interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.amitriptylineMonitor Closely (1)ziprasidone and amitriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.amobarbitalMonitor Closely (1)amobarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)amobarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.amoxapineContraindicated (1)ziprasidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Contraindicated.Monitor Closely (1)ziprasidone and amoxapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amoxapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.anagrelideSerious - Use Alternative (1)anagrelide and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.anticholinergic/sedative combosMonitor Closely (3)anticholinergic/sedative combos decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. anticholinergic/sedative combos decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.apomorphineSerious - Use Alternative (2)ziprasidone decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug. apomorphine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.aprepitantMinor (1)aprepitant will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.arformoterolMonitor Closely (2)ziprasidone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. arformoterol and ziprasidone both increase QTc interval. Use Caution/Monitor.aripiprazoleMonitor Closely (2)aripiprazole and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. aripiprazole and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)aripiprazole and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.armodafinilMonitor Closely (1)ziprasidone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)armodafinil will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.arsenic trioxideContraindicated (1)arsenic trioxide and ziprasidone both increase QTc interval. Contraindicated.artemetherSerious - Use Alternative (1)artemether and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.artemether/lumefantrineSerious - Use Alternative (1)artemether/lumefantrine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)artemether/lumefantrine will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.asenapineMonitor Closely (1)asenapine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.asenapine transdermalMonitor Closely (1)asenapine transdermal and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.atazanavirMinor (1)atazanavir will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.atogepantMonitor Closely (1)ziprasidone will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.atomoxetineSerious - Use Alternative (1)atomoxetine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.atracuriumMonitor Closely (3)atracurium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atracurium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineMonitor Closely (3)atropine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMMonitor Closely (3)ziprasidone increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. atropine IV/IM decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. atropine IV/IM decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibMonitor Closely (2)ziprasidone will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. avapritinib and ziprasidone both increase sedation. Use Caution/Monitor.axitinibMonitor Closely (1)ziprasidone increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.azelastineMonitor Closely (1)azelastine and ziprasidone both increase sedation. Use Caution/Monitor.azithromycinMonitor Closely (1)azithromycin and ziprasidone both increase QTc interval. Use Caution/Monitor.baclofenMonitor Closely (1)baclofen and ziprasidone both increase sedation. Use Caution/Monitor.bedaquilineMonitor Closely (1)ziprasidone and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsMonitor Closely (3)belladonna alkaloids decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna alkaloids decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumMonitor Closely (4)belladonna and opium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. belladonna and opium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. belladonna and opium and ziprasidone both increase sedation. Use Caution/Monitor.benazeprilMonitor Closely (1)ziprasidone, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.benperidolMonitor Closely (2)benperidol and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. benperidol and ziprasidone both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/acetaminophen, ziprasidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.benzphetamineMonitor Closely (1)ziprasidone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.bosentanMinor (1)bosentan will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.bosutinibMonitor Closely (1)bosutinib and ziprasidone both increase QTc interval. Use Caution/Monitor.brexanoloneMonitor Closely (1)brexanolone, ziprasidone. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and ziprasidone both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)brimonidine increases effects of ziprasidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.brivaracetamMonitor Closely (1)brivaracetam and ziprasidone both increase sedation. Use Caution/Monitor.bromocriptineSerious - Use Alternative (1)ziprasidone decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.brompheniramineMonitor Closely (1)brompheniramine and ziprasidone both increase sedation. Use Caution/Monitor.budesonideMinor (1)budesonide will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.buprenorphineMonitor Closely (1)buprenorphine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)buprenorphine subdermal implant and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine subdermal implant and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine transdermalMonitor Closely (1)buprenorphine transdermal and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine transdermal and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine, long-acting injectionMonitor Closely (2)ziprasidone increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate. buprenorphine, long-acting injection and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine, long-acting injection and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.butabarbitalMonitor Closely (1)butabarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)butabarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.butalbitalMonitor Closely (1)butalbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)butalbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.butorphanolMonitor Closely (1)butorphanol and ziprasidone both increase sedation. Use Caution/Monitor.cabergolineSerious - Use Alternative (1)ziprasidone decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.caffeineMonitor Closely (1)ziprasidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)ziprasidone, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.capecitabineMonitor Closely (1)capecitabine and ziprasidone both increase QTc interval. Use Caution/Monitor.carbamazepineMonitor Closely (1)carbamazepine will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.carbinoxamineMonitor Closely (1)carbinoxamine and ziprasidone both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and ziprasidone both increase sedation. Use Caution/Monitor.cenobamateMonitor Closely (1)cenobamate, ziprasidone. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibSerious - Use Alternative (1)ceritinib and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.chasteberryMinor (1)chasteberry decreases effects of ziprasidone by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).chloral hydrateMonitor Closely (1)chloral hydrate and ziprasidone both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and ziprasidone both increase sedation. Use Caution/Monitor.chloroquineSerious - Use Alternative (1)chloroquine increases toxicity of ziprasidone by QTc interval. Avoid or Use Alternate Drug.chlorpheniramineMonitor Closely (1)chlorpheniramine and ziprasidone both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (2)chlorpromazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. chlorpromazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.chlorpropamideMonitor Closely (1)ziprasidone, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.chlorzoxazoneMonitor Closely (1)chlorzoxazone and ziprasidone both increase sedation. Use Caution/Monitor.cimetidineMonitor Closely (1)cimetidine will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and ziprasidone both increase sedation. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)ciprofloxacin and ziprasidone both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.cisatracuriumMonitor Closely (3)cisatracurium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cisatracurium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.citalopramContraindicated (1)ziprasidone and citalopram both increase QTc interval. Contraindicated.Serious - Use Alternative (1)citalopram and ziprasidone both increase QTc interval. Contraindicated.clarithromycinMonitor Closely (1)clarithromycin will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)clarithromycin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and ziprasidone both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (1)ziprasidone, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineMonitor Closely (1)ziprasidone and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.clonazepamMonitor Closely (1)clonazepam and ziprasidone both increase sedation. Use Caution/Monitor.clonidineMonitor Closely (1)clonidine, ziprasidone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateMonitor Closely (1)clorazepate and ziprasidone both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. clozapine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.codeineMonitor Closely (1)codeine and ziprasidone both increase sedation. Use Caution/Monitor.conivaptanMinor (1)conivaptan will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.cortisoneMinor (1)cortisone will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.crizotinibMonitor Closely (1)crizotinib and ziprasidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyclizineMonitor Closely (4)cyclizine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. cyclizine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.