Classes
DEA Class; Rx
Common Brand Names; Geodon
- Antipsychotics, 2nd Generation;
- Antimanic Agents
Description
Used orally in adults for schizophrenia, as monotherapy for acute episodes of bipolar I disorder, and as an adjunct to lithium or valproate for maintenance treatment of bipolar I disorder; IM injection is used in adults for acute agitation due to schizophrenia
Has a potential for QT prolongation; as with all antipsychotics, boxed warning for increased mortality risk in elderly patients with dementia-related psychosis
Indications
Indicated for the treatment of schizophrenia.
Contraindications
Documented hypersensitivity
Any drugs or conditions that prolong QT interval
Recent acute myocardial infarction
Uncompensated heart failure
Adverse Effects
- Somnolence (11-15%)
- Headache (11%)
- Nausea (4-12%)
- Extrapyramidal symptoms (2-31%)
- Dizziness (3-16%)
- Respiratory disorders (1-8%)
- Constipation (2-9%)
- Dyspepsia (1-8%)
- Rash (4-5%)
- Tachycardia (2%)
- Hypoesthesia (2%)
- Priapism (1%)
- Orthostatic hypotension (5%)
- Xerostomia (1-5%)
- Anorexia (2%)
- Myalgia (2%)
- Rhinitis (1-4%)
- Cough (3%)
- Syncope
- Seizures
Warnings
Seizure disorders; may cause hypotension, EPS, somnolence, and sensory instability, which could lead to falls and, consequently, fractures or other injuries; for patients with diseases, conditions, or medications that could exacerbate these effects, complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy
Atypical antipsychotics have been associated with metabolic changes (eg, hyperglycemia, dyslipidemia, and body weight gain) that may increase cardiovascular/cerebrovascular risk
Hyperglycemia may occur and in some cases may be extreme, resulting in ketoacidosis, hyperosmolar coma, or death; monitor blood glucose of high-risk patients
Neuroleptic malignant syndrome reported with antipsychotic drugs
Tardive dyskinesia, acute dystonic reactions, pseudoparkinsonism, or akathisia may develop acutely or chronically
Discontinue if rash develops without an identified cause
Drug reaction with eosinophilia and systemic symptoms (DRESS) reported; DRESS consists of combination of three or more of the following: cutaneous reaction (such as rash or exfoliative dermatitis), eosinophilia, fever, lymphadenopathy and one or more systemic complications such as hepatitis, nephritis, pneumonitis, myocarditis, and pericarditis; DRESS is sometimes fatal; discontinue therapy if DRESS suspected
Pregnancy and Lactation
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to atypical antipsychotics.
Limited data from a published case report indicate the presence of drug in human milk
Maximum Dosage
160 mg/day PO or 40 mg/day IM.
160 mg/day PO. 40 mg/day IM is suggested from off-label use.
More than 16 years: 40 mg/day PO per Tourette’s off-label use. 20 mg/dose IM for acute agitation off-label use has been suggested.
13 to 16 years: 40 mg/day PO per Tourette’s off-label use. 10 mg/dose IM for acute agitation off-label use has been suggested.
12 years: 40 mg/day PO per Tourette’s off-label use. 10 mg/dose IM for acute agitation off-label use has been suggested.
7 to 11 years: 40 mg/day PO per Tourette’s off-label use. Safety and efficacy have not been established for IM dosing.
6 years or less: Safety and efficacy have not been established.
Not indicated.
How supplied
Ziprasidone hydrochloride; ziprasidone mesylate
capsule
- 20mg
- 40mg
- 60mg
- 80mg
powder for injection
- 20mg
