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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK548846_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK548846_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Pimavanserin/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/Pindolol/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK548846_"><span class="title" itemprop="name">Pimozide</span></h1><p class="small">Last Update: <span itemprop="dateModified">July 1, 2020</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Pimozide.OVERVIEW"><h2 id="_Pimozide_OVERVIEW_">OVERVIEW</h2><div id="Pimozide.Introduction"><h3>Introduction</h3><p>Pimozide is a conventional antipsychotic used largely in the therapy of Tourette syndrome. Pimozide therapy has not been associated with serum aminotransferase elevations nor with cases of clinically apparent acute liver injury.</p></div><div id="Pimozide.Background"><h3>Background</h3><p>Pimozide (pim' oh zide) is a diphenylbutylpiperidine derivative that differs structurally from the phenothiazines and appears to act by blocking dopamine type 2 (D2) receptors. Pimozide has other central and peripheral effects including anticholinergeric and alpha adrenergic blockade. Pimozide is indicated for the therapy of severe motor and verbal tics in patients with Tourette syndrome. It has also been used in therapy of schizophrenia. Pimozide was approved for use in the United States in 1984. As therapy of schizophrenia, pimozide has been replaced in large part by the atypical antipsychotics, which have fewer extrapyramidal side effects. Pimozide continues to be used in patients with motor or verbal tics due to Tourette syndrome. Pimozide is available as tablets of 1 and 2 mg in generic forms and under the brand name Orap. Typical doses are 1 to 2 mg daily in divided doses, increasing to a maximum of 10 mg daily. Pimozide can prolong the QT interval and, in rare instances, has caused sudden death for which reason the dose should be carefully chosen and drug levels monitored. Common side effects include drowsiness, dizziness, headache, blurred vision, dry mouth, and constipation. Uncommon but potentially severe adverse reactions include tardive dyskinesia, neuroleptic malignant syndrome and sudden death.</p></div><div id="Pimozide.Hepatotoxicity"><h3>Hepatotoxicity</h3><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.liver-test-abnormalities/">Liver test abnormalities</a> have not been reported to occur in of patients on pimozide, but the degree and duration of monitoring done in initial studies were not clear. Instances of clinically apparent acute liver injury have not been reported due to pimozide, and thus must be rare if they occur at all.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: E (unlikely cause of clinically apparent liver injury).</p></div><div id="Pimozide.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>Pimozide is extensively metabolized by the liver partially via the cytochrome P450 system (predominantly CYP 2D6) and levels can be seriously elevated in patients who concurrently receive CYP 2D6 inhibitors, particularly in persons who are poor metabolizers of CYP 2D6 substrates. The lack of hepatotoxicity may relate in part to the low dosage used (less than 10 mg daily).</p><p>Drug Class: <a href="/books/n/livertox/AntipsychoticAgents/">Antipsychotic Agents</a></p></div></div><div id="Pimozide.PRODUCT_INFORMATION"><h2 id="_Pimozide_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
|
||
<b>REPRESENTATIVE TRADE NAMES</b>
|
||
</p><p>Pimozide – Generic, Orap®</p><p>
|
||
<b>DRUG CLASS</b>
|
||
</p><p>Antipsychotic Agents</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Pimozide" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div><div id="Pimozide.CHEMICAL_FORMULA_AND_STRUCTURE"><h2 id="_Pimozide_CHEMICAL_FORMULA_AND_STRUCTURE_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="Pimozide.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548846/table/Pimozide.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Pimozide.Tc_lrgtbl__"><table><thead><tr><th id="hd_h_Pimozide.Tc_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_Pimozide.Tc_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NUMBER</th><th id="hd_h_Pimozide.Tc_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Pimozide.Tc_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Pimozide.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pimozide</td><td headers="hd_h_Pimozide.Tc_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/134983783" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">2062-78-4</a>
|
||
</td><td headers="hd_h_Pimozide.Tc_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C28-H29-F2-N3-O</td><td headers="hd_h_Pimozide.Tc_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/134983783" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134983783" alt="image 134983783 in the ncbi pubchem database" /></a>
|
||
