially helpful because Parkinson's disease medications will work properly.
Treatment & Diagnosis
Medications & Supplements
Prevention & Wellness
Subscribe to MedicineNet's General Health Newsletter
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
All content from the U.S. Food and Drug Administration prescribing information.