Atypical antipsychotic
Pimavanserin is an atypical antipsychotic medication used to treat hallucinations and delusions in people with Parkinson’s disease psychosis. It is taken once daily by mouth. Note that this medicine is not approved for treating psychosis in dementia patients unless it is specifically related to Parkinson's disease.
Brand names:pimavanserin
How to take
The recommended dose is 34 mg once daily.
You can take the capsule with or without food. The capsule can be swallowed whole or opened and the contents sprinkled on a tablespoon of soft food like applesauce, yogurt, or pudding. If you sprinkle it, eat the mixture immediately and do not save it for later.
Missed dose: If you miss a dose, the provided text does not specify instructions for missed doses.
Key warnings
Pimavanserin increases the risk of death in elderly patients with dementia-related psychosis. It is not approved to treat dementia-related psychosis unless the symptoms are specifically caused by Parkinson’s disease.
- ·Pimavanserin increases the risk of death in elderly patients with dementia-related psychosis. It is not approved to treat dementia-related psychosis unless the symptoms are specifically caused by Parkinson’s disease.
- ·There is a risk of heart rhythm issues (QT interval prolongation). Avoid using this with other drugs that affect heart rhythm.
- ·Elderly patients with dementia-related psychosis are at a higher risk of death when using antipsychotic drugs.
Do not use if
- ·Do not use pimavanserin if you have a history of allergic reactions to the drug or any of its ingredients, such as a rash, hives, or swelling of the tongue or throat.
Side effects
Common
Serious
- ·Increased risk of death in elderly patients with dementia-related psychosis
- ·Heart rhythm changes (QT interval prolongation)
- ·Severe allergic reactions (such as swelling of the tongue, throat, or face, or difficulty breathing)
Seek help if
- ·Signs of an allergic reaction like tongue swelling or difficulty breathing
- ·Changes in heart rhythm
- ·Severe confusion
Interactions
- ·Strong CYP3A4 inhibitors: If you take these, your pimavanserin dose should be reduced to 10 mg once daily.
- ·Strong or moderate CYP3A4 inducers: Do not use these together with pimavanserin.
- ·Drugs that affect heart rhythm: Avoid combining pimavanserin with other medicines known to prolong the QT interval (such as certain antibiotics or heart medications).
Special populations
PregnancyThere is no data on how pimavanserin affects pregnant women. While animal studies showed no birth defects at high doses, some studies showed toxicity in mothers and lower survival rates in offspring at certain doses. The actual risk to humans is unknown.
PediatricThe safety and effectiveness of pimavanserin have not been tested in children.
GeriatricNo dose adjustment is needed for elderly patients. Most patients in clinical studies were 65 years or older.
Talk to your doctor
Monitor
- ·Heart rhythm (QT interval)
- ·Swelling in legs or feet
- ·Confusion
- ·Allergic reactions
Questions to ask
- ·Should I avoid other medications that affect my heart rhythm while taking pimavanserin?
- ·How will pimavanserin interact with my current CYP3A4 medications?
- ·Is pimavanserin safe for me given my history of heart issues?
Pharmacokinetics
Practical
OverdoseThere is no specific antidote for an overdose. If an overdose is suspected, immediate heart monitoring (ECG) is necessary to check for irregular heart rhythms. You should contact a Poison Control Center immediately.
Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-26.