Pitolisant (Oral route)
Central Nervous System Agent
Uses of This Medicine:
Pitolisant is used to treat cataplexy (weak or paralyzed muscles) or excessive daytime sleepiness (EDS) in patients with narcolepsy. Narcolepsy is an uncontrollable desire for sleep or a sudden attack of deep sleep.
This medicine is available only with your doctor's prescription.
Before Using This Medicine:
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of pitolisant in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pitolisant in the elderly. However, elderly patients are more likely to have age-related heart, kidney, or liver problems, which may require caution and an adjustment in the dose for patients receiving this medicine.
Studies in women breastfeeding have demonstrated harmful infant effects. An alternative to this medication should be prescribed or you should stop breastfeeding while using this medicine.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Ethinyl Estradiol
- Inotuzumab Ozogamicin
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- St John's Wort
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other medical problems—
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Heart rhythm problems (eg, arrhythmia, slow heartbeat), or history of or
- Hypokalemia (low potassium in the blood) or
- Hypomagnesemia (low magnesium in the blood)—May increase risk for more serious side effects.
- Kidney disease, end stage—Use is not recommended in patients with this condition.
- Kidney disease, moderate to severe or
- Liver disease, moderate—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
- Liver disease, severe—Should not be used in patients with this condition.
Proper Use of This Medicine:
Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If you think this medicine is not working properly after you have taken it for several weeks, check with your doctor.
Take the tablet when you wake up in the morning.
Swallow the tablet whole. Do not crush, break, or chew it.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For cataplexy or excessive daytime sleepiness caused by narcolepsy:
- Adults—At first, 8.9 milligrams (mg) (two tablets of 4.45 mg) once a day on Week 1. Your doctor may increase your dose to 17.8 mg (one tablet of 17.8 mg) once a day on Week 2. Then, your doctor may increase your dose to 35.6 mg (two tablets of 17.8 mg) once a day on Week 3. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 35.6 mg per day.
- Children—Use and dose must be determined by your doctor.
- For cataplexy or excessive daytime sleepiness caused by narcolepsy:
If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
If you missed a dose, take the next dose on the following day when you first wake up in the morning.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using This Medicine:
It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.
This medicine does not take the place of getting enough sleep. It should not be used for occasional sleepiness that has not been diagnosed as narcolepsy. Ask your doctor for advice about good sleep habits.
Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.
Birth control pills may not work while you are using pitolisant. To keep from getting pregnant, use another form of birth control during treatment and for at least 21 days after your last dose. Other forms of birth control include condoms, diaphragms, or contraceptive foams or jellies.
It is important to tell your doctor if you become pregnant. Your doctor may want you to join a pregnancy exposure registry for patients taking this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Side Effects of This Medicine:
- Incidence not known
- Changes in behavior
- difficulty swallowing
- feeling sad or empty
- fast or irregular heartbeat
- hives, itching, skin rash
- lack of appetite
- loss of interest or pleasure
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- thoughts of killing oneself
- tightness in the chest
- trouble breathing
- trouble concentrating
- unusual tiredness or weakness
- More common
- trouble sleeping
- Less common
- body aches or pain
- burning, numbness, pain, or tingling in all fingers except smallest finger
- decreased appetite
- difficulty in moving
- dry mouth
- ear congestion
- loss of voice
- muscle or joint pain
- runny or stuffy nose
- seeing, hearing, or feeling things that are not there
- sore throat
- stomach pain or discomfort
- Incidence not known
- Weight gain
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Last Updated: 8/5/2022