CYP3A4 metabolism. Minor/Significance Unknown.nifedipineMinor (1)nifedipine will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.nilotinibSerious - Use Alternative (1)nilotinib and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)nilotinib will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.norepinephrineMonitor Closely (1)ziprasidone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nortriptylineMonitor Closely (1)ziprasidone and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.octreotideSerious - Use Alternative (1)octreotide and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)Serious - Use Alternative (1)octreotide (Antidote) and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.ofloxacinMonitor Closely (1)ofloxacin and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (2)olanzapine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. olanzapine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.oliceridineMonitor Closely (1)oliceridine, ziprasidone. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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.olodaterol inhaledMonitor Closely (1)ziprasidone and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasolopatadine intranasalSerious - Use Alternative (1)ziprasidone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. onabotulinumtoxinAMonitor Closely (3)onabotulinumtoxinA decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. onabotulinumtoxinA decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.ondansetronSerious - Use Alternative (1)ziprasidone and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.opium tinctureMonitor Closely (1)opium tincture and ziprasidone both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)orphenadrine and ziprasidone both increase sedation. Use Caution/Monitor.osilodrostatMonitor Closely (1)osilodrostat and ziprasidone both increase QTc interval. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and ziprasidone both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaliplatinMonitor Closely (1)oxaliplatin will increase the level or effect of ziprasidone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.Serious - Use Alternative (1)oxaliplatin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.oxazepamMonitor Closely (1)oxazepam and ziprasidone both increase sedation. Use Caution/Monitor.oxcarbazepineMinor (1)oxcarbazepine will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.oxybutyninMonitor Closely (3)oxybutynin decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin topicalMonitor Closely (3)oxybutynin topical decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxybutynin transdermalMonitor Closely (3)oxybutynin transdermal decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.oxycodoneMonitor Closely (1)oxycodone and ziprasidone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone and ziprasidone both increase sedation. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidoneMonitor Closely (3)paliperidone and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. paliperidone and ziprasidone both increase sedation. Use Caution/Monitor.pancuroniumMonitor Closely (3)pancuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pancuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.panobinostatSerious - Use Alternative (1)ziprasidone and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.papaveretumMonitor Closely (1)papaveretum and ziprasidone both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)ziprasidone and papaverine both increase sedation. Use Caution/Monitor.paroxetineMonitor Closely (2)paroxetine, 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). paroxetine and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.pasireotideMonitor Closely (1)ziprasidone and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibMonitor Closely (1)pazopanib and ziprasidone both increase QTc interval. Use Caution/Monitor.pentamidineContraindicated (1)pentamidine and ziprasidone both increase QTc interval. Contraindicated.pentazocineMonitor Closely (1)pentazocine and ziprasidone both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.perphenazineMonitor Closely (2)perphenazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. perphenazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)perphenazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.phendimetrazineMonitor Closely (1)ziprasidone increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenelzineMonitor Closely (1)phenelzine, 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).phenobarbitalMonitor Closely (1)phenobarbital and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)phenobarbital will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.phentermineMonitor Closely (1)ziprasidone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrineMonitor Closely (1)ziprasidone increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine POMonitor Closely (1)ziprasidone increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .phenytoinMinor (1)phenytoin will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.pholcodineMonitor Closely (1)ziprasidone and pholcodine both increase sedation. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)pimavanserin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.pimozideContraindicated (1)pimozide and ziprasidone both increase QTc interval. Contraindicated.Monitor Closely (2)pimozide and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. pimozide and ziprasidone both increase sedation. Use Caution/Monitor.pioglitazoneMonitor Closely (1)ziprasidone, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.pirbuterolMonitor Closely (1)ziprasidone increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pitolisantSerious - Use Alternative (1)ziprasidone and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.ponesimodSerious - Use Alternative (1)ponesimod, ziprasidone. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Consult cardiologist if considering treatment. Generally, should not be initiated in patients who are concurrently taking QT prolonging drugs with known arrhythmogenic properties, such as HR-lowering calcium channel blockers (eg, verapamil, diltiazem).posaconazoleMonitor Closely (1)posaconazole and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)posaconazole will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.pralidoximeMonitor Closely (3)pralidoxime decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. pralidoxime decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pramipexoleSerious - Use Alternative (1)ziprasidone decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.pramlintideMonitor Closely (1)ziprasidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.prednisoneMinor (1)prednisone will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.primaquineSerious - Use Alternative (1)primaquine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.primidoneMonitor Closely (1)primidone and ziprasidone both increase sedation. Use Caution/Monitor.Minor (1)primidone will decrease the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.procainamideContraindicated (1)procainamide and ziprasidone both increase QTc interval. Contraindicated.procarbazineMonitor Closely (1)procarbazine, 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).prochlorperazineMonitor Closely (2)prochlorperazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. prochlorperazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)prochlorperazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.promazineSerious - Use Alternative (1)promazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.promethazineMonitor Closely (3)promethazine, 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). promethazine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. promethazine and ziprasidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)promethazine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.propanthelineMonitor Closely (3)propantheline decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. propantheline decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propofolMonitor Closely (1)propofol and ziprasidone both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (1)ziprasidone increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)ziprasidone and protriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.quazepamMonitor Closely (1)quazepam and ziprasidone both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (3)quetiapine and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. quetiapine and ziprasidone both increase sedation. Use Caution/Monitor. quetiapine, ziprasidone. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.quinidineContraindicated (1)quinidine and ziprasidone both increase QTc interval. Contraindicated.quinineMonitor Closely (1)ziprasidone and quinine both increase QTc interval. Use Caution/Monitor.quinupristin/dalfopristinMinor (1)quinupristin/dalfopristin will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ramelteonMonitor Closely (1)ziprasidone and ramelteon both increase sedation. Use Caution/Monitor.ranolazineMonitor Closely (1)ranolazine and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.rapacuroniumMonitor Closely (3)rapacuronium decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. rapacuronium decreases levels of ziprasidone by pharmacodynamic antagonism. Use