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Author: Admin | 2025-04-28
Fluconazole (Diflucan)+Increased risk of QTc prolongationAvoid useOlanzapine – divalproex (Depakote)Reduced olanzapine levelsMonitor patient, and adjust olanzapine dose as needed based on therapeutic responseRisperidone - divalproex (Depakote)Increased valproic acid and/or ammonium levelsMonitor valproic acid and ammonium levelsZiprasidone – erythromycin+Increased risk of QTc prolongationAvoid useAripiprazole – fluoxetine (Prozac)Increased levels of aripiprazoleHalf the dose of aripiprazole, unless using for adjunctive treatment of depressionIloperidone – fluoxetine (Prozac)Increased levels of iloperidone and increased risk of QTc prolongationAvoid useIf necessary, reduce iloperidone dose by halfClozapine – fluvoxamine (Luvox)Increased levels of clozapineReduce clozapine dose by ~ one thirdAripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone – hydrocodone (i.e. Lortab)May increase sedative effectsReduce hydrocodone dose ~25%Aripiprazole – ketoconazoleIncreased aripiprazole levels and risk of QTc prolongationHalf the dose of aripiprazoleIf used in addition to a CYP 2D6 inhibitor, reduce aripiprazole dose to one fourth of the usual doseRisperidone - ketoconazoleIncreased risperidone levels and risk of QTc prolongationAvoid useClozapine, iloperidone, ziprasidone – ketoconazole+Increased levels of antipsychotic and risk of QTc prolongationAvoid useOlanzapine - lorazepam (Ativan)Increased risk of cardiorespiratory depressionAvoid use of parenteral benzodiazepines and IM olanzapineZiprasidone – methadone+Increased risk of QTc prolongationAvoid useAripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone – metoclopramide (Reglan)+ Increased risk of extrapyramidal symptoms and neuroleptic malignant syndromeAvoid useZiprasidone – moxifloxacin (Avelox)+Increased risk of QTc prolongationAvoid useAripiprazole - nelfinavir (Viracept)Increased aripiprazole levels and risk of QTc prolongationHalf the dose of aripiprazoleIf used in addition to a CYP 2D6 inhibitor, reduce aripiprazole dose to one fourth of the usual doseClozapine, Iloperidone – nelfinavir
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