Drug interactions
Aripiprazole + Ziprasidone
Severity: Major
Aripiprazole and Ziprasidone: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ziprasidone has one of the more notable QT effects among antipsychotics, and adding aripiprazole increases antipsychotic burden with a small further QT effect. The combination is rarely justified.
What this interaction means in plain words
Aripiprazole and Ziprasidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Aripiprazole belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic QTc prolongation.
What to do
Avoid dual therapy where possible. If necessary, obtain ECG, keep electrolytes normal and monitor for syncope or palpitations.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Abilify 1 mg/mL Oral Solution - SmPC sections 4.3/4.5 (class statement: medicinal products known to cause QT prolongation; "If aripiprazole is administered concomitantly with medicinal products known to cause QT prolongation or electrolyte imbalance, caution should be used.") — electronic medicines compendium (UK SmPC)
Other interactions of Aripiprazole
- Aripiprazole + Pimozide Contraindicated
- Aripiprazole + Thioridazine Contraindicated
- Amisulpride + Aripiprazole Major
- Aripiprazole + Arsenic trioxide Major
- Aripiprazole + Calcium / magnesium / potassium / sodium oxybates Major
- Aripiprazole + Carbamazepine Major
Other interactions of Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone Contraindicated
Frequently asked questions
Can I take Aripiprazole with Ziprasidone?
MediHelp rates the interaction as major. Aripiprazole and Ziprasidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ziprasidone has one of the more notable QT effects among antipsychotics, and adding aripiprazole increases antipsychotic burden with a small further QT effect. The combination is rarely justified.
How serious is the interaction between Aripiprazole and Ziprasidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid dual therapy where possible. If necessary, obtain ECG, keep electrolytes normal and monitor for syncope or palpitations.
What other medicines interact with Aripiprazole?
MediHelp also lists interactions of Aripiprazole with, for example, Pimozide, Thioridazine, Amisulpride. The full list is on the Aripiprazole page.
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