Drug & supplement interaction

Khat + Pimavanserin Tartrate

Pimavanserin Tartrate brand name: Nuplazid.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Khat has a moderate interaction with Pimavanserin Tartrate. Khat may affect response to antipsychotic treatment.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Khat and Pimavanserin Tartrate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIPSYCHOTIC DRUGS

Why this applies to Pimavanserin Tartrate

Pimavanserin Tartrate falls under ANTIPSYCHOTIC DRUGS — the group Khat interacts with.

Khat may affect response to antipsychotic treatment. In a large retrospective study of adults with newly diagnosed schizophrenia, chewing khat was associated with a decreased retention rate with the initial antipsychotic agent when compared with non-chewers, and lack of efficacy was the most commonly reported reason for switching antipsychotic agents among khat users. Until more is known, avoid khat in patients taking antipsychotic agents.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical concern with mixing khat and Nuplazid (pimavanserin). Khat is a powerful stimulant that revs up brain chemicals like dopamine, and that's the very system this medication is trying to calm down. Nuplazid is prescribed to ease the hallucinations and delusions that can come with Parkinson's psychosis, so a strong stimulant can work directly against it. In a large study of people starting antipsychotics, khat chewers were more likely to switch medications because their treatment simply wasn't working as well.

In plain terms, khat could make your medication less effective, meaning hallucinations or delusions might creep back in. On top of that, khat is illegal in the U.S. and hard on the heart. Please talk with your doctor or pharmacist before making any changes.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hakami T, Mahmoud M, Mohammed B, El-Setouhy M. Effects of khat use on response to antipsychotic medications in patients with newly diagnosed schizophrenia: a retrospective study. East Mediterr Health J 2021;27(4):353-360. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Khat Also Interacts With Other Medications

Khat has 4 major, 400 moderate known drug interactions in our database — the Pimavanserin Tartrate one above is one of them. If you take anything else, check it against the full list below.

Major 4 Moderate 400 No known interaction 2,426 (incl. Pimavanserin Tartrate)
Taking anything else?

Check Another of Your Medications Against Khat

Covers the 2,830 medications we’ve checked against Khat. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Pimavanserin Tartrate

This page covers Khat only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Pimavanserin Tartrate page lists 153 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 10 major · 103 moderate · 40 minor.

From our pharmacist’s overview on the Pimavanserin Tartrate page

“Pimavanserin (Nuplazid) eases the hallucinations and delusions of Parkinson's disease psychosis, and its supplement list deserves genuine care, since 10 of the 153 ingredients on file carry a major rating. The dominant pattern runs through CYP3A4, the liver enzyme that clears pimavanserin: grapefruit can push its blood level up, while St.”

Reviewed by 2 · Jul 18, 2026

Open the Pimavanserin Tartrate interaction page

How much people look this up

Where Khat and Pimavanserin Tartrate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Khat
Top half

#402 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Pimavanserin Tartrate
Top half

#743 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Khat

What is Khat?

Khat
  • Stimulant for energy and alertness
  • Euphoria and mood elevation
  • Reducing fatigue
  • Appetite suppression
  • Social and traditional ceremonies

Khat is a plant chewed for its amphetamine-like stimulant effects, but it carries serious risks including high blood pressure, heart problems, mental health effects, and dependence. It is a controlled substance and illegal in the United States and many other countries, so it should not be used.

Read the full Khat monograph & all interactions
Medication

About Pimavanserin

What Is Pimavanserin Used For?

Brand name: Nuplazid

Pimavanserin — sold as Nuplazid and also available as a generic capsule — is approved to treat hallucinations and delusions in adults with Parkinson's disease psychosis. These are the unsettling false perceptions and beliefs that can occur as part of Parkinson's disease.

It is not approved for psychosis caused by other forms of dementia. Using it in elderly patients with non-Parkinson's dementia-related psychosis carries serious safety risks.

See full Pimavanserin drug information
Keep checking

Other Drugs & Khat

Browse every other medication we’ve checked against Khat — both the ones with a known interaction and the ones without. Select any drug for the full detail.

4Major
400Moderate
0Minor
2,425No known interaction
4 Major 400 Moderate 2,425 No interaction
Major

4 interactions

Moderate

400 interactions

Showing 60 of 400 moderate interactions — see all 400 on the Khat page.

No interaction 2,425 drugs checked — show the list

We also checked Khat against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,425 medications checked with no known interaction — see the full Khat list.

See the full Khat interactions page
See every supplement checked against Pimavanserin Tartrate, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Khat monograph › Uses, safety, and every drug interaction in one place Pimavanserin Tartrate supplement interactions › Every supplement checked against Pimavanserin Tartrate, ranked by severity Pimavanserin drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Khat and Pimavanserin Tartrate Together: Common Questions

Can you take Khat with Pimavanserin Tartrate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Khat and Pimavanserin Tartrate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Pimavanserin Tartrate and Khat?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.