Drug interactions
Lurasidone + Ziprasidone
Severity: Major
Lurasidone 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
Combining two atypical antipsychotics adds receptor antagonism and increases sedation, orthostatic hypotension and extrapyramidal symptoms. Ziprasidone also prolongs the QT interval, so combined use adds proarrhythmic risk.
What this interaction means in plain words
Lurasidone 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.
Lurasidone belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive pharmacodynamic effects, including dopamine and serotonin antagonism and QT prolongation from ziprasidone.
What to do
Avoid combining unless clearly necessary. If used, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and extrapyramidal symptoms.
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
- Latuda 18.5mg film-coated tablets - SmPC sections 4.3/4.5 (class statement: some other antipsychotics; "Caution is advised when prescribing lurasidone with medicinal products known to prolong the QT interval, e.g. class IA antiarrhythmics (e.g. quinidine, disopyra") — electronic medicines compendium (UK SmPC)
Other interactions of Lurasidone
- Apalutamide + Lurasidone Contraindicated
- Atazanavir + Lurasidone Contraindicated
- Carbamazepine + Lurasidone Contraindicated
- Clarithromycin + Lurasidone Contraindicated
- Cobicistat + Lurasidone Contraindicated
- Conivaptan + Lurasidone Contraindicated
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 Lurasidone with Ziprasidone?
MediHelp rates the interaction as major. Lurasidone 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. Combining two atypical antipsychotics adds receptor antagonism and increases sedation, orthostatic hypotension and extrapyramidal symptoms. Ziprasidone also prolongs the QT interval, so combined use adds proarrhythmic risk.
How serious is the interaction between Lurasidone 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 combining unless clearly necessary. If used, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and extrapyramidal symptoms.
What other medicines interact with Lurasidone?
MediHelp also lists interactions of Lurasidone with, for example, Apalutamide, Atazanavir, Carbamazepine. The full list is on the Lurasidone page.
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