</td></tr></tbody></table></div></div></div><div id="Pimozide.ANNOTATED_BIBLIOGRAPHY"><h2 id="_Pimozide_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 01 July 2020</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Pimozide.REF.zimmerman.1999">Zimmerman HJ. Neuroleptic drugs. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 483-91.<div><i>(Expert review of hepatotoxicity of neuroleptic drugs published in 1999; mentions a single case of cholestatic jaundice due to pimozide).</i></div><div>Larry D, Ripault MP. Hepatotoxicity of psychotropic drugs and drugs of abuse. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 443-62.</div><div><i>(Review of hepatotoxicity of psychiatric agents does not discuss pimozide).</i></div></div></li><li><div class="bk_ref" id="Pimozide.REF.meyer.2018">Meyer JM. Pharmacotherapy of psychosis and mania. In, Brunton LL, Hilal-Dandan R, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 13th ed. New York: McGraw-Hill, 2018, pp. 279-302.<div><i>(Textbook of pharmacology and therapeutics).</i></div></div></li><li><div class="bk_ref" id="Pimozide.REF.claghorn.1974.1005">Claghorn JL. A double-blind comparison of pimozide vs. trifluoperazine in schizophrenic outpatients. <span><span class="ref-journal">Curr Ther Res Clin Exp. </span>1974;<span class="ref-vol">16</span>:1005–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/4214658" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4214658</span></a>]<div>
|
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<i>(Small trial of 6 months of pimozide vs trifluoperazine therapy in 87 subjects with monitoring of serum tests; 3 on pimozide and 6 on trifluoperazine had “some transient laboratory alterations”, but which tests, by how much and when was not defined).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.kolivakis.1974.998">Kolivakis T, Azim H, Kingstone E. A double-blind comparison of pimozide and chlorpromazine in the maintenance care of chronic schizophrenic outpatients. <span><span class="ref-journal">Curr Ther Res Clin Exp. </span>1974;<span class="ref-vol">16</span>:998–1004.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/4214674" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 4214674</span></a>]<div>
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<i>(Trial of pimozide vs chlorpromazine for 6 months with laboratory monitoring, no mention of ALT elevations or hepatotoxicity).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.pinder.1976.1">Pinder RM, Brogden RN, Swayer R, Speight TM, Spencer R, Avery GS. Pimozide: a review of its pharmacological properties and therapeutic uses in psychiatry. <span><span class="ref-journal">Drugs. </span>1976;<span class="ref-vol">12</span>:1–40.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/824116" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 824116</span></a>]<div>
|
||
<i>(Short review of pharmacology, indications and side effects of pimozide; no mention of ALT elevations or hepatotoxicity).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.colvin.1985.421">Colvin CL, Tankanow RM. Pimozide: use in Tourette's syndrome. <span><span class="ref-journal">Drug Intell Clin Pharm. </span>1985;<span class="ref-vol">19</span>:421–4.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/3891283" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3891283</span></a>]<div>
|
||
<i>(Review of structure, pharmacology and efficacy of pimozide in short term studies in Tourette syndrome; no mention of hepatotoxicity).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.allison.1999.1686">Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, Weiden PJ. Antipsychotic-induced weight gain: a comprehensive research synthesis. <span><span class="ref-journal">Am J Psychiatry. </span>1999;<span class="ref-vol">156</span>:1686–96.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10553730" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10553730</span></a>]<div>
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<i>(Systematic review of 81 articles on weight change with antipsychotics, using change after 10 weeks to compare agents: clozapine +5.7, olanzapine +4.2, chlorpromazine +4.2, risperidone +1.7, loxapine +0.6, haloperidol +0.5, ziprasidone +0.3, molindone -0.1, and pimozide -2.7 kg).</i>
|
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</div></div></li><li><div class="bk_ref" id="Pimozide.REF.rogers.2012.1187">Rogers HL, Bhattaram A, Zineh I, Gobburu J, Mathis M, Laughren TP, Pacanowski M. CYP2D6 genotype information to guide pimozide treatment in adult and pediatric patients: basis for the U.S. Food and Drug Administration's new dosing recommendations. <span><span class="ref-journal">J Clin Psychiatry. </span>2012;<span class="ref-vol">73</span>:1187–90.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/23059146" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23059146</span></a>]<div>
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<i>(Review of the pharmacogenetics of pimozide and the role of CYP 2D6 and CYP 2D6 inhibitors in its metabolism and adverse events).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.hern_ndez.2014.231">Hernández N, Bessone F, Sánchez A, di Pace M, Brahm J, Zapata R, A, Chirino R, et al. Profile of idiosyncratic drug induced liver injury in Latin America. An analysis of published reports. <span><span class="ref-journal">Ann Hepatol. </span>2014;<span class="ref-vol">13</span>:231–9.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24552865" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24552865</span></a>]<div>
