Can you take Sodium phenylbutyrate / taurursodiol with Ziprasidone?
1 drug interaction and 59 additional warnings found for the following 2 drugs:
- sodium phenylbutyrate/taurursodiol
- ziprasidone
Drug interactions
Moderate drug interactions
Moderate:
ziprasidone taurursodiol
Applies to: ziprasidone and sodium phenylbutyrate / taurursodiol
Taurursodiol may alter the blood levels and effects of ziprasidone. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Contact your doctor if your condition changes or you experience increased side effects. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
sodium phenylbutyrate Food/Lifestyle
Applies to: sodium phenylbutyrate / taurursodiol
Food may affect the absorption of sodium phenylbutyrate. A high-fat, high-calorie meal (approximately 800 to 1000 calories; 500 to 600 calories from fat, 250 calories from carbohydrate, 150 calories from protein) has been shown to reduce the absorption of sodium phenylbutyrate, although it is unknown what impact this may have on the overall effectiveness of the medication. The manufacturer recommends taking sodium phenylbutyrate before a meal or snack. This is especially important if you weigh less than 70 kg (approximately 154 pounds). Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.
Moderate:
ziprasidone Food/Lifestyle
Applies to: ziprasidone
Alcohol can increase the nervous system side effects of ziprasidone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with ziprasidone. Do not use more than the recommended dose of ziprasidone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Disease interactions
57 potential interactions Applies to: 49 conditions, including High Cholesterol, Depression, Bipolar Disorder, Weight Loss, and Heart Failure.
Abnormal Electrocardiogram
Major:
ziprasidone
Ziprasidone has a major potential interaction with Abnormal Electrocardiogram.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Alcoholism
Major:
ziprasidone
Ziprasidone has a major potential interaction with Alcoholism.
The use of neuroleptic agents is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of neuroleptic agents may be additive with those of alcohol. Severe respiratory depression and respiratory arrest may occur. Therapy with neuroleptic agents should be administered cautiously in patients who might be prone to acute alcohol intake.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Alcoholism.
Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.
Altered Consciousness
Major:
ziprasidone
Ziprasidone has a major potential interaction with Altered Consciousness.
The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.
Arrhythmia
Major:
ziprasidone
Ziprasidone has a major potential interaction with Arrhythmia.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Arrhythmia.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Biliary Obstruction
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Biliary Obstruction.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Bipolar Disorder
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Bipolar Disorder.
Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset.
Breast Cancer
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Breast Cancer.
The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.
Central Nervous System Disorders
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Central Nervous System Disorders.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Cerebrovascular Insufficiency
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Cerebrovascular Insufficiency.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Dehydration
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Dehydration.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Dementia
Major:
ziprasidone
Ziprasidone has a major potential interaction with Dementia.
Antipsychotic drugs are not approved for the treatment of patients with dementia-related psychosis. Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo.
Depression
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Depression.
Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset.
Diabetes Mellitus
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Diabetes Mellitus.
Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported with the use of atypical antipsychotic agents. Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. It is recommended that patients with risk factors for diabetes mellitus starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment, and periodically thereafter. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when treatment with these agents was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the atypical antipsychotic drug.
Diarrhea
Major:
ziprasidone
Ziprasidone has a major potential interaction with Diarrhea.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Diarrhea.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Dysphagia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Dysphagia.
Esophageal dysmotility and aspiration have been associated with the use of antipsychotic drugs. These drugs should be administered cautiously in patients at risk for aspiration pneumonia.
Electrolyte Abnormalities
Major:
ziprasidone
Ziprasidone has a major potential interaction with Electrolyte Abnormalities.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Fluid Retention
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Fluid Retention.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Gallbladder Disease
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Gallbladder Disease.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Head Injury
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Head Injury.
Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.
Heart Attack
Major:
ziprasidone
Ziprasidone has a major potential interaction with Heart Attack.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Heart Failure
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Heart Failure.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Major:
ziprasidone
Ziprasidone has a major potential interaction with Heart Failure.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Heart Failure.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
High Cholesterol
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with High Cholesterol.
