General Information of Drug (ID: DMR7IVC)

Drug Name
Pimavanserin
Synonyms ST51054136; AC-5273; I14-1981; 1-[(4-fluorophenyl)methyl]-1-(1-methyl-4-piperidyl)-3-[[4-(2-methylpropoxy)phenyl]methyl]urea
Indication
Disease Entry ICD 11 Status REF
Parkinson disease 8A00.0 Approved [1]
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 0 Molecular Weight (mw) 427.6
Topological Polar Surface Area (xlogp) 4.5
Rotatable Bond Count (rotbonds) 8
Hydrogen Bond Donor Count (hbonddonor) 1
Hydrogen Bond Acceptor Count (hbondacc) 4
ADMET Property
Absorption Cmax
The maximum plasma concentration (Cmax) of drug is 4.7 +/- 1.6 mg/L [2]
Absorption Tmax
The time to maximum plasma concentration (Tmax) is 131 +/- 56 h [2]
Elimination
0.55% of a 34 mg oral dose was excreted unchanged in the urine and 1.53% was eliminated in feces [3]
Half-life
The concentration or amount of drug in body reduced by one-half in 57 hours [4]
Metabolism
The drug is metabolized via the hepatic [4]
Vd
The volume of distribution (Vd) of drug is 2173 L [3]
Chemical Identifiers
Formula
C25H34FN3O2
IUPAC Name
1-[(4-fluorophenyl)methyl]-1-(1-methylpiperidin-4-yl)-3-[[4-(2-methylpropoxy)phenyl]methyl]urea
Canonical SMILES
CC(C)COC1=CC=C(C=C1)CNC(=O)N(CC2=CC=C(C=C2)F)C3CCN(CC3)C
InChI
InChI=1S/C25H34FN3O2/c1-19(2)18-31-24-10-6-20(7-11-24)16-27-25(30)29(23-12-14-28(3)15-13-23)17-21-4-8-22(26)9-5-21/h4-11,19,23H,12-18H2,1-3H3,(H,27,30)
InChIKey
RKEWSXXUOLRFBX-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
10071196
ChEBI ID
CHEBI:133017
CAS Number
706779-91-1
DrugBank ID
DB05316
TTD ID
D0J8JP
ACDINA ID
D00531

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
5-HT 2A receptor (HTR2A) TTJQOD7 5HT2A_HUMAN Modulator [5], [1]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Parkinson disease
ICD Disease Classification 8A00.0
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
5-HT 2A receptor (HTR2A) DTT HTR2A 1.68E-01 -0.3 -0.14
5-HT 2A receptor (HTR2A) DTT HTR2A 5.59E-01 0.15 0.21
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Pimavanserin (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Metreleptin DM1NOEK Moderate Increased metabolism of Pimavanserin caused by Metreleptin mediated induction of CYP450 enzyme. Acute diabete complication [5A2Y] [16]
Ivosidenib DM8S6T7 Major Increased risk of prolong QT interval by the combination of Pimavanserin and Ivosidenib. Acute myeloid leukaemia [2A60] [17]
Midostaurin DMI6E0R Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Midostaurin. Acute myeloid leukaemia [2A60] [16]
Arn-509 DMT81LZ Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Arn-509. Acute myeloid leukaemia [2A60] [18]
Gilteritinib DMWQ4MZ Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Gilteritinib. Acute myeloid leukaemia [2A60] [16]
Oliceridine DM6MDCF Major Additive CNS depression effects by the combination of Pimavanserin and Oliceridine. Acute pain [MG31] [19]
Ivabradine DM0L594 Major Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Ivabradine. Angina pectoris [BA40] [18]
Bedaquiline DM3906J Major Increased risk of prolong QT interval by the combination of Pimavanserin and Bedaquiline. Antimicrobial drug resistance [MG50-MG52] [20]
Levalbuterol DM5YBO1 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Levalbuterol. Asthma [CA23] [21]
Troleandomycin DMUZNIG Major Decreased metabolism of Pimavanserin caused by Troleandomycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [16]
Pexidartinib DMS2J0Z Moderate Increased metabolism of Pimavanserin caused by Pexidartinib mediated induction of CYP450 enzyme. Bone/articular cartilage neoplasm [2F7B] [16]
Eribulin DM1DX4Q Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Eribulin. Breast cancer [2C60-2C6Y] [16]
