Histamine H3 receptor inverse agonist
Pitolisant
Brand names: Wakix, Ozawade
Adult dose
Dose: Initial 9mg OD morning, titrate weekly to 18–36mg OD
Route: PO
Frequency: OD
Clinical pearls
- Narcolepsy with/without cataplexy; obstructive sleep apnoea–related daytime sleepiness
- Take in morning — can disturb sleep if late
Contraindications
- Severe hepatic impairment
- Breastfeeding
- Hypersensitivity
Side effects
- Insomnia
- Headache
- Nausea
- Anxiety
- QT prolongation
Interactions
- QT-prolonging drugs
- Strong CYP2D6 inhibitors
- Hormonal contraceptives (alternative needed)
Monitoring
- ECG
- LFTs
Reference: BNF; NICE TA665/TA766; SmPC; https://bnf.nice.org.uk/drugs/pitolisant/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Acute Stroke Management · NICE NG128 / RCP 2023
- TIA Assessment (ABCD2) · NICE NG128 / NICE CG68
- Bacterial Meningitis (Adults) · NICE CG102 / BIA 2016
- Parkinson's Disease Management · NICE NG71 2017