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Nuplazid Generic Name & Formulations
Legal Class
Rx
General Description
Pimavanserin 10mg; tabs.
Pharmacological Class
Atypical antipsychotic.
See Also
How Supplied
Tabs, caps—30
Manufacturer
Generic Availability
NO
Mechanism of Action
The mechanism of action of pimavanserin in the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis is unclear. 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.
Nuplazid Indications
Indications
Treatment of hallucinations and delusions associated with Parkinson's disease (PD) psychosis.
Nuplazid Dosage and Administration
Adult
Caps: may be swallowed whole or opened and entire contents sprinkled over a tablespoon (15mL) of applesauce, yogurt, pudding, or a liquid nutritional supplement; consume mixture immediately without chewing. 34mg once daily without titration. Concomitant strong CYP3A4 inhibitors: 10mg once daily. Concomitant strong or moderate CYP3A4 inducers: avoid.
Children
Not established.
Nuplazid Contraindications
Not Applicable
Nuplazid Boxed Warnings
Boxed Warning
Increased mortality in elderly patients with dementia-related psychosis.
Nuplazid Warnings/Precautions
Warnings/Precautions
Elderly with dementia-related psychosis: increased risk of death. Not for treating patients with dementia who experience psychosis, unless their hallucinations/delusions are related to PD. Avoid in patients with known or congenital QT prolongation, history of cardiac arrhythmias, symptomatic bradycardia, hypokalemia, or hypomagnesemia. Severe renal impairment (CrCl <30mL/min), ESRD. Pregnancy. Nursing mothers.
Nuplazid Pharmacokinetics
Distribution
Mean apparent volume of distribution: 2173 L. Plasma protein bound: ~95%.
Elimination
Fecal, renal.
Nuplazid Interactions
Interactions
Potentiated by strong CYP3A4 inhibitors (eg, itraconazole, ketoconazole, clarithromycin, indinavir); see Adults. Antagonized by strong CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin, St. John's wort) or moderate CYP3A4 inducers (eg, modafinil, thioridazine, efavirenz, nafcillin); see Adults. Avoid concomitant drugs known to prolong QT interval including Class 1A (eg, quinidine, procainamide, disopyramide) or Class 3 antiarrhythmics (eg, amiodarone, sotalol), certain antipsychotics (eg, ziprasidone, chlorpromazine, thioridazine), and certain antibiotics (eg, gatifloxacin, moxifloxacin).
Nuplazid Adverse Reactions
Adverse Reactions
Peripheral edema, confusional state, nausea, hallucination, constipation, gait disturbance.
Nuplazid Clinical Trials
See Literature
Nuplazid Note
Not Applicable
Nuplazid Patient Counseling
See Literature
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