Drug interactions
Tacrolimus + Ziprasidone
Severity: Major
Tacrolimus 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 agents can prolong the QT interval, raising the risk of torsades de pointes. Tacrolimus-related electrolyte changes such as hypomagnesemia and hyperkalemia may add to the risk.
What this interaction means in plain words
Tacrolimus 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.
Tacrolimus belongs to Miscellaneous; Ziprasidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation through pharmacodynamic effects.
What to do
Avoid if an alternative antipsychotic is feasible. If combined, monitor ECG and serum magnesium and potassium.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Tacrolimus with Ziprasidone?
MediHelp rates the interaction as major. Tacrolimus 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 agents can prolong the QT interval, raising the risk of torsades de pointes. Tacrolimus-related electrolyte changes such as hypomagnesemia and hyperkalemia may add to the risk.
How serious is the interaction between Tacrolimus 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 if an alternative antipsychotic is feasible. If combined, monitor ECG and serum magnesium and potassium.
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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