Risperidone and Ziprasidone interaction

Risperidone and Ziprasidone: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Ziprasidone (Geodon) label · effective 2025-01-13

Major

Cerebrovascular Adverse Reactions, Including Stroke, in Elderly Patients with Dementia-Related Psychosis In placebo-controlled trials in elderly subjects with dementia, patients randomized to risperidone, aripiprazole, and olanzapine had a higher incidence of stroke and transient ischemic attack, including fatal stroke.

Warnings and precautionsnames RisperidoneView label on DailyMed
Major

…drugs, ziprasidone is contraindicated: • in patients with a known history of QT prolongation (including congenital long QT syndrome) • in patients with recent acute myocardial infarction • in patients with uncompensated heart failure Pharmacokinetic/pharmacodynamic studies between ziprasidone and other drugs that prolong the QT interval have not been performed.

Contraindicationsby drug classView label on DailyMed
Major

An additive effect of ziprasidone and other drugs that prolong the QT interval cannot be excluded.

Contraindicationsby drug classView label on DailyMed
Major

QT Prolongation and Risk of Sudden Death Ziprasidone use should be avoided in combination with other drugs that are known to prolong the QTc interval [see Contraindications (4.1) and Drug Interactions (7.4) ] .

Warnings and precautionsby drug classView label on DailyMed
Major

As with other antipsychotic drugs and placebo, sudden unexplained deaths have been reported in patients taking ziprasidone at recommended doses.

Warnings and precautionsby drug classView label on DailyMed

From the Risperidone (RISPERDAL CONSTA) label · effective 2025-11-05

Moderate

RISPERDAL CONSTA and other antipsychotic drugs should be used cautiously in patients at risk for aspiration pneumonia. [see also Boxed Warning and Warnings and Precautions (5.1) ] 5.13 Priapism Priapism has been reported during postmarketing surveillance [see Adverse Reactions (6.2) ] .

Warnings and precautionsby drug classView label on DailyMed
Minor

Risperidone is associated with higher levels of prolactin elevation than other antipsychotic agents.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.