Drug interactions
Erythromycin ethylsuccinate + Ziprasidone
Severity: Major
Erythromycin ethylsuccinate 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
Erythromycin prolongs the QT interval and has been linked to torsades de pointes. Combined with ziprasidone, the risk of QTc prolongation and ventricular arrhythmia is raised.
What this interaction means in plain words
Erythromycin ethylsuccinate 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 hERG channel blockade causing QT prolongation; erythromycin's CYP3A4 inhibition may modestly raise ziprasidone levels.
What to do
Prefer a non-macrolide antibiotic with less QT effect. If it is unavoidable, check ECG and electrolytes before and during treatment.
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 Erythromycin ethylsuccinate with Ziprasidone?
MediHelp rates the interaction as major. Erythromycin ethylsuccinate 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. Erythromycin prolongs the QT interval and has been linked to torsades de pointes. Combined with ziprasidone, the risk of QTc prolongation and ventricular arrhythmia is raised.
How serious is the interaction between Erythromycin ethylsuccinate 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: Prefer a non-macrolide antibiotic with less QT effect. If it is unavoidable, check ECG and electrolytes before and during treatment.
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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