Drug interactions
Rilpivirine + Ziprasidone
Severity: Major
Rilpivirine 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 rilpivirine at supratherapeutic doses has been associated with QT prolongation. Ziprasidone carries a notable QT risk, so the combination raises the chance of torsades de pointes, especially with other risk factors.
What this interaction means in plain words
Rilpivirine 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.
Rilpivirine belongs to Anti Virals; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT interval prolongation through cardiac potassium channel (hERG) blockade.
What to do
Avoid the combination where possible and choose a less QT-prolonging antipsychotic. If it is unavoidable, obtain a baseline and follow-up ECG and correct potassium and magnesium.
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 Ziprasidone
- Amiodarone + Ziprasidone Contraindicated
- Amitriptyline + Ziprasidone Contraindicated
- Arsenic trioxide + Ziprasidone Contraindicated
- Bedaquiline + Ziprasidone Contraindicated
- Chloroquine + Ziprasidone Contraindicated
- Citalopram + Ziprasidone Contraindicated
Other interactions of Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Rilpivirine with Ziprasidone?
MediHelp rates the interaction as major. Rilpivirine 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 rilpivirine at supratherapeutic doses has been associated with QT prolongation. Ziprasidone carries a notable QT risk, so the combination raises the chance of torsades de pointes, especially with other risk factors.
How serious is the interaction between Rilpivirine 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 and choose a less QT-prolonging antipsychotic. If it is unavoidable, obtain a baseline and follow-up ECG and correct potassium and magnesium.
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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