Drug interactions
Nortriptyline + Ziprasidone
Severity: Major
Nortriptyline 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 is a recognised QT-prolonging antipsychotic and its label advises against combining it with other QT-prolonging drugs. Nortriptyline adds to this effect, raising the risk of torsades de pointes.
What this interaction means in plain words
Nortriptyline 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.
Nortriptyline belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive prolongation of cardiac repolarization (QT interval).
What to do
Avoid the combination where possible and choose a less QT-active antipsychotic. If it must be used, monitor ECG and keep potassium and magnesium normal.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Nortriptyline and Ziprasidone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Nortriptyline
- Disopyramide + Nortriptyline Contraindicated
- Dofetilide + Nortriptyline Contraindicated
- Dronedarone + Nortriptyline Contraindicated
- Ibutilide + Nortriptyline Contraindicated
- Isocarboxazid + Nortriptyline Contraindicated
- Methylene blue + Nortriptyline 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 Nortriptyline with Ziprasidone?
MediHelp rates the interaction as major. Nortriptyline 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 is a recognised QT-prolonging antipsychotic and its label advises against combining it with other QT-prolonging drugs. Nortriptyline adds to this effect, raising the risk of torsades de pointes.
How serious is the interaction between Nortriptyline 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 the combination where possible and choose a less QT-active antipsychotic. If it must be used, monitor ECG and keep potassium and magnesium normal.
What other medicines interact with Nortriptyline?
MediHelp also lists interactions of Nortriptyline with, for example, Disopyramide, Dofetilide, Dronedarone. The full list is on the Nortriptyline page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
