Drug interactions
Paroxetine + Ziprasidone
Severity: Major
Paroxetine 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 has a notable QT-prolonging effect, and adding paroxetine may contribute further QT risk, raising the potential for torsades de pointes in susceptible patients. Serotonergic and dopamine-blocking effects together also rarely lead to serotonin syndrome or NMS.
What this interaction means in plain words
Paroxetine 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.
Paroxetine belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation and serotonergic/dopaminergic pharmacodynamic effects.
What to do
Obtain a baseline ECG and correct potassium and magnesium before and during co-therapy. Avoid in patients with long QT, cardiac disease or other QT-prolonging drugs, and monitor for serotonin toxicity or NMS.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline 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 Paroxetine with Ziprasidone?
MediHelp rates the interaction as major. Paroxetine 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 has a notable QT-prolonging effect, and adding paroxetine may contribute further QT risk, raising the potential for torsades de pointes in susceptible patients. Serotonergic and dopamine-blocking effects together also rarely lead to serotonin syndrome or NMS.
How serious is the interaction between Paroxetine 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: Obtain a baseline ECG and correct potassium and magnesium before and during co-therapy. Avoid in patients with long QT, cardiac disease or other QT-prolonging drugs, and monitor for serotonin toxicity or NMS.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Methylene blue, Phenelzine. The full list is on the Paroxetine page.
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