Drug interactions
Nelfinavir + Ziprasidone
Severity: Moderate
Nelfinavir 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
Nelfinavir inhibits CYP3A4, which is one of the metabolic routes of ziprasidone, so ziprasidone exposure may rise modestly. Because ziprasidone prolongs the QT interval, higher levels could add to arrhythmia risk, though the effect of CYP3A4 inhibition on ziprasidone is limited since aldehyde oxidase handles most of its clearance.
What this interaction means in plain words
Nelfinavir 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.
Nelfinavir belongs to Anti Virals; Ziprasidone belongs to Central Nervous System.
Why it happens
Nelfinavir inhibits CYP3A4-mediated metabolism of ziprasidone, a minor elimination pathway.
What to do
Obtain a baseline ECG and keep potassium and magnesium within normal range. Watch for QT prolongation and signs of excess sedation or orthostasis during co-therapy.
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
Other interactions of Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Nelfinavir with Ziprasidone?
MediHelp rates the interaction as moderate. Nelfinavir 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. Nelfinavir inhibits CYP3A4, which is one of the metabolic routes of ziprasidone, so ziprasidone exposure may rise modestly. Because ziprasidone prolongs the QT interval, higher levels could add to arrhythmia risk, though the effect of CYP3A4 inhibition on ziprasidone is limited since aldehyde oxidase handles most of its clearance.
How serious is the interaction between Nelfinavir 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 keep potassium and magnesium within normal range. Watch for QT prolongation and signs of excess sedation or orthostasis during co-therapy.
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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