Cenobamate and Pimavanserin interaction
Cenobamate and Pimavanserin: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Pimavanserin (NUPLAZID) label · effective 2026-06-18
Strong or Moderate CYP3A4 Inducers: Avoid concomitant use of NUPLAZID.
Intervention: Avoid concomitant use of strong or moderate CYP3A4 inducers with NUPLAZID [see Dosage and Administration (2.3) ] .
Strong CYP3A4 Inhibitors: Reduce NUPLAZID dose to 10 mg once daily.
Strong CYP3A4 Inhibitors Clinical Impact: Concomitant use of NUPLAZID with a strong CYP3A4 inhibitor increases pimavanserin exposure [see Clinical Pharmacology (12.3) ] .
Intervention: If NUPLAZID is used with a strong CYP3A4 inhibitor, reduce the dosage of NUPLAZID [see Dosage and Administration (2.3) ].
From the Cenobamate (Xcopri) label · effective 2025-08-25
Concomitant use with other CNS depressants or alcohol may have additive effects.
CNS Depressants and Alcohol Concomitant use of XCOPRI with other CNS depressants, including alcohol, may increase the risk of neurological adverse reactions, including sedation and somnolence [see Warnings and Precautions ( 5.5 )] .
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Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.