Other drugs besides Ziprasidone which may affect the heart rhythm (QTc prolongation in the EKG) include dofetilide, pimozide, quinidine, sotalol, procainamide, and sparfloxacin among others. QTc prolongation can infrequently result in serious, rarely fatal, irregular heartbeats. Consult your doctor or pharmacist for details. Ask for instructions about whether you need to stop any other QTc-prolonging drugs you may be using in order to minimize the risk of this effect. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription products you may use, especially of: a diuretic (water pill), blood pressure medicine, or heart rhythm medicine; carbamazepine (Carbatrol, Tegretol); cisapride (Propulsid); haloperidol (Haldol); narcotic pain medication; medicines used to treat Parkinson's Disease such as levodopa (Dopar, Larodopa, Sinemet, Atamet, others); or antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), ketoconazole (Nizoral), telithromycin (Ketek); anti-Parkinson drugs (e.g., pramipexole, ropinirole), azole antifungals (e.g., ketoconazole, itraconazole), certain blood pressure medications (e.g., beta-blockers such as metoprolol or propranolol, "water pills" or diuretics such as furosemide or hydrochlorothiazide, or alpha-blockers such as doxazosin or prazosin).
Tell your doctor or pharmacist if you take drugs that cause drowsiness, including: anti-anxiety drugs (e.g., diazepam), antihistamines that cause drowsiness (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep (e.g., sedatives), muscle relaxants, narcotic pain relievers (e.g., codeine), other psychiatric medicines (e.g., phenothiazines such as chlorpromazine, or tricyclics such as amitriptyline), tranquilizers. Check the labels on all your medicine (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Do not start or stop any medicine without doctor or pharmacist approval.
Ziprasidone should never be taken together with any of the following drugs, or a life-threatening heart rhythm disorder could occur:
arsenic trioxide (Trisenox); dolasetron (Anzemet); droperidol (Inapsine); halofantrine (Halfan); mefloquine (Lariam);
levomethadyl acetate (no longer available in the U.S.); tacrolimus (Prograf); antibiotics such as gatifloxacin (Tequin), pentamidine (NebuPent, Pentam), moxifloxacin (Avelox), sparfloxacin (Zagam), telithromycin (Ketek); heart rhythm medicine such as dofetilide (Tikosyn), disopyramide (Norpace), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace); or medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril).
This list is not complete and there may be other drugs that can interact with Ziprasidone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.