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Ziprasidone (Intramuscular route)

Pronunciation:

zi-PRAS-i-done

Brand Names:

  • Geodon

Dosage Forms:

  • Powder for Solution

Warnings:

Intramuscular route(Powder for Solution)

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death compared with placebo. Although the causes of death in clinical trials were varied, most of the deaths appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that antipsychotic drugs may increase mortality. It is unclear from these studies to what extent the mortality findings may be attributed to the antipsychotic drug as opposed to patient characteristics. Ziprasidone mesylate is not approved for the treatment of patients with dementia-related psychosis .

Classifications:

Therapeutic—

Antipsychotic

Chemical—

Benzisothiazoyl

Uses of This Medicine:

Ziprasidone injection is used to treat agitation that occurs with schizophrenia, a mental disorder. This medicine should not be used to treat behavioral problems in elderly patients who have dementia.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of ziprasidone injection in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ziprasidone injection in the elderly. However, this medicine should not be used for behavioral problems in older adults with dementia.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Acecainide
  • Ajmaline
  • Amifampridine
  • Amiodarone
  • Amisulpride
  • Aprindine
  • Arsenic Trioxide
  • Artemether
  • Astemizole
  • Azimilide
  • Bepridil
  • Bretylium
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Cisapride
  • Citalopram
  • Clarithromycin
  • Clozapine
  • Crizotinib
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Dronedarone
  • Droperidol
  • Enflurane
  • Erythromycin
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Foscarnet
  • Gatifloxacin
  • Gemifloxacin
  • Halofantrine
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Isoflurane
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Levomethadyl
  • Lidoflazine
  • Lorcainide
  • Lumefantrine
  • Mefloquine
  • Mesoridazine
  • Methadone
  • Metoclopramide
  • Moxifloxacin
  • Nilotinib
  • Octreotide
  • Ondansetron
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Pimozide
  • Piperaquine
  • Pirmenol
  • Posaconazole
  • Prajmaline
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Quetiapine
  • Quinidine
  • Saquinavir
  • Sematilide
  • Sertindole
  • Sorafenib
  • Sotalol
  • Sparfloxacin
  • Spiramycin
  • Sultopride
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Terfenadine
  • Thioridazine
  • Tizanidine
  • Toremifene
  • Trifluoperazine
  • Vandetanib
  • Vasopressin
  • Vemurafenib
  • Vilanterol
  • Vinflunine
  • Zolmitriptan
  • Zotepine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Ajmaline
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Apomorphine
  • Arsenic Trioxide
  • Asenapine
  • Azithromycin
  • Chlorpromazine
  • Ciprofloxacin
  • Clomipramine
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Desipramine
  • Disopyramide
  • Doxepin
  • Eslicarbazepine Acetate
  • Fingolimod
  • Formoterol
  • Granisetron
  • Haloperidol
  • Hydromorphone
  • Hydroquinidine
  • Iloperidone
  • Imipramine
  • Lapatinib
  • Levofloxacin
  • Lopinavir
  • Mifepristone
  • Milnacipran
  • Mitotane
  • Norfloxacin
  • Nortriptyline
  • Ofloxacin
  • Paliperidone
  • Perflutren Lipid Microsphere
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Protriptyline
  • Quinine
  • Ranolazine
  • Salmeterol
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sunitinib
  • Telavancin
  • Tetrabenazine
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Vardenafil
  • Voriconazole

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Carbamazepine

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alzheimer's disease or dementia or
  • Bradycardia (slow heartbeat) or
  • Dehydration or
  • Heart attack, history of or
  • Heart failure or
  • Heart or blood vessel disease or
  • Hypokalemia (low potassium in the blood) or
  • Hypomagnesemia (low magnesium in the blood) or
  • Hypotension (low blood pressure) or
  • Hypovolemia (low amount of blood) or
  • Stroke, history of or
  • Trouble with swallowing—May cause side effects to become worse.
  • Blood or bone marrow problems (e.g., agranulocytosis, leukopenia, neutropenia) or
  • Breast cancer, prolactin-dependent or
  • Diabetes mellitus or
  • Hyperglycemia (high blood sugar) or
  • Hyperprolactinemia (high prolactin in the blood) or
  • Neuroleptic malignant syndrome (NMS), history of or
  • Priapism (painful or prolonged erection of the penis) or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Heart attack, recent or
  • Heart failure, uncompensated or
  • Heart rhythm problems (e.g., arrhythmia, QT prolongation), history of—Should not be used in patients with these conditions.
  • Kidney disease—Use with caution. Higher blood levels of ziprasidone injection may occur, increasing the chance of side effects.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine. This medicine is given as a shot into one of your muscles.

Your doctor will give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine can cause changes in the heart rhythm, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects. Call your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

Check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs while you are using this medicine.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

Ziprasidone injection can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection, or if you have a fever or chills, a cough or hoarseness, lower back or side pain, or painful or difficult urination.

If you develop a skin rash, hives, or any allergic reaction to this medicine, stop using the medicine and check with your doctor as soon as possible.

This medicine may cause some people to become drowsy or dizzy, or to have trouble with thinking or controlling body movements. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that requires you to be alert, well-coordinated, or able to think well.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

Avoid activities involving high temperature or humidity. This medicine may reduce your body's ability to adjust to the heat.

Ziprasidone injection may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies. If you or your caregiver notice any of these side effects, tell your doctor right away.

Avoid drinking alcohol while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
Chills
cold sweats
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
Less common
Anxiety
bleeding from rectum or bloody stools
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in personality
chest pain or discomfort
cough
diarrhea
difficulty with speaking
drooling
dry mouth
excessive muscle tone
feeling of warmth or heat
feeling that others are watching you or controlling your behavior
feeling that others can hear your thoughts
feeling, seeing, or hearing things that are not there
fever
flushing or redness of the skin, especially on the face and neck
general feeling of discomfort or illness
headache
hyperventilation
incremental or ratchet-like movement of the muscles
irregular heartbeats
irritability
joint pain
loss of appetite
loss of balance control
multiple swollen and inflamed skin lesions
muscle aches and pains
muscle discomfort
muscle tension or tightness
muscle trembling, jerking, or stiffness
nausea
nervousness
painful or prolonged erection of the penis
pounding in the ears
restlessness
rigid or stiff muscles
runny nose
severe mood or mental changes
shaking
shivering
shortness of breath
shuffling walk
slow or fast heartbeat
sore throat
stiffness of the limbs
sweating
trouble sleeping
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
unusual behavior
unusual tiredness or weakness
vomiting
Rare
Actions that are out of control
convulsions
difficulty with breathing
fainting
fast, pounding, or irregular heartbeat or pulse
high fever
high or low blood pressure
hives
itching
lip smacking or puckering
loss of bladder control
overactive reflexes
poor coordination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid or worm-like movements of the tongue
shivering
talking or acting with excitement you cannot control
trembling
twitching
unexpected or excess milk flow from the breasts
unusually pale skin
wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Pain at the site of injection
sleepiness or unusual drowsiness
Less common
Acid or sour stomach
back pain
belching
constipation
cramps
heartburn
heavy bleeding
inability to sit still
indigestion
need to keep moving
pain
runny nose
sleeplessness
sneezing
stomach discomfort, upset, or pain
stuffy nose
tooth disorder
unable to sleep
weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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