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Brand name: Nuplazid®
Generic name: Pimavanserin
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
Pimavanserin is a medication that works in the brain to treat hallucinations and delusions associated with Parkinson’s disease psychosis. It is also known as aselective serotonin inverse agonist. The exact mechanism in which Pimavanserin works to help with Parkinson’s disease psychosis is unknown but thought to help with psychosis by blocking certain serotonin receptors.
Symptoms of Parkinson’s disease psychosis include:
Pimavanserin may help with some or all of these symptoms.
A person with Parkinson’s disease may begin to have delusions or hallucinations. These symptoms may continue to occur throughout the illness. Do not stop taking pimavanserin, even when you feel better.
With input from you, your health care provider will assess how long you will need to take the medicine.
Missing doses of pimavanserin may increase your risk for a relapse in your symptoms.
Do not change your dose of pimavanserin without talking to your healthcare provider.
For pimavanserin to work properly, it should be taken every day as prescribed by your healthcare provider.
Pregnancy is uncommon in people with Parkinson’s disease. There is no information on pimavanserin’s use in pregnant women that would help predict the risk of serious side effects to an unborn child. If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
There is no information regarding pimavanserin in lactation, therefore, caution should be advised when breast-feeding.
The recommended dose for pimavanserin is 34 mg, usually taken as two 17mg tablets, once daily with or without food.
Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or a friend to remind you or check in with you to be sure you are taking your medication.
If you miss a dose of pimavanserin, take it as soon as you remember, unless it is closer to the time of your next dose.
If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
Do not double your dose (e.g. take more than 34 mg total) or take more than prescribed.
Avoid drinking alcohol or using illegal drugs while you are taking pimavanserin. They may decrease the benefits (worsen your confusion) and increase adverse effects (sedation, nausea) of the medication.
If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of pimavanserin does not exist.
Common side effects
Peripheral edema, confusion, abnormal gait, hallucination, nausea, constipation
Rare side effects
Urinary tract infections, fatigue
Serious side effects
Patients who take pimavanserin may be at risk for a certain type of arrhythmia (irregular heart beat). To lower this risk, this medication should be used in the smallest effective dose when the benefits outweigh the risks. Your doctor may order an EKG to monitor for irregular heart beat.
Allergic reaction is a risk to any component of pimavanserin. The patient should watch for signs of an allergic reaction such as wheezing, chest tightness, itching, swelling of face or lips.
None have been reported at this time.
The following medications may increase the risk of an arrhythmia (irregular heart beat) when taken with pimavanserin:
The following medications may increase the levels and the effects of pimavanserin:
The following medications may decrease the levels and the effects of pimavanserin:
It is very important to tell your doctor how you feel things are going during the first few weeks after you start taking pimavanserin. It may take several days to see symptoms improve after you start pimavanserin. It may take up to 2 weeks to see significant changes in symptoms.
Increased mortality in elderly patients with dementia-related psychosis
©2019 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Illness (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.
This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.
Call the NAMI Helpline at
text "NAMI" to 741741