Drug interactions
Rifampin + Ziprasidone
Severity: Moderate
Rifampin and Ziprasidone: moderate 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
Rifampin is a strong inducer of metabolic enzymes including CYP3A4 and may reduce ziprasidone exposure. Ziprasidone is only partly metabolized by CYP3A4, so the effect is smaller than for fully CYP3A4-dependent drugs, but loss of antipsychotic efficacy is possible.
What this interaction means in plain words
Rifampin and Ziprasidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Induction of CYP3A4 by rifampin increases ziprasidone metabolism.
What to do
Monitor for reduced antipsychotic response and consider a ziprasidone dose increase if symptoms worsen. Reassess the dose when rifampin is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Rifampin with Ziprasidone?
MediHelp rates the interaction as moderate. Rifampin and Ziprasidone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rifampin is a strong inducer of metabolic enzymes including CYP3A4 and may reduce ziprasidone exposure. Ziprasidone is only partly metabolized by CYP3A4, so the effect is smaller than for fully CYP3A4-dependent drugs, but loss of antipsychotic efficacy is possible.
How serious is the interaction between Rifampin and Ziprasidone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for reduced antipsychotic response and consider a ziprasidone dose increase if symptoms worsen. Reassess the dose when rifampin is stopped.
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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