Indications
Ziprasidone is an antipsychotic medicine used to treat schizophrenia, a long-term mental illness that affects thinking, feelings and behaviour, and to treat manic or mixed episodes of bipolar disorder. It may also be used, together with a mood stabiliser, for long-term bipolar treatment. An injection form is used in hospital to calm severe agitation in schizophrenia.
How It Works
Ziprasidone changes the activity of natural brain chemicals, mainly dopamine and serotonin, by blocking some of their receptors. This helps reduce symptoms such as hallucinations, unusual beliefs, disorganised thinking and extreme mood highs.
Dosage and Administration
The dose is started low and adjusted by a psychiatrist or doctor for each person, so take it exactly as prescribed. Capsules are usually taken twice a day and must be swallowed whole with a proper meal, as food greatly increases how much is absorbed. Do not stop suddenly; your doctor will reduce the dose gradually if needed. The injection is given only by a doctor or nurse.
Interactions
Do not combine with other medicines that can affect heart rhythm (QT prolongation), such as Amiodarone, Sotalol, Quinidine, Moxifloxacin, Haloperidol, Thioridazine, Pimozide, Erythromycin or Methadone. Carbamazepine can lower its levels and Ketoconazole can raise them. Alcohol, sleeping pills, opioid painkillers and antihistamines may increase drowsiness. It may reduce the effect of Levodopa and other Parkinson’s medicines. Medicines that lower potassium or magnesium, such as some diuretics, can increase heart risks.
Contraindications
Do not use if you are allergic to Ziprasidone, have a known long QT interval or a history of certain heart rhythm problems, have had a recent heart attack, or have uncontrolled heart failure. It must not be taken with other QT-prolonging medicines.
Side Effects
Common side effects include:
- Drowsiness, dizziness or tiredness
- Restlessness or an urge to keep moving
- Stiffness, tremor or slow movements
- Nausea, indigestion, constipation, dry mouth
- Headache, blurred vision, runny nose
- Dizziness on standing up quickly
It can raise blood sugar and, less often, affect weight and blood fats. Rarely it causes uncontrolled movements of the face or body that may become long-lasting.
Get urgent medical help if you have fainting, a fast or irregular heartbeat, a high fever with stiff muscles, sweating and confusion, a widespread rash with fever or swollen glands, difficulty swallowing or breathing, a painful erection lasting more than 4 hours, seizures, or thoughts of harming yourself.
Pregnancy and Lactation
Information in pregnancy is limited. Babies exposed in the last three months of pregnancy may have stiffness, shaking, drowsiness or feeding problems after birth. Do not stop the medicine on your own; discuss pregnancy plans with your doctor, who will weigh the risks of untreated illness. Small amounts may pass into breast milk; breastfeeding is generally not recommended unless your doctor advises it.
Precautions and Warnings
Older people with dementia who take antipsychotics have a higher risk of stroke and death; Ziprasidone is not approved for dementia-related behaviour. Your doctor may check an ECG and blood potassium and magnesium before and during treatment. Use with care in heart disease, low blood pressure, diabetes, seizures, liver disease and swallowing problems. It may cause drowsiness, so avoid driving or machinery until you know how it affects you. Avoid alcohol, overheating and dehydration.
Overdose
Overdose may cause severe drowsiness, slurred speech, abnormal movements, anxiety, changes in blood pressure and dangerous heart rhythm changes. Seek emergency medical help immediately.
Therapeutic Class
Atypical (second-generation) antipsychotic.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Injections are stored as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.