Drug interactions
Nefazodone + Ziprasidone
Severity: Moderate
Nefazodone and Ziprasidone: moderate 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
Nefazodone is a potent CYP3A4 inhibitor and may raise ziprasidone levels, although ziprasidone is only partly metabolized by CYP3A4. Higher exposure may add to QT prolongation, sedation and orthostasis. Nefazodone itself has serotonergic activity.
What this interaction means in plain words
Nefazodone and Ziprasidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Inhibition of CYP3A4-mediated ziprasidone metabolism.
What to do
Obtain a baseline ECG and check potassium and magnesium. Monitor for QT prolongation and adverse effects, and reduce the ziprasidone dose if needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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
Frequently asked questions
Can I take Nefazodone with Ziprasidone?
MediHelp rates the interaction as moderate. Nefazodone and Ziprasidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Nefazodone is a potent CYP3A4 inhibitor and may raise ziprasidone levels, although ziprasidone is only partly metabolized by CYP3A4. Higher exposure may add to QT prolongation, sedation and orthostasis. Nefazodone itself has serotonergic activity.
How serious is the interaction between Nefazodone and Ziprasidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and check potassium and magnesium. Monitor for QT prolongation and adverse effects, and reduce the ziprasidone dose if needed.
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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