Tucatinib DMBESUA Major Decreased metabolism of Pimavanserin caused by Tucatinib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [16]
Palbociclib DMD7L94 Moderate Decreased metabolism of Pimavanserin caused by Palbociclib mediated inhibition of CYP450 enzyme. Breast cancer [2C60-2C6Y] [16]
Bosutinib DMTI8YE Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Bosutinib. Breast cancer [2C60-2C6Y] [16]
PF-04449913 DMSB068 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and PF-04449913. Chronic myelomonocytic leukaemia [2A40] [16]
Olodaterol DM62B78 Moderate Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Olodaterol. Chronic obstructive pulmonary disease [CA22] [22]
Vilanterol DMF5EK1 Moderate Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Vilanterol. Chronic obstructive pulmonary disease [CA22] [21]
Osilodrostat DMIJC9X Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Osilodrostat. Cushing syndrome [5A70] [16]
Ivacaftor DMZC1HS Moderate Decreased metabolism of Pimavanserin caused by Ivacaftor mediated inhibition of CYP450 enzyme. Cystic fibrosis [CA25] [16]
MK-8228 DMOB58Q Moderate Decreased metabolism of Pimavanserin caused by MK-8228 mediated inhibition of CYP450 enzyme. Cytomegaloviral disease [1D82] [16]
Esketamine DMVU687 Moderate Additive CNS depression effects by the combination of Pimavanserin and Esketamine. Depression [6A70-6A7Z] [23]
Deutetrabenazine DMUPFLI Moderate Additive CNS depression effects by the combination of Pimavanserin and Deutetrabenazine. Dystonic disorder [8A02] [24]
Ingrezza DMVPLNC Moderate Additive CNS depression effects by the combination of Pimavanserin and Ingrezza. Dystonic disorder [8A02] [25]
Cenobamate DMGOVHA Moderate Increased metabolism of Pimavanserin caused by Cenobamate mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [16]
Stiripentol DMMSDOY Moderate Decreased metabolism of Pimavanserin caused by Stiripentol mediated inhibition of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [16]
Rufinamide DMWE60C Moderate Increased metabolism of Pimavanserin caused by Rufinamide mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [16]
Eslicarbazepine DMZREFQ Moderate Increased metabolism of Pimavanserin caused by Eslicarbazepine mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [16]
Boceprevir DMBSHMF Major Decreased metabolism of Pimavanserin caused by Boceprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [16]
Telaprevir DMMRV29 Major Decreased metabolism of Pimavanserin caused by Telaprevir mediated inhibition of CYP450 enzyme. Hepatitis virus infection [1E50-1E51] [16]
MK-1439 DM215WE Moderate Increased metabolism of Pimavanserin caused by MK-1439 mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [16]
Fostemsavir DM50ILT Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Fostemsavir. Human immunodeficiency virus disease [1C60-1C62] [16]
Cobicistat DM6L4H2 Major Decreased metabolism of Pimavanserin caused by Cobicistat mediated inhibition of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [16]
Etravirine DMGV8QU Moderate Increased metabolism of Pimavanserin caused by Etravirine mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [16]
Rilpivirine DMJ0QOW Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Rilpivirine. Human immunodeficiency virus disease [1C60-1C62] [16]
BMS-201038 DMQTAGO Moderate Decreased metabolism of Pimavanserin caused by BMS-201038 mediated inhibition of CYP450 enzyme. Hyper-lipoproteinaemia [5C80] [16]
Lesinurad DMUR64T Moderate Increased metabolism of Pimavanserin caused by Lesinurad mediated induction of CYP450 enzyme. Inborn purine/pyrimidine/nucleotide metabolism error [5C55] [16]
Suvorexant DM0E6S3 Moderate Decreased metabolism of Pimavanserin caused by Suvorexant mediated inhibition of CYP450 enzyme. Insomnia [7A00-7A0Z] [16]
