Buprenorphine and Pimozide: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Buprenorphine
Pimozide
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Taking buprenorphine and pimozide together is not recommended. Both medicines can slow down your brain and breathing, so combining them can make you very drowsy, dizzy, or short of breath. On top of that, both drugs can affect your heart's rhythm (something called QT prolongation), and together they may raise the risk of a dangerous irregular heartbeat.
Please don't stop or change either medicine on your own. Instead, reach out to your doctor or pharmacist soon. They can look at your full medication list and find a safer plan for you. This is very manageable once your care team knows.
Contraindicated combination. Buprenorphine and pimozide together carry two additive risks:
- Additive CNS depression: increased sedation, respiratory depression risk.
- Additive QT prolongation: heightened risk of torsades de pointes and serious ventricular arrhythmias.
Both agents are active drugs (not prodrugs); the concern is pharmacodynamic summation rather than a metabolic shift. Evidence is theoretical, but given pimozide's well-established QT liability the pairing is formally contraindicated. If both are truly unavoidable, an alternative analgesic or antipsychotic should be sought; otherwise avoid co-prescribing. If exposure occurs, obtain ECG, monitor QTc and electrolytes (K+, Mg2+), and observe respiratory/sedation status.
What happens
Increased risk of CNS depression and an increased risk of QT interval prolongation
Interaction Deep Dive
Giving pimozide together with QT-prolonging CNS depressants is contraindicated, because the combination can raise the likelihood of CNS depression while also potentially adding to QT interval prolongation and serious ventricular arrhythmias1.
Why it happens (mechanism)
Additive CNS depression; additive QT interval prolongation
How to manage this interaction
This pairing is flagged as one to avoid, but your care team can manage it. Keep taking both medicines as prescribed until you speak with a professional, and do not stop either one on your own.
- Contact your prescriber or pharmacist promptly so they can review both drugs.
- Your team will likely look for a safer alternative to one of the medicines.
- They may check your heart rhythm (ECG) and monitor you more closely.
- Report extreme drowsiness, trouble breathing, fainting, dizziness, or a racing/irregular heartbeat right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
3 reports — tap to read
a) In a controlled study, a single 2 mg dose of pimozide administered together with racemic citalopram 40 mg once daily for 11 days produced a mean rise in QTc values of roughly 10 msec relative to pimozide administered by itself. Racemic citalopram did not change the mean AUC or Cmax of pimozide. The mechanism underlying this pharmacodynamic interaction is unknown 1.
b) In experimental studies involving conditions other than Tourette's Disorder, sudden and unexpected deaths have been reported in patients taking pimozide at doses around 1 mg per kg. One potential mechanism for these deaths is prolongation of the QT interval, which may make patients more susceptible to ventricular arrhythmia. Obtain an electrocardiogram before starting pimozide therapy and at intervals afterward, particularly during the phase of dose adjustment 1.
c) Zotepine is capable of prolonging the QTc interval 2.
Common questions
Can I take Buprenorphine and Pimozide together?
Buprenorphine and pimozide together can add up to dangerous sedation and heart-rhythm risk, so this combination is generally avoided. Talk to your prescriber or pharmacist promptly rather than changing anything yourself. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Buprenorphine and Pimozide interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Buprenorphine and Pimozide interaction managed?
This pairing is flagged as one to avoid, but your care team can manage it. Keep taking both medicines as prescribed until you speak with a professional, and do not stop either one on your own. Contact your prescriber or pharmacist promptly so they can review both drugs. Your team will likely look for a safer alternative to one of the medicines. They may check your heart rhythm (ECG) and monitor yo… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Buprenorphine or Pimozide need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: Pimozide oral tablet, pimozide oral tablet. Endo USA, Inc (per DailyMed), Malvern, PA, 2017. DailyMed
- Sweetman S (Ed): Martindale: The Complete Drug Reference. London: Pharmaceutical Press. Electronic version, MICROMEDEX, Greenwood Village, Colorado, Edition expires 06/2004.
Keep reading about Buprenorphine
Keep reading about Pimozide
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist