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Geodon Fact Sheet

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Medication Name (brand): 
Geodon
Medication Name (clinical): 
ziprasidone
Manufacturer: 

Pfizer

Indications: 
  • Schizophrenia, both short-term and maintenance treatment.

  • Bipolar disorder, manic and mixed episodes.
  • IM version approved for treatment of acute agitation in patients with schizophrenia.

Mechanism: 

D2 and 5HT 2 receptor antagonist.

Dosing: 
  • Supplied in 20 mg, 40 mg, 60 mg, and 80 mg capsules (not breakable). Also available for acute agitation as an injectable in 20 mg/ml single-dose vials.

  • Start at 20 mg BID with food for 2-3 days, then increase to 80 mg BID. Can usually increase rather quickly to 60 mg or 80 mg BID.
  • Can probably go higher than the recommended daily maximum of 160 mg; there is good safety data for doses up to 320 mg/day.

Side Effects: 
  • BLACK BOX WARNING: All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo.

  • Most common are somnolence, dizziness, and akathisia. Treat akathisia with inderal 20 mg BID or nadolol 20-40 mg QD.
  • EPS: Low risk, but possible, especially at higher doses.
  • Weight gain: Very little, about 1 pound in short-term trials.
  • Glucose, lipids: Minimal to no effect.
  • EKG: Average increase in QTc greater than any other atypical although not much more than for Seroquel. Post-marketing surveillance has shown one or two instance of torsade possibly related to Geodon use.
  • Prolactin level: No effect.
  • Pregnancy Category C.

Drug-drug Interactions: 

The following drugs are contraindicated in combination with Geodon because they all cause QT widening: Psychiatric drugs: thioridazine (Mellaril), chlorpromazine (Thorazine), mesoridazine (Serentil), pimozide (Orap), droperidal. Others: arsenic trioxide, dofetilidine, dolasetron mesylate, gatifloxacin, halofantrine, levomethadyl acetate, mefloquine, moxifloxacin, pentamidine, probucol, quinidine, sotalol, sparfloxacin, and tacrolimus.

Pharmokinetics: 

Short half-life of 7 hours, leading to manufacturer’s recommendation of BID dosing, but in practice QD dosing is as effective.

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