Drug interactions
Methylenedioxymethamphetamine + Ziprasidone
Severity: Major
Methylenedioxymethamphetamine 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
MDMA is a stimulant that raises heart rate, temperature and serotonergic activity, while ziprasidone prolongs the QT interval and blocks dopamine and serotonin receptors. The combination may raise arrhythmia risk and hyperthermia, and dopamine blockade may add to the risk of neuroleptic malignant syndrome.
What this interaction means in plain words
Methylenedioxymethamphetamine 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 QT and cardiovascular effects with opposing serotonergic and dopaminergic actions; pharmacodynamic.
What to do
Advise strict avoidance of MDMA during ziprasidone therapy. If exposure occurs, obtain an ECG and monitor temperature and electrolytes.
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 Methylenedioxymethamphetamine with Ziprasidone?
MediHelp rates the interaction as major. Methylenedioxymethamphetamine 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. MDMA is a stimulant that raises heart rate, temperature and serotonergic activity, while ziprasidone prolongs the QT interval and blocks dopamine and serotonin receptors. The combination may raise arrhythmia risk and hyperthermia, and dopamine blockade may add to the risk of neuroleptic malignant syndrome.
How serious is the interaction between Methylenedioxymethamphetamine 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: Advise strict avoidance of MDMA during ziprasidone therapy. If exposure occurs, obtain an ECG and monitor temperature and electrolytes.
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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