R Zep 2 Tablet

Pimozide
2mg
Reliance Formulation Pvt Ltd.
Pack size 1
Dispensing mode
Source
Agent
Retail Price 6.73 NPR

Indications

R Zep 2 Tablet is used for: Tourette Disorder

Adult Dose

Tourette Disorder Initial 1-2 mg PO qDay ; increase every other day; not to exceed 10 mg/day Maintenance: <0.2 mg/kg/day or 10 mg/day, choose lowest dose

Child Dose

Tourette Disorder < 2 years Safety & efficacy not established 2-12 years Initial: 0.05 mg/kg/day PO qHS Can be increased q3Days to 0.2 mg/kg/day PO qHS Maintenance dose: 2-4 mg/day; not to exceed 10 mg/day >12 years Initial 1-2 mg PO qDay ; increase every other day; not to exceed 10 mg/day Maintenance: <0.2 mg/kg/day or 10 mg/day, choose lowest dose

Renal Dose

Administration

May be taken with or without food

Contra Indications

Prolonged QT interval, family history of congenital QT prolongation, history of cardiac arrhythmias; severe toxic CNS depression, comatose states; known uncorrected hypokalaemia or hypomagnesaemia. Concomitant use w/ inhibitors of CYP3A4 or CYP2D6 isoenzymes, SSRIs and drugs known to prolong the QT interval.

Precautions

Patient w/ CV diseases, Parkinson's disease, phaeochromocytoma, history of seizures or other conditions that potentially lower the seizure threshold (e.g. alcohol withdrawal, brain damage). CYP2D6 poor metabolisers. Hepatic or renal impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may impair alertness, esp at the start of treatment, if affected, do not drive or operate machinery. Monitoring Parameters Monitor ECG before and during treatment. Monitor cardiac function and electrolytes periodically.

Pregnancy-Lactation

Interactions

Avoid use w/ drugs that cause electrolyte disturbances (e.g. diuretics). Increased CNS depression produced by other CNS depressants (e.g. hypnotics, sedatives or strong analgesics). Increased risk of extrapyramidal effects w/ anti-emetics (e.g. metoclopramide). Increased risk of CNS toxicity w/ sibutramine. Enhanced hypotensive effect w/ Ca channel blockers. May impair the anti-Parkinson effect of levodopa. Potentially Fatal: Concurrent use w/ inhibitors of CYP3A4 (e.g. azole antifungals, antiviral protease inhibitors, macrolide antibiotics, nefazodone) or CYP2D6 (e.g. quinidine) may lead to elevated plasma concentrations, increasing the risk of cardiac arrhythmias. Concomitant use w/ SSRIs (e.g. citalopram, escitalopram, paroxetine, sertraline) may cause extrapyramidal effects, oculogyric crises and sedation. Increased risk of arrhythmias due to prolonged QT interval w/ TCAs, terfenadine, astemizole, antimalarials and cisapride.

Adverse Effects

Side effects of Pimozide : Extrapyramidal effects, sedation, akathisia, akinesia, drowsiness, behaviour changes, somnolence, depression, insomnia, speech disorder, nervousness, headache, abnormal dreams, hyperkinesias; xerostomia, constipation, increased salivation and appetite, diarrhoea, taste disturbances, thirst, dysphagia; impotence, rash; muscle tightness and weakness, rigidity, stooped posture, change in handwriting, myalgia, torticollis, tremor; decreased accommodation, visual disturbances, photophobia. Potentially Fatal: Neuroleptic malignant syndrome.

Mechanism of Action

Pimozide is a long-acting antipsychotic structurally similar to butyrophenones which block dopaminergic receptors in the CNS, resulting in neuroleptic effects. It also exhibits some Ca-blocking activity.

Note

R Zep 2 2mg Tablet manufactured by Reliance Formulation Pvt Ltd.. Its generic name is Pimozide. R Zep 2 is availble in Nepal. Farmaco Nepal drug index information on R Zep 2 Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.

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