Ziprasidone


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Schizophrenia As ziprasidone HCl: Initial: 20 mg bid, may increase at intervals of not <2 days up to 80 mg bid. Maintenance: 20 mg bid. Acute mixed or manic episodes in bipolar disorder As ziprasidone HCl: Initial: 40 mg bid, increased to 60-80 mg bid on the 2nd day. Adjust subsequent doses according to patient's response and tolerance level. Maintenance treatment of bipolar I disorder (adjunctive therapy to either lithium or valproate): Continue at the same dosage on which the patient was initially stabilised w/in 40-80 mg bid. IM Acute agitation in schizophrenia As ziprasidone mesilate: 10-20 mg. Max: 40 mg/day for 3 consecutive days. Doses of 10 mg may be given 2 hrly and doses of 20 mg may be repeated 4 hrly. Switch to oral therapy as soon as possible.
Administration
Should be taken with food.
Contraindications
Patient w/ history of QT prolongation or cardiac arrhythmias, recent acute MI or decompensated heart failure. Concurrent use w/ other drugs known to prolong the QT interval.
Special Precautions
Patient w/ history of seizures or conditions that lower the seizure threshold, CV or cerebrovascular disease, conditions which predispose to hypotension. Renal impairment. Elderly w/ dementia-related psychosis. Pregnancy and lactation. Patient Counselling This drug may cause somnolence, impairment of judgment, thinking or motor skills, if affected, do not drive, operate machinery or perform hazardous tasks. Avoid alcohol. Monitoring Parameters Monitor serum electrolytes if on concurrent diuretic therapy. Monitor ECG in patients who show symptoms of torsades de pointes (e.g. syncope, dizziness, palpitations); wt gain. Closely monitor worsening of glucose control in patients w/ pre-existing DM. Frequently monitor CBC during 1st few mth of therapy in patients w/ pre-existing low leucocyte count or history of drug-induced leucopenia or neutropenia.
Adverse Reactions
Somnolence, rash or urticaria, GI disturbances, dizziness, flu-like symptoms, HTN, headache, agitation, confusion, dyspnoea, orthostatic hypotension, increased prolactin levels, wt gain, sexual dysfunction, extrapyramidal symptoms, tardive dyskinesia, hyperglycaemia. Rarely, cholestatic jaundice, hepatitis, seizures, leucopenia, neutropenia, thrombocytopenia, hyperlipidaemia.
Potentially Fatal: Life-threatening arrhythmias e.g. torsades de pointes and sudden death, neuroleptic malignant syndrome, agranulocytosis, drug reaction w/ eosinophilia and systemic symptoms (DRESS).
Drug Interactions
May antagonise effects of levodopa and dopaminergics. May enhance effects of other CNS depressants and certain antihypertensives. Altered metabolism w/ CYP3A4 inducers (e.g. carbamazepine), and inhibitors (e.g. ketoconazole).
CIMS Class
ATC Classification
N05AE04 - ziprasidone ; Belongs to the class of indole derivatives antipsychotics.
Disclaimer: This information is independently developed by CIMS based on ziprasidone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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