Ziprasidone and Relugolix: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ziprasidone
Relugolix
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Both ziprasidone (Geodon) and relugolix (Orgovyx) can affect the heart's electrical timing, something doctors call the QT interval. When two medicines that both do this are taken together, the effect can add up. In rare cases, a longer QT interval can lead to a dangerous, fast, or irregular heartbeat.
Because of this, combining these two is generally something doctors try to avoid. The good news is that your care team can manage this. If you have been prescribed both, don't stop either one on your own. Instead, reach out to your pharmacist or doctor so they can review your medicines and decide on the safest plan for you.
Effect: Additive QT-interval prolongation with increased risk of serious ventricular arrhythmias (including torsades de pointes).
Mechanism: Pharmacodynamic (additive), not metabolic. Both agents are associated with QT prolongation; neither is a prodrug, so direction is straightforward additive risk. Ziprasidone labeling contraindicates concomitant use with other QT-prolonging drugs.
Evidence: Theoretical/additive, but severity on file is contraindicated.
- Avoid coadministration where possible; consider an alternative agent.
- If unavoidable, obtain baseline and follow-up ECGs and correct electrolytes (K+, Mg2+).
- Watch for syncope, palpitations, dizziness.
What happens
An increased risk of QT interval prolongation
Interaction Deep Dive
Using ziprasidone together with medications known to prolong the QT interval is contraindicated, because combining them may heighten the likelihood of QT prolongation and dangerous ventricular arrhythmias12.
Why it happens (mechanism)
Additive QT interval prolongation
How to manage this interaction
Keep taking both medicines exactly as prescribed until you speak with your care team. This combination is flagged as one to avoid, so your prescriber will want to review it.
- Your care team may choose an alternative medicine for one of the two so they aren't taken together.
- If both are truly needed, they may monitor you more closely, including checking your heart tracing (ECG) and blood minerals like potassium and magnesium.
- Tell your doctor right away if you feel fainting, dizziness, palpitations, or an irregular heartbeat.
Bring an up-to-date medication list to your pharmacist or prescriber so they can tailor the safest plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ziprasidone and Relugolix together?
Ziprasidone and relugolix can each lengthen the QT interval, and together the risk of a dangerous heart rhythm adds up, so this pairing is generally avoided. Don't stop either drug on your own, but contact your pharmacist or doctor promptly to review safer options. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ziprasidone and Relugolix interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Ziprasidone and Relugolix interaction managed?
Keep taking both medicines exactly as prescribed until you speak with your care team. This combination is flagged as one to avoid, so your prescriber will want to review it. Your care team may choose an alternative medicine for one of the two so they aren't taken together. If both are truly needed, they may monitor you more closely, including checking your heart tracing (ECG) and blood minerals li… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Ziprasidone or Relugolix need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: GEODON(R) intramuscular injection, ziprasidone mesylate intramuscular injection. Viatris Specialty LLC(per FDA), Morgantown, WV, 2025.
- Product Information: GEODON(R) oral capsules, ziprasidone oral capsules. Viatris Specialty LLC(per FDA), Morgantown, WV, 2025. DailyMed
Keep reading about Ziprasidone
Keep reading about Relugolix
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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