|
||
<i>(Systematic review of literature of drug induced liver injury in Latin American countries published from 1996 to 2012 identified 176 cases, only one of which was attributed to chlorpromazine, the only antipsychotic medication listed).</i>
|
||
</div></div></li><li><div class="bk_ref" id="Pimozide.REF.chalasani.2015.1340">Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al. United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. <span><span class="ref-journal">Gastroenterology. </span>2015;<span class="ref-vol">148</span>:1340–52.e7.</span> [<a href="/pmc/articles/PMC4446235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4446235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25754159" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25754159</span></a>]<div>
|
||
<i>(Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, 5 cases [0.6%] were attributed to antipsychotic agents, including 3 due to quetiapine and 2 to olanzapine, but none to pimozide]).</i>
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<a href="https://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&pubmedfilters=true&term=(Pimozide/AE)+AND+Human%5BMH%5D+AND+(drug+induced+liver+injury+OR+jaundice/CI+OR+bile+duct+diseases/CI+OR+liver/DE+OR+liver+diseases/CI)+AND+(%221900/1/1%22%5BEDat%5D:%222999/12/31%22%5BEDat%5D)" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Recent References on Pimozide: from PubMed.gov</a>
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<a href="https://clinicaltrials.gov/ct2/results?term=Pimozide" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Trials on Pimozide: from ClinicalTrials.gov</a>
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Epub 2015 Feb 23.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/21732066" ref="ordinalpos=1&linkpos=3&log$=relatedarticles&logdbfrom=pubmed">Cardiovascular safety of aripiprazole and pimozide in young patients with Tourette syndrome.</a><span class="source">[Neurol Sci. 2011]</span><div class="brieflinkpop offscreen_noflow">Cardiovascular safety of aripiprazole and pimozide in young patients with Tourette syndrome.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Gulisano M, Calì PV, Cavanna AE, Eddy C, Rickards H, Rizzo R. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Neurol Sci. 2011 Dec; 32(6):1213-7. Epub 2011 Jul 6.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/19370666" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pimozide for tics in Tourette's syndrome.</a><span class="source">[Cochrane Database Syst Rev. 2009]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pimozide for tics in Tourette's syndrome.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Pringsheim T, Marras C. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Cochrane Database Syst Rev. 2009 Apr 15; 2009(2):CD006996. Epub 2009 Apr 15.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/12639456" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pimozide: use in dermatology.</a><span class="source">[Dermatol Online J. 2003]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Pimozide: use in dermatology.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">van Vloten WA. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Dermatol Online J. 2003 Mar; 9(2):3. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=31644153" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=31644153" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8e109ab82281a803e8b95">Pimozide - LiverTox</a><div class="ralinkpop offscreen_noflow">Pimozide - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8e108f4a390645e33a265">Pimavanserin - LiverTox</a><div class="ralinkpop offscreen_noflow">Pimavanserin - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8e108a68b6b5afc7668cc">Pilocarpine - LiverTox</a><div class="ralinkpop offscreen_noflow">Pilocarpine - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8e107b15b832ebc11cdcc">Phosphodiesterase Type 5 (PDE5) Inhibitors - LiverTox</a><div class="ralinkpop offscreen_noflow">Phosphodiesterase Type 5 (PDE5) Inhibitors - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8e106ab82281a803e75a1">Phenytoin - LiverTox</a><div class="ralinkpop offscreen_noflow">Phenytoin - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
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<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
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<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
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<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
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<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
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<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
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<a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p>
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