From the FDA Drug Label
2 DOSAGE AND ADMINISTRATION
2.1 Recommended Dosage The recommended dose of NUPLAZID is 34 mg taken orally once daily, without titration. 2.2 Administration Information NUPLAZID can be taken with or without food [see Clinical Pharmacology (12. 3)].
The recommended dosing schedule for Nuplazid (pimavanserin) is 34 mg taken orally once daily. The drug label does not specify whether it should be taken in the morning or night, only that it can be taken with or without food 1.
From the Research
The recommended dosing schedule for Nuplazid (pimavanserin) is 34 mg taken once daily, with or without food, and it can be taken at any time of day, either in the morning or at night, as there is no specific recommendation for the timing of administration in the provided evidence. This dose is typically provided as two 17 mg tablets taken together. No dose titration is required when initiating treatment, meaning patients can start directly at the full therapeutic dose. For patients with moderate to severe hepatic impairment, the dose should be reduced to 17 mg once daily 2. No dose adjustment is necessary for patients with renal impairment or for elderly patients. Nuplazid is primarily used to treat hallucinations and delusions associated with Parkinson's disease psychosis. The medication works as a selective serotonin 5-HT2A receptor inverse agonist/antagonist, which helps reduce psychotic symptoms without worsening motor symptoms of Parkinson's disease. Unlike traditional antipsychotics, Nuplazid does not block dopamine receptors, making it particularly suitable for Parkinson's patients who need treatment for psychosis without exacerbating their movement disorder.
Some key points to consider when prescribing Nuplazid include:
- The efficacy of pimavanserin in treating Parkinson's disease psychosis has been demonstrated in several studies, including a Phase 3 trial that showed a significant decrease in SAPS-PD scores compared to placebo 3.
- Pimavanserin has been shown to be well-tolerated with few adverse effects and no significant worsening of motor function 4.
- The medication has been approved by the FDA for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis 5.
- It is essential to monitor patients for potential adverse effects, such as falls, hallucinations, and urinary tract infections, which were reported in clinical trials 2.
Overall, Nuplazid is a valuable treatment option for patients with Parkinson's disease psychosis, and its dosing schedule can be flexible to accommodate individual patient needs.