pimozide

Antipsychotic • Brands: Orap

Last reviewed: 2026-02-23

General information

Class: Antipsychotic
Common US brands: Orap
Typical dose range: The label emphasizes slow, gradual titration to balance tic suppression with adverse effects. Baseline and periodic ECG monitoring is described as essential, particularly during dose adjustment (label).
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-23

Dosing & forms

Forms/strengths: Tablets: 1 mg and 2 mg (label/manufacturer-dependent).
Frequency: Children: label describes starting 0.05 mg/kg once daily (preferably at bedtime) and titrating every third day to a maximum of 0.2 mg/kg/day (not to exceed 10 mg/day). It also describes CYP2D6 genotyping requirements at higher doses (label).
Typical range: The label emphasizes slow, gradual titration to balance tic suppression with adverse effects. Baseline and periodic ECG monitoring is described as essential, particularly during dose adjustment (label).

Mechanism (brief)

Dopamine receptor antagonist used primarily for Tourette’s disorder (tic suppression). Carries QT prolongation risk and has extensive contraindicated drug interactions (label).

Metabolism & Half‑life

Metabolism: CYP2D6, CYP3A4
Half‑life: —

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Baseline ECG and periodic ECGs during dose adjustment (label).
Electrolytes (hypokalemia/hypomagnesemia increases torsades risk; label).
Medication list review after any new prescription (QT and CYP interactions).
Movement symptoms and tardive dyskinesia screening.
Sedation and functional impairment when combined with other sedatives.

Sources

Pimozide tablets prescribing information — DailyMed (2024)
Practice guideline recommendations summary: Treatment of tics in people with Tourette syndrome and chronic tic disorders — Neurology (PMC) (2019)
Torsade de Pointes (StatPearls) — StatPearls Publishing (NCBI Bookshelf) (2025)
AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology — Pharmacopsychiatry (2018)

General information

Class: Antipsychotic

Common US brands: Orap

Typical dose range: The label emphasizes slow, gradual titration to balance tic suppression with adverse effects. Baseline and periodic ECG monitoring is described as essential, particularly during dose adjustment (label).

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2026-02-23

Dosing & forms

Forms/strengths: Tablets: 1 mg and 2 mg (label/manufacturer-dependent).

Frequency: Children: label describes starting 0.05 mg/kg once daily (preferably at bedtime) and titrating every third day to a maximum of 0.2 mg/kg/day (not to exceed 10 mg/day). It also describes CYP2D6 genotyping requirements at higher doses (label).

Typical range: The label emphasizes slow, gradual titration to balance tic suppression with adverse effects. Baseline and periodic ECG monitoring is described as essential, particularly during dose adjustment (label).

Monitoring highlights

Baseline ECG and periodic ECGs during dose adjustment (label).

Electrolytes (hypokalemia/hypomagnesemia increases torsades risk; label).

Medication list review after any new prescription (QT and CYP interactions).

Movement symptoms and tardive dyskinesia screening.

Sedation and functional impairment when combined with other sedatives.