Sertraline 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
Pimozide
No brand names on recordSertraline
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.
These two medicines should not be taken together. Sertraline slows down the way your body breaks down pimozide. That means pimozide can build up to higher levels than intended. Pimozide is a drug where even small changes in blood level matter, so having too much can be dangerous.
The biggest worry is an effect on your heart's rhythm (called QT prolongation), which both drugs can add to. This can lead to a serious irregular heartbeat. Please don't stop or change either medicine on your own. Talk with your doctor or pharmacist right away so they can choose a safer combination for you.
Contraindicated combination. Sertraline inhibits CYP2D6-mediated metabolism of pimozide, increasing pimozide plasma concentrations and AUC. Both agents also contribute additive QT interval prolongation.
- Direction: increased pimozide exposure and enhanced pharmacodynamic (cardiac) risk.
- Concern: pimozide has a narrow therapeutic index; effect documented even at low pimozide doses.
- Risk: QTc prolongation, torsades de pointes, ventricular arrhythmias.
- Evidence: probable.
- Management: avoid coadministration; select a non-interacting alternative. If exposure has occurred, monitor ECG/QTc and electrolytes.
What happens
Increased pimozide exposure, an increased risk of pimozide-related adverse events and an increased risk of QT interval prolongation
Interaction Deep Dive
Because pimozide has a narrow therapeutic index and because an interaction has been observed even at low doses of pimozide, its use together with sertraline is contraindicated. When sertraline is given alongside pimozide, plasma levels of pimozide rise, potentially raising the likelihood of QTc prolongation and ventricular arrhythmias1.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated metabolism of pimozide; additive QT interval prolongation
How to manage this interaction
This pairing is contraindicated, meaning it should be avoided. Because sertraline raises pimozide levels and both can affect heart rhythm, your care team will typically not use these two together.
- Keep taking your medicines as prescribed until you speak with your prescriber. Do not stop anything on your own.
- Your care team may choose an alternative to one of these drugs so you get effective treatment without this risk.
- Ask your pharmacist or doctor promptly, especially if you notice palpitations, dizziness, or fainting.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a controlled study using a single 2 mg dose of pimozide, giving sertraline 200 mg daily until steady state was reached produced a mean rise of approximately 40% in the pimozide area under the concentration-time curve (AUC) and maximum plasma concentrations (Cmax), but did not produce any EKG changes. Because the highest recommended pimozide dose (10 mg) has not been tested together with sertraline, the impact on the QT interval and pharmacokinetic parameters at doses above 2 mg is not known 1.
Common questions
Can I take Sertraline and Pimozide together?
Pimozide and sertraline should not be taken together because sertraline raises pimozide levels and both can prolong the QT interval, risking dangerous heart rhythms. Contact your prescriber or pharmacist to arrange a safer alternative, and do not stop either drug on your own. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sertraline 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 Sertraline and Pimozide interaction managed?
This pairing is contraindicated, meaning it should be avoided. Because sertraline raises pimozide levels and both can affect heart rhythm, your care team will typically not use these two together. Keep taking your medicines as prescribed until you speak with your prescriber. Do not stop anything on your own. Your care team may choose an alternative to one of these drugs so you get effective treatm… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Sertraline 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 (1)
- Product Information: ZOLOFT oral tablets, oral solution, sertraline hydrochloride oral tablets, oral solution. Viatris Specialty LLC (per FDA), Morgantown, WV, 2023. DailyMed
Keep reading about Pimozide
Keep reading about Sertraline
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