Drug interactions
Hydroxyzine + Ziprasidone
Severity: Major
Hydroxyzine and Ziprasidone: major interaction.
Last updated
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
Hydroxyzine is associated with QT prolongation and torsades de pointes, and ziprasidone is a recognized QT-prolonging antipsychotic. Used together they significantly increase the risk of serious ventricular arrhythmia.
What this interaction means in plain words
Hydroxyzine 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.
Hydroxyzine belongs to Respiratory; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QTc prolongation through blockade of cardiac potassium channels (hERG).
What to do
Avoid the combination and use a non-QT-prolonging anxiolytic or antihistamine instead. If unavoidable, use the lowest hydroxyzine dose, check ECG and electrolytes, and monitor for palpitations or syncope.
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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Other interactions of Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone Contraindicated
Other interactions of Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Ziprasidone?
MediHelp rates the interaction as major. Hydroxyzine 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. Hydroxyzine is associated with QT prolongation and torsades de pointes, and ziprasidone is a recognized QT-prolonging antipsychotic. Used together they significantly increase the risk of serious ventricular arrhythmia.
How serious is the interaction between Hydroxyzine 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 the combination and use a non-QT-prolonging anxiolytic or antihistamine instead. If unavoidable, use the lowest hydroxyzine dose, check ECG and electrolytes, and monitor for palpitations or syncope.
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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