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Ziprasidone

Pronunciation

Generic Name: ziprasidone (zi-PRAS-i-done)
Brand Name: Geodon

Ziprasidone is an atypical antipsychotic. It may increase the risk of death when used to treat mental problems caused by dementia in elderly patients. Most of the deaths were linked to heart problems or infection. Ziprasidone is not approved to treat mental problems caused by dementia. Discuss any questions or concerns with your doctor.


Ziprasidone is used for:

Treating acute agitation in patients with schizophrenia who require an injectable medicine. It may also be used for other conditions as determined by your doctor.

Ziprasidone is an antipsychotic. It may work by altering the balance of certain chemicals that occur naturally in the brain, which are responsible for thinking and behavior.

Do NOT use ziprasidone if:

  • you are allergic to any ingredient in ziprasidone
  • you have recently had a heart attack, have severe heart failure, or have a history of certain types of irregular heartbeat (eg, long QT syndrome)
  • you are taking astemizole, cisapride, dofetilide, droperidol, halofantrine, levomethadyl, a macrolide immunosuppressive (eg, tacrolimus), mefloquine, methadone, nilotinib, pentamidine, certain phenothiazines (eg, thioridazine), pimozide, probucol, procainamide, quinidine, certain quinolone antibiotics (eg, moxifloxacin), a serotonin receptor antagonist antiemetic (eg, dolasetron), sotalol, sparfloxacin, terfenadine, or tetrabenazine

Contact your doctor or health care provider right away if any of these apply to you.

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Before using ziprasidone:

Some medical conditions may interact with ziprasidone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have considered or attempted suicide
  • if you have had any problems with fainting or dizziness
  • if you have a history of heart problems (eg, heart failure, slow or irregular heartbeat), low blood potassium or magnesium levels, low blood volume, low white blood cell counts, a drug-induced movement disorder, diabetes, kidney or liver problems, stroke, heart attack, low blood pressure, seizures, difficulty swallowing, neuroleptic malignant syndrome (NMS), Alzheimer disease, or dementia
  • if you have diabetes or a family history of diabetes or if you are very overweight
  • if you have had high blood prolactin levels or a history of certain types of cancer (eg, breast, pancreas, pituitary), or if you are at risk for breast cancer
  • if you are dehydrated, drink alcohol, or will be exposed to high temperatures

Some MEDICINES MAY INTERACT with ziprasidone. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Arsenic, astemizole, bepridil, chloroquine, cisapride, class III antiarrhythmics (eg, amiodarone, sotalol), dofetilide, domperidone, droperidol, halofantrine, haloperidol, IA and IC antiarrhythmics (eg, flecainide, procainamide, propafenone, quinidine), kinase inhibitors (eg, lapatinib, nilotinib), levomethadyl , macrolide immunosuppressives (eg, tacrolimus), macrolides and ketolides (eg, azithromycin, erythromycin), maprotiline, mefloquine, methadone, pentamidine, phenothiazines (eg, thioridazine), pimozide, probucol, quinolones (eg, ciprofloxacin, moxifloxacin), serotonin receptor antagonist antiemetics (eg, dolasetron), sparfloxacin, streptogramins (eg, mitomycin, pristinamycin), terfenadine, or tetrabenazine because the risk of side effects such as abnormal heart rhythms may be increased
  • Tramadol because the risk of seizures may be increased
  • Ketoconazole because it may increase the risk of ziprasidone's side effects
  • Carbamazepine because it may decrease ziprasidone's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if ziprasidone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use ziprasidone:

Use ziprasidone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Ziprasidone is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using ziprasidone at home, a health care provider will teach you how to use it. Be sure you understand how to use ziprasidone. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Do not use ziprasidone if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • If you miss a dose of ziprasidone, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use ziprasidone.

Important safety information:

  • Ziprasidone may cause drowsiness, dizziness, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use ziprasidone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using ziprasidone; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Ziprasidone may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not become overheated in hot weather or while you are being active; heatstroke may occur.
  • Ziprasidone may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
  • Ziprasidone is intended for short-term control of acute agitation symptoms. If you require continuous treatment for your condition, your doctor may switch you to an oral medicine.
  • Ziprasidone may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Ziprasidone may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
  • Diabetes patients - Ziprasidone may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Serotonin syndrome is a possibly fatal syndrome that can be caused by ziprasidone. Your risk may be greater if you take ziprasidone with certain other medicines (eg, "triptans," monoamine oxidase inhibitors [MAOIs]). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if you have any of these symptoms.
  • NMS is a possibly fatal syndrome that can be caused by ziprasidone. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.
  • Ziprasidone may increase the amount of a certain hormone (prolactin) in your blood. Symptoms may include enlarged breast, missed menstrual period, decreased sexual ability, or nipple discharge. Contact your doctor right away if you experience any of these symptoms.
  • Some patients who take ziprasidone may develop muscle movements that they cannot control. This is more likely to happen in elderly patients, especially women. The chance that this will happen or that it will become permanent is greater in those who take ziprasidone in higher doses or for a long time. Muscle problems may also occur after short-term treatment with low doses. Tell your doctor at once if you have muscle problems with your arms; legs; or your tongue, face, mouth, or jaw (eg, tongue sticking out, puffing of cheeks, mouth puckering, chewing movements) while taking ziprasidone.
  • Lab tests, including electrolyte levels, complete blood cell counts (CBC), or fasting blood sugar levels, may be performed while you use ziprasidone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use ziprasidone with caution in the ELDERLY; they may be more sensitive to its effects, especially dizziness and lightheadedness upon sitting or standing up and uncontrolled muscle movements.
  • Ziprasidone should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking ziprasidone while you are pregnant. Using ziprasidone during the third trimester may result in uncontrolled muscle movements or withdrawal symptoms in the newborn. Discuss any questions or concerns with your doctor. It is not known if ziprasidone is found in breast milk. Do not breast-feed while taking ziprasidone.

Possible side effects of ziprasidone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Anxiety; constipation; diarrhea; dizziness; drowsiness; dry mouth; feeling unusually tired or sleepy; headache; increased cough or runny nose; loss of appetite; nausea; pain at the injection site; restlessness; upset stomach; vomiting; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); abnormal thoughts; change in amount of urine produced; confusion; decreased sexual ability; difficulty speaking or swallowing; enlarged breasts; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; inability to move; missed menstrual period; muscle rigidity; muscle spasms or twitching; nipple discharge; pounding in the chest; prolonged or painful erection; seizures; shortness of breath; suicidal thoughts or attempts; sweating; symptoms of high blood sugar (increased thirst, increased urination, confusion, flushing, rapid breathing, or fruity breath odor); tremor; uncontrolled movements (eg, arm or leg movements, twitching of the face or tongue, jerking or twisting); unusual mood or mental changes; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; irregular heartbeat; seizure; slurring of speech; uncontrolled movement of the head and neck.

Proper storage of ziprasidone:

Ziprasidone is usually handled and stored by a health care provider. If you are using ziprasidone at home, store ziprasidone as directed by your pharmacist or health care provider. Keep ziprasidone, as well as needles and syringes, out of the reach of children and away from pets.

General information:

  • If you have any questions about ziprasidone, please talk with your doctor, pharmacist, or other health care provider.
  • Ziprasidone is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take ziprasidone or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about ziprasidone. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ziprasidone. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using ziprasidone.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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