Drug Warnings: Before taking Zipratic, tell your doctor about any heart disease, family history of sudden cardiac death, low potassium or magnesium, fainting spells, stroke, seizure disorder, diabetes, high cholesterol, liver or kidney problems, or a history of neuroleptic malignant syndrome or tardive dyskinesia. Ziprasidone can prolong the QT interval in some people; your doctor may check an ECG and electrolytes, especially if you have cardiac risk or are on other medicines that affect heart rhythm. Zipratic is not approved for dementia-related psychosis and may increase mortality in elderly patients with this condition. Avoid alcohol and activities requiring full alertness until you know how you respond.
Drug–drug interactions: Zipratic should not be combined with strong QT-prolonging drugs such as certain antiarrhythmics (for example amiodarone, sotalol, quinidine), some macrolide or fluoroquinolone antibiotics, or other antipsychotics known to prolong QT. Medicines that affect liver enzymes may alter levels of ziprasidone; strong CYP3A4 inducers like carbamazepine can lower its effect, while potent inhibitors such as ketoconazole can increase exposure. Using Zipratic with benzodiazepines, opioids, sedating antihistamines, or alcohol can increase drowsiness and dizziness. Tell your doctor about all prescription and non-prescription medicines and herbal products, including antidepressants, as serotonergic combinations may rarely increase the risk of serotonin toxicity.
Drug–food interactions: Always take Zipratic with food; a substantial meal improves absorption and clinical effect. Limit alcohol because it adds to sedation and may impair judgment.
Drug–disease interactions: Use Zipratic with caution if you have cardiac conduction problems, a history of long QT, electrolyte disturbances, seizures, diabetes or risk of diabetes, Parkinson’s disease, or severe liver impairment. Report palpitations, syncope, persistent restlessness, uncontrolled movements, signs of high blood sugar, or fever with muscle stiffness without delay.
Storage and patient advice: Keep capsules in a cool, dry place away from direct light and out of children’s reach. Continue Zipratic exactly as prescribed even when you start to feel better, and keep regular follow-ups so your clinician can monitor response, weight, metabolic parameters, and, when indicated, ECG.