Drug Interaction Report

MONITOR CLOSELY: Ziprasidone can cause dose-related prolongation of the QT interval. While clinical data are lacking, the coadministration of ziprasidone and agents that can produce hypokalemia and/or hypomagnesemia (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins) may result in elevated risk of ventricular arrhythmias, including ventricular tachycardia and torsade de pointes, because of additive arrhythmogenic potential.

MANAGEMENT: Caution is advised when ziprasidone must be used concomitantly with medications that can cause potassium and/or magnesium disturbances. Serum electrolytes should be monitored and any abnormalities corrected prior to initiating therapy with ziprasidone. Patients should be advised to notify their physician if they experience possible signs of an electrolyte imbalance, such as weakness, lethargy, drowsiness, confusion, muscle pains or cramps, dizziness, nausea, vomiting, tachycardia, or an irregular heartbeat.

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.