Caution/Monitor. ziprasidone increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.remimazolamMonitor Closely (1)remimazolam, ziprasidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.repaglinideMonitor Closely (1)ziprasidone, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.ribociclibSerious - Use Alternative (1)ribociclib and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.rifabutinMonitor Closely (1)rifabutin will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifampinMonitor Closely (1)rifampin will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rifapentineMinor (1)rifapentine will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rilpivirineMonitor Closely (1)rilpivirine increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.risperidoneMonitor Closely (3)risperidone and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely. risperidone and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. risperidone and ziprasidone both increase sedation. Use Caution/Monitor.ritonavirMinor (1)ritonavir will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.rocuroniumMonitor Closely (3)rocuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rocuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.romidepsinMonitor Closely (1)romidepsin and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely. Avoid using ziprasidone with other QTc prolonging agents.ropiniroleSerious - Use Alternative (1)ziprasidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.rosiglitazoneMonitor Closely (1)ziprasidone, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.rufinamideMinor (1)rufinamide will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinibMinor (1)ziprasidone will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)ziprasidone will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.safinamideSerious - Use Alternative (1)ziprasidone decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.sageMinor (1)ziprasidone and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (1)ziprasidone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.saquinavirContraindicated (1)ziprasidone increases toxicity of saquinavir by QTc interval. Contraindicated. Potential for serious and/or life threatening reactions such as cardiac arrhythmias.saxagliptinMonitor Closely (1)ziprasidone, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.scopolamineMonitor Closely (3)scopolamine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. scopolamine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.scullcapMonitor Closely (1)ziprasidone and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)secobarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.selegilineMonitor Closely (1)selegiline, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).selinexorSerious - Use Alternative (1)selinexor, ziprasidone. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.selpercatinibMonitor Closely (1)selpercatinib increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor.sertralineMonitor Closely (1)sertraline and ziprasidone both decrease QTc interval. Modify Therapy/Monitor Closely.sevofluraneSerious - Use Alternative (1)sevoflurane and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.shepherd's purseMonitor Closely (1)ziprasidone and shepherd's purse both increase sedation. Use Caution/Monitor.siponimodSerious - Use Alternative (1)siponimod and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.sitagliptinMonitor Closely (1)ziprasidone, sitagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.sodium oxybateSerious - Use Alternative (1)ziprasidone, sodium oxybate. 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.sodium sulfate/?magnesium sulfate/potassium chlorideMonitor Closely (2)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. . sodium sulfate/?magnesium sulfate/potassium chloride increases effects of ziprasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.sodium sulfate/potassium sulfate/magnesium sulfateMonitor Closely (2)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of ziprasidone by QTc interval. Use Caution/Monitor. Consider predose and post-colonoscopy ECGs in patients at increased risk of serious cardiac arrhythmias. . sodium sulfate/potassium sulfate/magnesium sulfate increases effects of ziprasidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.solifenacinMonitor Closely (3)solifenacin decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Serious - Use Alternative (1)solifenacin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.sorafenibContraindicated (1)sorafenib and ziprasidone both increase QTc interval. Contraindicated.sotalolContraindicated (1)sotalol and ziprasidone both increase QTc interval. Contraindicated.St John's WortMonitor Closely (1)St John's Wort will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.stiripentolMonitor Closely (1)stiripentol, ziprasidone. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilMonitor Closely (1)sufentanil and ziprasidone both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, ziprasidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. 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.sulfamethoxazoleMonitor Closely (1)sulfamethoxazole and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.sumatriptanMonitor Closely (1)sumatriptan, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).sumatriptan intranasalMonitor Closely (1)sumatriptan intranasal, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).sunitinibSerious - Use Alternative (1)sunitinib and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.tacrolimusSerious - Use Alternative (1)tacrolimus and ziprasidone both increase QTc interval. Contraindicated.tapentadolMonitor Closely (1)tapentadol and ziprasidone both increase sedation. Use Caution/Monitor.tazemetostatMonitor Closely (1)ziprasidone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.telavancinMonitor Closely (1)telavancin and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.temazepamMonitor Closely (1)temazepam and ziprasidone both increase sedation. Use Caution/Monitor.terbutalineMonitor Closely (1)ziprasidone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tetrabenazineMonitor Closely (1)ziprasidone and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)tetrabenazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.thioridazineMonitor Closely (2)thioridazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. thioridazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)thioridazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.thiothixeneMonitor Closely (2)thiothixene and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. thiothixene and ziprasidone both increase sedation. Use Caution/Monitor.tinidazoleMonitor Closely (1)ziprasidone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tiotropiumMonitor Closely (3)tiotropium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tiotropium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tolazamideMonitor Closely (1)ziprasidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.tolbutamideMonitor Closely (1)ziprasidone, tolbutamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.tolterodineMonitor Closely (3)tolterodine decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. tolterodine decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.topiramateMonitor Closely (1)ziprasidone and topiramate both increase sedation. Modify Therapy/Monitor Closely.Minor (1)topiramate will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.toremifeneContraindicated (1)ziprasidone and toremifene both increase QTc interval. Contraindicated. Concurrent use of ziprasidone with other agents that prolong QTc interval is contraindicated.tramadolMonitor Closely (1)tramadol and ziprasidone both increase sedation. Use Caution/Monitor.tranylcypromineMonitor Closely (1)tranylcypromine, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).trazodoneMonitor Closely (1)ziprasidone and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.triazolamMonitor Closely (1)triazolam and ziprasidone both increase sedation. Use Caution/Monitor.triclabendazoleMonitor Closely (1)triclabendazole and ziprasidone both increase QTc interval. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos and ziprasidone both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (2)trifluoperazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. trifluoperazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.trimethoprimMonitor Closely (1)trimethoprim and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.trimipramineMonitor Closely (1)ziprasidone and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.triprolidineMonitor Closely (1)triprolidine and ziprasidone both increase sedation. Use Caution/Monitor.triptorelinSerious - Use Alternative (1)triptorelin increases toxicity of ziprasidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.tropisetronMonitor Closely (1)tropisetron and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.trospium chlorideMonitor Closely (3)trospium chloride decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.umeclidinium bromide/vilanterol inhaledSerious - Use Alternative (1)ziprasidone increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vandetanibSerious - Use Alternative (1)ziprasidone, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a