Drug interactions
Lithium + Ziprasidone
Severity: Major
Lithium 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
Ziprasidone has a notable QT-prolonging effect and lithium may add to cardiac repolarization changes. The combination increases the risk of torsades de pointes, particularly with other risk factors.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation; ziprasidone blocks cardiac hERG potassium channels.
What to do
Prefer an antipsychotic with lower QT liability when combined with lithium. If used, obtain a baseline ECG, keep electrolytes normal and monitor the ECG after dose changes.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium 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 Lithium with Ziprasidone?
MediHelp rates the interaction as major. Lithium 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 a notable QT-prolonging effect and lithium may add to cardiac repolarization changes. The combination increases the risk of torsades de pointes, particularly with other risk factors.
How serious is the interaction between Lithium 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 an antipsychotic with lower QT liability when combined with lithium. If used, obtain a baseline ECG, keep electrolytes normal and monitor the ECG after dose changes.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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