Polyethylene glycol DM4I1JP Moderate Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Polyethylene glycol. Irritable bowel syndrome [DD91] [18]
Glycerol phenylbutyrate DMDGRQO Moderate Increased metabolism of Pimavanserin caused by Glycerol phenylbutyrate mediated induction of CYP450 enzyme. Liver disease [DB90-DB9Z] [16]
Crizotinib DM4F29C Major Increased risk of prolong QT interval by the combination of Pimavanserin and Crizotinib. Lung cancer [2C25] [26]
Brigatinib DM7W94S Moderate Increased metabolism of Pimavanserin caused by Brigatinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [16]
Ceritinib DMB920Z Major Decreased metabolism of Pimavanserin caused by Ceritinib mediated inhibition of CYP450 enzyme. Lung cancer [2C25] [16]
PF-06463922 DMKM7EW Moderate Increased metabolism of Pimavanserin caused by PF-06463922 mediated induction of CYP450 enzyme. Lung cancer [2C25] [16]
Osimertinib DMRJLAT Major Increased risk of prolong QT interval by the combination of Pimavanserin and Osimertinib. Lung cancer [2C25] [27]
Selpercatinib DMZR15V Major Increased risk of prolong QT interval by the combination of Pimavanserin and Selpercatinib. Lung cancer [2C25] [18]
Lumefantrine DM29GAD Major Increased risk of prolong QT interval by the combination of Pimavanserin and Lumefantrine. Malaria [1F40-1F45] [23]
Inotuzumab ozogamicin DMAC130 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Inotuzumab ozogamicin. Malignant haematopoietic neoplasm [2B33] [16]
Idelalisib DM602WT Major Decreased metabolism of Pimavanserin caused by Idelalisib mediated inhibition of CYP450 enzyme. Mature B-cell leukaemia [2A82] [16]
Vemurafenib DM62UG5 Major Increased risk of prolong QT interval by the combination of Pimavanserin and Vemurafenib. Melanoma [2C30] [28]
LGX818 DMNQXV8 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and LGX818. Melanoma [2C30] [16]
Dabrafenib DMX6OE3 Moderate Increased metabolism of Pimavanserin caused by Dabrafenib mediated induction of CYP450 enzyme. Melanoma [2C30] [16]
Allopregnanolone DMNLHAC Moderate Additive CNS depression effects by the combination of Pimavanserin and Allopregnanolone. Mental/behavioural/neurodevelopmental disorder [6E20-6E8Z] [29]
Lasmiditan DMXLVDT Moderate Additive CNS depression effects by the combination of Pimavanserin and Lasmiditan. Migraine [8A80] [30]
Siponimod DM2R86O Major Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Siponimod. Multiple sclerosis [8A40] [23]
Ozanimod DMT6AM2 Major Increased risk of ventricular arrhythmias by the combination of Pimavanserin and Ozanimod. Multiple sclerosis [8A40] [31]
Romidepsin DMT5GNL Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Romidepsin. Mycosis fungoides [2B01] [16]
Entrectinib DMMPTLH Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Entrectinib. Non-small cell lung cancer [2C25] [23]
Rucaparib DM9PVX8 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Rucaparib. Ovarian cancer [2C73] [16]
Triclabendazole DMPWGBR Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Triclabendazole. Parasitic worm infestation [1F90] [16]
Macimorelin DMQYJIR Major Increased risk of prolong QT interval by the combination of Pimavanserin and Macimorelin. Pituitary gland disorder [5A60-5A61] [32]
Lefamulin DME6G97 Major Increased risk of prolong QT interval by the combination of Pimavanserin and Lefamulin. Pneumonia [CA40] [33]
Lonafarnib DMGM2Z6 Major Decreased metabolism of Pimavanserin caused by Lonafarnib mediated inhibition of CYP450 enzyme. Premature ageing appearance [LD2B] [16]
Degarelix DM3O8QY Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Degarelix. Prostate cancer [2C82] [18]
ABIRATERONE DM8V75C Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and ABIRATERONE. Prostate cancer [2C82] [18]
