Monograph Details
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Central Nervous System
> Psychosis
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GEODON for INJECTION |
| Manufacturer |
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Pfizer Labs |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Serotonin and dopamine antagonist. |
| Generic Name |
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Ziprasidone (as mesylate) 20mg/mL; pwd for IM inj after reconstitution; preservative-free. |
| Also |
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• GEODON
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| Indications |
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Rapid control of acute agitation. |
| Children |
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Not recommended. |
| Adults |
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10–20mg IM as needed, max 40mg/day (10mg every 2 hours; or 20mg every 4 hours); usual max 3 days. Switch to oral form as soon as possible. |
| Contraindications |
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History of QT prolongation. Congenital long QT syndrome. Recent acute MI. Uncompensated heart failure. Concomitant drugs that cause QT prolongation, including dofetilide, sotalol, quinidine, other Class Ia and III antiarrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl, dolasetron, probucol, tacrolimus. |
| Precautions |
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Concomitant use of oral and IM forms: not recommended. Renal (IM form) or hepatic impairment (both forms). Discontinue if QTc >500 msec persists, neuroleptic malignant syndrome, or unexplained rash occurs; consider discontinuing if tardive dyskinesia occurs. Conditions that increase risk of torsade de pointes (eg, bradycardia, hypokalemia, hypomagnesemia). Monitor potassium, magnesium, others if risk of electrolyte disturbances (eg, diarrhea); correct imbalance before starting. Avoid in significant cardiovascular disease (eg, arrhythmias). Evaluate cardiac function if symptoms of torsade de pointes occur (eg, dizziness, palpitations, syncope). Cardio- or cerebrovascular disease. Diabetes. Risk of hypotension or seizures. History of breast cancer. Dysphagia. Exposure to extreme heat. Reevaluate periodically. Write Rx for smallest practical amount. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. May potentiate CNS drugs, antihypertensives. Antagonizes levodopa, dopamine agonists. Extent of absorption and/or plasma levels may be affected by CYP3A4 inducers (eg, carbamazepine) or inhibitors (eg, ketoconazole). Correct hypokalemia, hypomagnesemia due to diuretics. |
| Adverse Reactions |
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Somnolence, extrapyramidal syndrome, respiratory disorder, GI upset, rash, dystonia, tachycardia, myalgia, akathisia, asthenia, postural hypotension, QTc prolongation, headache, weight gain, inj site reactions; rare: priapism. |
| How Supplied |
Caps—60
Inj (single-use vials)—1 |
| Additional Resources |
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• Related Prescribing Note |
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