Atypical antipsychotic drugs have been associated with undesirable alterations in lipid levels. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. Before or soon after initiation of antipsychotic medications, a fasting lipid profile should be obtained at baseline and monitored periodically during treatment.
History - Myocardial Infarction
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with History - Myocardial Infarction.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Hyperprolactinemia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Hyperprolactinemia.
The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.
Hypokalemia
Major:
ziprasidone
Ziprasidone has a major potential interaction with Hypokalemia.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Hypotension
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Hypotension.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Ischemic Heart Disease
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Ischemic Heart Disease.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Leukemia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Leukemia.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Liver Disease
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Liver Disease.
Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Liver Disease.
Most neuroleptic agents are extensively metabolized by the liver. The plasma concentrations of these agents may be increased and the half-lives prolonged in patients with impaired hepatic function. Therapy with neuroleptic agents should be administered cautiously in patients with significant liver disease. Lower initial dosages and slower titration may be appropriate.
Magnesium Imbalance
Major:
ziprasidone
Ziprasidone has a major potential interaction with Magnesium Imbalance.
The use of ziprasidone is contraindicated in patients with congenital or acquired QT interval prolongation syndromes, recent acute myocardial infarction, uncompensated heart failure, or a history of cardiac arrhythmias. Ziprasidone can prolong the QT interval of the electrocardiogram in a dose-related manner. The risk of torsade de pointes is progressively increased as the degree of prolongation becomes greater. In clinical trials, ziprasidone increased the QTc interval by approximately 10 msec at the highest recommended daily dosage of 160 mg compared to placebo. The manufacturer states that ziprasidone should be discontinued in patients with persistent QTc measurements greater than 500 msec.
Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of ziprasidone on the QT interval and should be corrected prior to institution of ziprasidone therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with ziprasidone.
Malabsorption Syndrome
Moderate:
sodium phenylbutyrate / taurursodiol
The taurursodiol in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Malabsorption Syndrome.
Sodium phenylbutyrate-taurursodiol contains taurursodiol, a bile acid. In patients with disorders that interfere with bile acid circulation, there may be an increased risk for diarrhea and patients should be monitored appropriately. Other conditions such as pancreatic insufficiency, intestinal malabsorption, or intestinal diseases that may alter the concentration of bile acids, may also lead to decreased absorption of this drug and its components. Consider consulting with a GI specialists with experience managing these GI disorders. Patients with disorders of enterohepatic circulation (e.g., biliary infection, active cholecystitis, etc.), severe pancreatic disorders (e.g., pancreatitis), and intestinal disorders that may alter concentrations of bile acids (e.g., ileal resection, regional ileitis, etc.) were excluded from clinical studies and there is no experience in patients with these conditions. Caution is advised.
Multiple Myeloma
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Multiple Myeloma.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Myoneural Disorder
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Myoneural Disorder.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Neuroleptic Malignant Syndrome
Major:
ziprasidone
Ziprasidone has a major potential interaction with Neuroleptic Malignant Syndrome.
The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.
Neutropenia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Neutropenia.
Cases of leukopenia, neutropenia, and agranulocytosis have been reported with the use of atypical antipsychotic agents. Patients with preexisting low white blood cell count may be at increased risk. Therapy with these agents should be administered cautiously in patients with a history of, or predisposition to, decreased white blood cell or neutrophil counts. Clinical monitoring of hematopoietic function is recommended. At the first sign of a clinically significant decline in white blood cells, discontinuation of atypical antipsychotic therapy should be considered in the absence of other causative factors, and the patient closely monitored for fever or other signs and symptoms of infection.
Parkinsonism
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Parkinsonism.
The use of neuroleptic agents is associated with pseudo-parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill-rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually 1 to 2 weeks following initiation of therapy or an increase in dosage. Older neuroleptic agents such as haloperidol are more likely to induce these effects, and their use may be contraindicated in patients with Parkinson's disease or parkinsonian symptoms.
Penis Disorders
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Penis Disorders.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Peripheral Neuropathy
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Peripheral Neuropathy.
Sodium phenylbutyrate is a pro-drug and is rapidly metabolized to the active, phenylacetate. Neurotoxicity, including exacerbation of a preexisting neuropathy, has been reported with the use of intravenous phenylacetate. The acute onset and reversibility when the phenylacetate infusion was discontinued suggested a drug effect. Care should be exercised when prescribing sodium phenylbutyrate to patients at risk for neurotoxicity.