Enzalutamide DMGL19D Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Enzalutamide. Prostate cancer [2C82] [18]
Relugolix DMK7IWL Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Relugolix. Prostate cancer [2C82] [18]
Amisulpride DMSJVAM Major Increased risk of prolong QT interval by the combination of Pimavanserin and Amisulpride. Schizophrenia [6A20] [34]
Asenapine DMSQZE2 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Asenapine. Schizophrenia [6A20] [28]
Voxelotor DMCS6M5 Moderate Decreased metabolism of Pimavanserin caused by Voxelotor mediated inhibition of CYP450 enzyme. Sickle-cell disorder [3A51] [16]
Telotristat ethyl DMDIYFZ Moderate Increased metabolism of Pimavanserin caused by Telotristat ethyl mediated induction of CYP450 enzyme. Small intestine developmental anomaly [DA90] [16]
Larotrectinib DM26CQR Moderate Decreased metabolism of Pimavanserin caused by Larotrectinib mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [16]
Armodafinil DMGB035 Moderate Increased metabolism of Pimavanserin caused by Armodafinil mediated induction of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [16]
LEE011 DMMX75K Moderate Decreased metabolism of Pimavanserin caused by LEE011 mediated inhibition of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [16]
Triptorelin DMTK4LS Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Triptorelin. Solid tumour/cancer [2A00-2F9Z] [18]
Pitolisant DM8RFNJ Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Pitolisant. Somnolence [MG42] [16]
Telavancin DM58VQX Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Telavancin. Staphylococcal/streptococcal disease [1B5Y] [16]
Brilinta DMBR01X Moderate Decreased metabolism of Pimavanserin caused by Brilinta mediated inhibition of CYP450 enzyme. Thrombosis [DB61-GB90] [16]
Lenvatinib DMB1IU4 Moderate Increased risk of prolong QT interval by the combination of Pimavanserin and Lenvatinib. Thyroid cancer [2D10] [16]
Cabozantinib DMIYDT4 Major Increased risk of prolong QT interval by the combination of Pimavanserin and Cabozantinib. Thyroid cancer [2D10] [18]
Elagolix DMB2C0E Moderate Increased metabolism of Pimavanserin caused by Elagolix mediated induction of CYP450 enzyme. Uterine fibroid [2E86] [16]
⏷ Show the Full List of 81 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
FD&C blue no. 1 E00263 19700 Colorant
Saccharin sodium anhydrous E00443 656582 Flavoring agent
Ferric oxide black E00522 16211978 Colorant
Hypromellose E00634 Not Available Coating agent
Magnesium stearate E00208 11177 lubricant
Polyethylene glycol 3350 E00652 Not Available Coating agent; Diluent; Ointment base; Plasticizing agent; Solvent; Suppository base; lubricant
Polyethylene glycol 4000 E00654 Not Available Coating agent; Diluent; Ointment base; Plasticizing agent; Solvent; Suppository base; lubricant
Polyvinyl alcohol E00666 Not Available Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Talc E00520 16211421 Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide E00322 26042 Coating agent; Colorant; Opacifying agent
Colcothar yellow E00436 518696 Colorant
Haematite red E00236 14833 Colorant
Cellulose microcrystalline E00698 Not Available Adsorbent; Suspending agent; Diluent
Pregelatinized starch E00674 Not Available Binding agent; Diluent; Disintegrant
⏷ Show the Full List of 14 Pharmaceutical Excipients of This Drug
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Pimavanserin 17 mg tablet 17 mg Oral Tablet Oral
Pimavanserin Tartrate 10 mg tablet 10 mg Tablet Oral
Pimavanserin Tartrate 34 mg capsule 34 mg Capsule Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1 2016 FDA drug approvals. Nat Rev Drug Discov. 2017 Feb 2;16(2):73-76.
