Drug interactions
Posaconazole + Ziprasidone
Severity: Major
Posaconazole 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 can prolong the QT interval, and their combined use raises the risk of torsades de pointes and other serious ventricular arrhythmias. Risk is higher with electrolyte disturbances, bradycardia or underlying cardiac disease.
What this interaction means in plain words
Posaconazole 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.
Posaconazole belongs to Anti Fungals; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive blockade of cardiac potassium channels (hERG) causing QT prolongation; posaconazole may also modestly raise ziprasidone exposure via CYP3A4 inhibition.
What to do
Avoid the combination where possible; if it is necessary, obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider an alternative antipsychotic or antifungal.
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 Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole 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 Posaconazole with Ziprasidone?
MediHelp rates the interaction as major. Posaconazole 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 can prolong the QT interval, and their combined use raises the risk of torsades de pointes and other serious ventricular arrhythmias. Risk is higher with electrolyte disturbances, bradycardia or underlying cardiac disease.
How serious is the interaction between Posaconazole 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; if it is necessary, obtain a baseline and follow-up ECG and correct potassium and magnesium. Consider an alternative antipsychotic or antifungal.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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