Drug interactions
Procainamide + Ziprasidone
Severity: Contraindicated
Procainamide and Ziprasidone: contraindicated interaction.
Last updated Sources: US FDA label
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
Procainamide is a class Ia antiarrhythmic that prolongs QT and can cause torsades de pointes. Combining it with ziprasidone further raises the risk of life-threatening ventricular arrhythmia. This pairing is contraindicated in ziprasidone labeling.
What this interaction means in plain words
Procainamide and Ziprasidone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive prolongation of the QT interval via blockade of cardiac potassium channels.
What to do
Do not co-prescribe; use an alternative antiarrhythmic or an antipsychotic with lower QT risk. Check ECG and electrolytes if therapy changes are being transitioned.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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References
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 Procainamide with Ziprasidone?
MediHelp rates the interaction as contraindicated. Procainamide and Ziprasidone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Procainamide is a class Ia antiarrhythmic that prolongs QT and can cause torsades de pointes. Combining it with ziprasidone further raises the risk of life-threatening ventricular arrhythmia. This pairing is contraindicated in ziprasidone labeling.
How serious is the interaction between Procainamide and Ziprasidone?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-prescribe; use an alternative antiarrhythmic or an antipsychotic with lower QT risk. Check ECG and electrolytes if therapy changes are being transitioned.
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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