2 FDA approval: ado-trastuzumab emtansine for the treatment of patients with HER2-positive metastatic breast cancer. Clin Cancer Res. 2014 Sep 1;20(17):4436-41.
3 Cruz MP: Pimavanserin (Nuplazid): A Treatment for Hallucinations and Delusions Associated With Parkinson's Disease. P T. 2017 Jun;42(6):368-371.
4 FDA Approved Drug Product: NUPLAZID (pimavanserin) for oral use
5 Pimavanserin, a selective serotonin (5-HT)2A-inverse agonist, enhances the efficacy and safety of risperidone, 2mg/day, but does not enhance efficacy of haloperidol, 2mg/day: comparison with reference dose risperidone, 6mg/day.Schizophr Res.2012 Nov;141(2-3):144-52.
6 Pharmacological characterisation of the agonist radioligand binding site of 5-HT(2A), 5-HT(2B) and 5-HT(2C) receptors. Naunyn Schmiedebergs Arch Pharmacol. 2004 Aug;370(2):114-23.
7 Current and novel approaches to the drug treatment of schizophrenia. J Med Chem. 2001 Feb 15;44(4):477-501.
8 Hughes B: 2009 FDA drug approvals. Nat Rev Drug Discov. 2010 Feb;9(2):89-92.
9 Radium 223 dichloride for prostate cancer treatment. Drug Des Devel Ther. 2017 Sep 6;11:2643-2651.
10 Mullard A: 2010 FDA drug approvals. Nat Rev Drug Discov. 2011 Feb;10(2):82-5.
11 Anxiolytic effects of aniracetam in three different mouse models of anxiety and the underlying mechanism. Eur J Pharmacol. 2001 May 18;420(1):33-43.
12 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health Human Services. 2019
13 Beneficial effects of sarpogrelate hydrochloride, a 5-HT2A receptor antagonist, supplemented with pioglitazone on diabetic model mice. Endocr Res. 2009;34(1-2):18-30.
14 Clinical pipeline report, company report or official report of Lundbeck.
15 Central serotonin receptors as targets for drug research. J Med Chem. 1987 Jan;30(1):1-12.
16 Product Information. Nuplazid (pimavanserin). Accelis Pharma, East Windsor, NJ.
17 Product Information. Tibsovo (ivosidenib). Agios Pharmaceuticals, Cambridge, MA.
18 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
19 US Food and Drug Administration "FDA warns about serious risks and death when combining opioid pain or cough medicines with benzodiazepines requires its strongest warning.".
20 Product Information. Sirturo (bedaquiline). Janssen Pharmaceuticals, Titusville, NJ.
21 Product Information. Arcapta Neohaler (indacaterol). Novartis Pharmaceuticals, East Hanover, NJ.
22 Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32. [PMID: 7042176]
23 Cerner Multum, Inc. "Australian Product Information.".
24 Product Information. Austedo (deutetrabenazine). Teva Pharmaceuticals USA, North Wales, PA.
25 Product Information. Ingrezza (valbenazine). Neurocrine Biosciences, Inc., San Diego, CA.
26 Product Information. Xalkori (crizotinib). Pfizer U.S. Pharmaceuticals Group, New York, NY.
27 Product Information. Tagrisso (osimertinib). Astra-Zeneca Pharmaceuticals, Wilmington, DE.
28 Canadian Pharmacists Association.
29 Product Information. Zulresso (brexanolone). Sage Therapeutics, Inc., Cambridge, MA.
30 Product Information. Reyvow (lasmiditan). Lilly, Eli and Company, Indianapolis, IN.
31 Product Information. Zeposia (ozanimod). Celgene Corporation, Summit, NJ.
32 Product Information. Macrilen (macimorelin). Aeterna Zentaris, Charleston, SC.
33 Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.
34 Product Information. Barhemsys (amisulpride). Acacia Pharma, Inc, Indianapolis, IN.