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Orap is an antipsychotic medication used to treat symptoms of Tourette’s syndrome.

Pimozide is a diphenylbutylpiperidine derived antipsychotic drug that suppresses motor and verbal tics related to Tourette’s by blocking dopamine receptors in your brain. This inhibitory action allows Orap to help manage Tourette’s syndrome, especially in combination with its other central and peripheral effects like anticholinergic and alpha-adrenergic inhibition.

This antipsychotic medication is a popular choice for treating involuntary motor movements and vocal tics related to Tourette’s syndrome. Orap is generally well tolerated and thanks to is extended half-life can be taken in once-daily doses.

Uses and Dosage

The dose of Orap that is prescribed will vary depending on the individual being treated. Follow all your doctor’s directions and read Orap packaging labels carefully.

  • Swallow tablets whole
  • Your Orap dosage should be slowly introduced and adjusted until tics are suppressed with minimal drug side effects
  • Wait up to two weeks before concluding whether tic increases are disease related or not
  • Adult doses are usually initiated with 1 or 2mg divided daily, increased every other day
  • Most adult maintenance doses range up to 10mg daily or less
  • Adults are not recommended to take more than 10mg a day
  • For children taking Orap, doses should be initiated at 0.05mg per kg of body weight taken once before bed
  • After initiation, pediatric doses can be increased every third day to a maximum of 0.2mg/kg
  • Children should not take more than 10mg a day
  • Symptoms may take several weeks to improve, continue using Orap as directed
  • Contact your doctor if symptoms persist or worsen
  • Do not suddenly stop taking Orap to avoid unpleasant withdrawal symptoms
  • You will need regular checkups during treatment with Orap
  • Your heart function may need to be tested using an electrocardiograph or ECG
  • Store Orap at room temperature away from moisture, heat, and light

Side Effects

Orap may cause some side effects to develop while affecting the chemicals in your brain to decrease tics from Tourette’s syndrome. Speak with your doctor for more information relating to any symptoms that you may experience when taking pimozide.

Common Orap side effects:

  • Problems with vision or speech
  • Drowsiness, trouble sleeping
  • Feeling restless
  • Tight muscles
  • Constipation
  • Dry mouth

Serious Side Effects

Some more serious adverse reactions may occur when taking pimozide. Stop using Orap and contact your doctor if you develop any of the following side effects:

  • Uncontrolled muscle movements in your face
  • Fast or pounding heartbeats, fluttering in your chest, shortness of breath, sudden dizziness
  • Fever, chills, tiredness, mouth sores, skin sores
  • Seizure
  • Severe nervous system reaction (stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out)

Allergic Reactions

Do not use Orap if you are allergic to pimozide or any other antipsychotic medications. If you notice signs of an allergic reaction, stop using this medication and call your doctor right away.

Orap allergy symptoms may include:

  • Hives
  • Difficulty breathing
  • Swelling of face, lips, tongue, or throat


Pimozide may impair your reactions; avoid driving or performing any hazardous activities until you know how Orap will affect you.

Avoid drinking alcohol during treatment with Orap because it can cause certain pimozide side effects to increase.

Grapefruit may interact with pimozide and cause unwanted side effects; avoid ingesting grapefruit products while using Orap.

Do not use Orap if you have any of the following:

  • Long QT syndrome
  • Low potassium or magnesium levels
  • If you take any medications that can cause tics such as a stimulant or ADHD medicine

To ensure your safety when taking Orap, tell your doctor if you have ever had any of the following:

  • Liver disease
  • Kidney disease
  • Seizures or epilepsy
  • Heart problems, high blood pressure, or a heart attack
  • Enlarged prostate or troubles urinating
  • Glaucoma

Some drugs can interact with pimozide and cause adverse reactions. To avoid any dangerous interactions, tell your doctor about all the medications that you take, including over the counter medicine, but especially any of the following:

  • ADHD medication
  • Antibiotic or antifungal medicine
  • Another antipsychotic medication
  • Antidepressants
  • Antiviral medicine to treat hepatitis C or HIV
  • Anti-malaria medication
  • Heart rhythm medication
  • Medicine to treat or prevent nausea and vomiting
  • Triptan migraine medicine
  • Opioid medication

Using Orap alongside any medications that cause you to be drowsy can worsen this effect caused by pimozide. Ask your doctor before using opioid medication, sleeping pills, muscle relaxants, or medicine for anxiety or seizures.

Consult with your doctor if you are pregnant or plan to become pregnant while taking Orap. Pimozide can cause complications and problems in your newborn if taken during the last three months of pregnancy. Do not stop taking this medication without first speaking with your doctor.

Do not breastfeed during treatment with Orap.

Orap is not an approved treatment for anyone under the age of 12.

Form and Strength

This Tourette’s medication is available in tablet form.

Orap tablet strength:

  • 2mg
  • 4mg

The 2 and 4mg strength Orap tablets are both available in quantities of 100.


What precautions should you take while taking Orap?

You should avoid driving or performing any hazardous tasks such as operating heavy machinery during treatment with Orap, especially at the beginning before you know how the drug will affect you. Pimozide may impair your thinking or reactions.

What are the interactions with Orap?

Orap may interact with several kinds of drugs and cause adverse reactions. The main medications that could lead to adverse interactions include antibiotics, antifungal medicines, protease inhibitors, phenothiazines, antidepressants, and heart medications. Consult with your doctor to determine a treatment plan that works best for you.



Additional information

Brand Name:


Scientific Name:


Other Names:

Orap, Pimozide


2mg, 4mg

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