Information about Orap (Pimozide)
Orap is a prescription medication that contains pimozide, an antipsychotic drug belonging to the butyrophenone class. It is used primarily to treat Tourette syndrome and certain severe tic disorders. Pimozide works by blocking dopamine receptors in the brain, helping to lessen the severity of tics and manage the symptoms of Tourette syndrome. Orap can also be prescribed in certain cases for the management of schizophrenia or other conditions as determined by a healthcare provider.
Product Highlights
- Orap is mainly used for the management of severe tics in patients with Tourette syndrome, especially in those who do not respond to first-line treatments like behavioral therapy or other medications.
- It may also be used for patients with other severe tic disorders that do not respond to other treatments.
- In some cases, Orap may be used off-label to treat certain psychiatric conditions like schizophrenia or acute psychosis, although it is not a first-line treatment for these conditions.
Key Ingredient
Key Benefits
- Orap is effective in reducing the frequency and severity of motor and vocal tics in individuals with Tourette syndrome, improving overall quality of life.
- By decreasing dopamine activity, pimozide can help manage aggressive behavior, impulsivity, and other symptoms associated with tic disorders.
- Orap is typically taken once daily, providing a convenient treatment option for patients needing consistent management of their symptoms.
- Orap is particularly beneficial for patients whose tics are not adequately controlled by other medications or non-pharmacological treatments.
Direction of Use
- The usual starting dose for Tourette syndrome is 1-2 mg per day, which can be gradually increased based on the patient’s response and tolerance. The maximum recommended dose is typically 10 mg per day, but doses above 4-6 mg should only be used in severe cases and under close supervision.
- Orap tablets should be taken once daily, preferably at the same time each day, with or without food.
- Regular follow-up appointments are required to monitor for potential side effects, particularly with higher doses. Blood pressure, ECG (electrocardiogram), and other cardiovascular monitoring may be necessary.
Safety Concerns
- Pimozide can cause QT interval prolongation (a measure of time for the heart’s electrical cycle), which increases the risk of serious arrhythmias. It is important to monitor electrocardiograms (ECG) before starting treatment, and periodically during treatment, especially if the dose is increased.
- Like other antipsychotics, Orap carries a risk of neuroleptic malignant syndrome, a life-threatening condition characterized by high fever, muscle rigidity, altered mental status, and autonomic dysregulation. If these symptoms occur, seek prompt medical attention.
- These include tremors, rigidity, bradykinesia (slowness of movement), and other movement disorders. EPS may occur more frequently in patients taking higher doses of pimozide.
- Long-term use of pimozide, like other antipsychotics, may increase the risk of developing tardive dyskinesia, a condition characterized by involuntary movements, especially of the face and mouth.
- Pimozide can cause sedation, dizziness, and drowsiness, particularly when first starting the medication or when the dose is increased. Patients should be cautious about operating heavy machinery or driving until they know how the drug affects them.
- Pimozide should be avoided during pregnancy unless absolutely necessary, as it may harm the fetus. It is also contraindicated in breastfeeding due to the potential for serious side effects in the infant.
- Pimozide can interact with other medications, especially those that affect the QT interval or CYP450 enzymes, such as azole antifungals, macrolide antibiotics, and certain antidepressants. Always inform your healthcare provider about any medications, including over-the-counter drugs and herbal supplements, that you are taking.
Avoid Orap (Pimozide) If
- You are allergic to pimozide or any other ingredient in Orap.
- You have a history of QT interval prolongation, arrhythmias, or heart conditions that predispose you to an increased risk of heart rhythm disturbances.
- You are currently taking medications that prolong the QT interval, such as certain antifungals, antibiotics, or antidepressants.
- You are pregnant or planning to become pregnant (unless deemed absolutely necessary by your healthcare provider).
- You are breastfeeding, as pimozide may pass into breast milk and harm a nursing infant.
- You have a history of neuroleptic malignant syndrome (NMS), severe liver disease, or severe mental health disorders (unless closely monitored by a healthcare provider).
- You have severe central nervous system (CNS) depression, which can worsen with pimozide use.
