Drug interactions
Risperidone + Ziprasidone
Severity: Major
Risperidone 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 antipsychotics prolong the QTc interval, and ziprasidone has a notable QT liability. Combined use increases the risk of torsades de pointes, and also adds sedation and extrapyramidal effects.
What this interaction means in plain words
Risperidone 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.
Risperidone belongs to Central Nervous System; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation via hERG blockade, plus additive dopamine D2 antagonism and sedation.
What to do
Avoid concurrent use where possible; if unavoidable, obtain baseline and follow-up ECGs and correct potassium and magnesium. Consider antipsychotic monotherapy.
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 Risperidone
- Ibutilide + Risperidone Contraindicated
- Risperidone + Vandetanib Contraindicated
- Adagrasib + Risperidone Major
- Amiodarone + Risperidone Major
- Amisulpride + Risperidone Major
- Amoxapine + Risperidone Major
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 Risperidone with Ziprasidone?
MediHelp rates the interaction as major. Risperidone 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 antipsychotics prolong the QTc interval, and ziprasidone has a notable QT liability. Combined use increases the risk of torsades de pointes, and also adds sedation and extrapyramidal effects.
How serious is the interaction between Risperidone 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 concurrent use where possible; if unavoidable, obtain baseline and follow-up ECGs and correct potassium and magnesium. Consider antipsychotic monotherapy.
What other medicines interact with Risperidone?
MediHelp also lists interactions of Risperidone with, for example, Ibutilide, Vandetanib, Adagrasib. The full list is on the Risperidone page.
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