(Legend)

Generic Name

• Ziprasidone
  T½ = po 7h; IM 2–5 h
  Protein binding = 99%
  Pregnancy category B

Trade Name

• Geodon
• Zeldox

Dose Range/Adult Daily Dose

• Range: 40–160 mg/d
  Schizophrenia: Start: 20 mg po bid, up to 80 mg bid
  Mania: Start: 40 mg po bid, up to 80 mg bid; IM: 10–20 mg prn (up to 40 mg/d)

Use/Common Side Effects (CSE)

• Use: Schizophrenia, bipolar (manic and mixed), IM: acute agitation
  CSE: Dizziness, drowsiness, restlessness, nausea, constipation, diarrhea, PROLONGED QT INTERVAL, NMS; NEW: Serious: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) [rash, fever, swollen lymph nodes]. Seek urgent medical help.

Geriatric & Dose Considerations

• ↓Dose in elderly.
  Contraindicated: QT prolongation, Caution w CV/hepatic disease and CV drugs; >65 y; Alzheimer’s dementia. Risk of falls.
  Warning: ↑ mortality in elderly with dementia-related psychosis

Classification

• Antipsychotic [Atypical]/mood stabilizer

Assessment Cautions

• Persistent QTc measurements >500: D/C ziprasidone. Evaluate palpitations, syncope. Agents (pimozide) that prolong QT interval are contrainidicated. Avoid CNS depressants. Monitor BP, pulse, ECG, and for EPS, NMS, and TD; also BMI, FBS, lipids.