Drug interactions
Paliperidone + Ziprasidone
Severity: Major
Paliperidone 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
Both drugs prolong the QT interval, and combining them raises the risk of torsades de pointes. Additive dopamine blockade also increases extrapyramidal effects, sedation and the chance of neuroleptic malignant syndrome.
What this interaction means in plain words
Paliperidone 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.
Paliperidone belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation through hERG potassium channel blockade, plus additive D2 antagonism and sedation.
What to do
Avoid combining where possible; if unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and neurological effects.
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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Other interactions of Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
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 Paliperidone with Ziprasidone?
MediHelp rates the interaction as major. Paliperidone 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. Both drugs prolong the QT interval, and combining them raises the risk of torsades de pointes. Additive dopamine blockade also increases extrapyramidal effects, sedation and the chance of neuroleptic malignant syndrome.
How serious is the interaction between Paliperidone 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 where possible; if unavoidable, obtain a baseline ECG, correct potassium and magnesium, and monitor QTc and neurological effects.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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