Drug interactions
Buprenorphine transdermal + Ziprasidone
Severity: Major
Buprenorphine transdermal and Ziprasidone: major interaction.
Last updated Sources: US FDA label
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
Transdermal buprenorphine can prolong the QT interval in a dose-related way, and ziprasidone has well-known QT effects, so the combination may increase torsades risk. Additive sedation may also occur.
What this interaction means in plain words
Buprenorphine transdermal 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.
Why it happens
Additive QTc prolongation and additive CNS depression.
What to do
Avoid if possible; otherwise obtain a baseline ECG, correct electrolytes, use the lowest buprenorphine dose and monitor QTc and sedation.
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
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 Buprenorphine transdermal with Ziprasidone?
MediHelp rates the interaction as major. Buprenorphine transdermal 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. Transdermal buprenorphine can prolong the QT interval in a dose-related way, and ziprasidone has well-known QT effects, so the combination may increase torsades risk. Additive sedation may also occur.
How serious is the interaction between Buprenorphine transdermal 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 if possible; otherwise obtain a baseline ECG, correct electrolytes, use the lowest buprenorphine dose and monitor QTc and sedation.
What other medicines interact with Ziprasidone?
MediHelp also lists interactions of Ziprasidone with, for example, Amiodarone, Amitriptyline, Arsenic trioxide. The full list is on the Ziprasidone page.
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