Drug interactions
Ziprasidone + Zotepine
Severity: Major
Ziprasidone and Zotepine: 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 are antipsychotics, so combining them increases dopamine blockade and the risk of extrapyramidal symptoms, sedation and neuroleptic malignant syndrome. Both also prolong the QT interval, and zotepine lowers the seizure threshold.
What this interaction means in plain words
Ziprasidone and Zotepine 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.
Why it happens
Additive dopamine D2 antagonism, sedation and QT prolongation.
What to do
Avoid combining antipsychotics unless clearly needed, and use the lowest effective doses. Obtain an ECG, check electrolytes, and monitor for extrapyramidal symptoms, fever and rigidity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Ziprasidone and Zotepine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Ziprasidone with Zotepine?
MediHelp rates the interaction as major. Ziprasidone and Zotepine 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 are antipsychotics, so combining them increases dopamine blockade and the risk of extrapyramidal symptoms, sedation and neuroleptic malignant syndrome. Both also prolong the QT interval, and zotepine lowers the seizure threshold.
How serious is the interaction between Ziprasidone and Zotepine?
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 combining antipsychotics unless clearly needed, and use the lowest effective doses. Obtain an ECG, check electrolytes, and monitor for extrapyramidal symptoms, fever and rigidity.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