Peyronie Disease
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Peyronie Disease.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Priapism
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Priapism.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Renal Dysfunction
Major:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a major potential interaction with Renal Dysfunction.
The use of sodium phenylbutyrate may cause fluid retention in patients with congestive heart failure, renal dysfunction, or sodium retention with edema. Sodium phenylbutyrate is primarily excreted by the kidney and these patients may exhibit reduced excretion. Therapy with sodium phenylbutyrate should be administered cautiously in these patients. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Moderate:
sodium phenylbutyrate / taurursodiol
The sodium phenylbutyrate in sodium phenylbutyrate / taurursodiol has a moderate potential interaction with Renal Dysfunction.
Sodium phenylbutyrate is primarily metabolized in the liver and kidney. Therapy with sodium phenylbutyrate should be administered cautiously in patients with liver disease. Monitoring plasma levels of ammonia, arginine, branched-chain amino acids and serum proteins to maintain within normal limits and glutamine to less than 1000 mcmol/L is recommended.
Respiratory Arrest
Major:
ziprasidone
Ziprasidone has a major potential interaction with Respiratory Arrest.
The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.
Seizures
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Seizures.
Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.
Sickle Cell Anemia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Sickle Cell Anemia.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Syncope
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Syncope.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Tardive Dyskinesia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Tardive Dyskinesia.
Tardive dyskinesia (TD) has occurred in patients treated with antipsychotic drugs; the syndrome consists of potentially irreversible, involuntary, dyskinetic movements. The risk appears highest in older patients (particularly older women) but it is not possible to predict which patients are likely to develop TD; whether antipsychotic drugs differ in their potential to cause TD is unknown. The risk of TD and the likelihood that it will become irreversible increase with the duration of therapy and the total cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low dosages; it may also occur after discontinuation of therapy. TD may remit (partially or completely) upon discontinuation of antipsychotic therapy, although antipsychotic therapy itself may suppress (or partially suppress) signs/symptoms of TD, possibly masking the underlying process; the effect of symptomatic suppression on the long-term course of TD is unknown. In patients with preexisting drug-induced TD, initiating or increasing the dosage of antipsychotic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. In patients requiring chronic therapy, the lowest dose and shortest duration of therapy producing a satisfactory clinical response are recommended; the need for continued therapy should be reassessed periodically. If signs/symptoms of TD occur during antipsychotic therapy, discontinuation of the offending agent should be considered; however, some patients may require treatment despite the presence of TD.
Thalassemia
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Thalassemia.
Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.
Vomiting
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Vomiting.
The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.
Weight Loss
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Weight Loss.
Weight gain has been observed with atypical antipsychotic use. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. When treating pediatric patients with atypical antipsychotic agents, weight gain should be monitored and assessed against that expected for normal growth. Monitor weight at baseline and frequently thereafter.
Moderate:
ziprasidone
Ziprasidone has a moderate potential interaction with Weight Loss.
Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported with the use of atypical antipsychotic agents. Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. It is recommended that patients with risk factors for diabetes mellitus starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment, and periodically thereafter. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when treatment with these agents was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the atypical antipsychotic drug.
More resources
sodium phenylbutyrate / taurursodiol
A total of 590 drugs are known to interact with sodium phenylbutyrate / taurursodiol.
- Sodium phenylbutyrate / taurursodiol is in the drug class miscellaneous central nervous system agents.
- Sodium phenylbutyrate / taurursodiol is used to treat Amyotrophic Lateral Sclerosis.
ziprasidone
A total of 756 drugs are known to interact with ziprasidone.
- Ziprasidone is in the drug class atypical antipsychotics.
-
Ziprasidone is used to treat the following conditions:
- Autism
- Bipolar Disorder
- Body Dysmorphic Disorder (off-label)
- Obsessive Compulsive Disorder (off-label)
- Paranoid Disorder (off-label)
- Schizoaffective Disorder
- Schizophrenia
- Tourette's Syndrome (off-label)
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
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