ziprasidone
Ziprasidone (Geodon) is an atypical antipsychotic medication used to treat bipolar I disorder and schizophrenia in adults. It works by balancing the levels of certain chemicals in the brain, like dopamine and serotonin. Ziprasidone (Geodon) is taken by mouth, typically twice daily. It's also available as an injection that's given into the muscles by a healthcare provider to treat agitation in schizophrenia. Some common side effects of ziprasidone (Geodon) include uncontrolled body movements, sleepiness, and nausea.
What is Ziprasidone (Geodon)?
What is Ziprasidone (Geodon) used for?
How Ziprasidone (Geodon) works
Ziprasidone (Geodon) is an atypical antipsychotic. It treats schizophrenia and bipolar disorder by changing the levels of dopamine and serotonin in your brain. This can help with your thinking, mood, and behavior.
Drug facts
Side effects of Ziprasidone (Geodon)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Uncontrolled body movements (14%)
- Sleepiness (14%)
- Nausea (10%)
- Constipation (9%)
- Indigestion (8%)
- Restlessness (8%)
- Dizziness (8%)
- Respiratory tract infection (8%)
Note: Side effects listed were reported by people who took ziprasidone for schizophrenia in a clinical study
Less Common Side Effects
- Weakness
- Chest pain
- Racing heart
- Diarrhea
- Dry mouth
- Not feeling hungry
- Runny nose
- Cough
- Rash
- Changes in vision
Ziprasidone (Geodon) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts and behavior
- Seizures
- Difficulty swallowing
- Uncontrolled muscle movements (tardive dyskinesia): sticking out your tongue, puffing out your cheeks, puckering your mouth, lip smacking, chewing, and shaking in your arms and legs
- Neuroleptic malignant syndrome: fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
- Stroke: numbness or weakness typically on one side of the body, loss of balance, headache, blurred vision, difficulty speaking
- Dangerously high blood sugar: frequently thirsty, needing to urinate often, tiredness, nausea, vomiting, difficulty breathing, having fruity breath, having dry mouth
- Serious infections: fever, headache, chills, body aches, cough, weakness
- Serious skin reactions: fever, body ache, chills, rash, blistering or peeling skin
More on Ziprasidone (Geodon) side effects
The following Ziprasidone (Geodon) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
difficulty with speaking
fear or nervousness
inability to sit still
loss of balance control
muscle trembling, jerking, or stiffness
need to keep moving
restlessness
shuffling walk
stiffness of the limbs
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
Less common
Blurred vision
body aches or pain
congestion
dizziness
fast, pounding, or irregular heartbeat or pulse
headache
hoarseness
pounding in the ears
slow or fast heartbeat
swelling of the tongue
tender, swollen glands in the neck
trouble with swallowing
voice changes
Rare
Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
persistent, painful erection
seizures
Incidence not known
Inability to move the eyes
increased blinking or spasms of the eyelid
sticking out of tongue
trouble with breathing
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual facial expressions
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
belching
indigestion
lack or loss of strength
rash
stomach discomfort, upset, or pain
weakness
Less common
Blistering, crusting, irritation, itching, or reddening of the skin
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in vision
cracked, dry, or scaly skin
difficulty with moving
increase in salivation
itching or reddening of the skin
joint pain
loss of appetite
muscle ache
muscle pains or stiffness
muscle tightness
swelling
swollen joints
vomiting
weakness of the arms and legs
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Ziprasidone (Geodon)
Pros
- Taken by mouth
- Less likely to weight gain than other similar medications
- Available as a lower-cost generic medication
Cons
- Taken twice daily
- Might take several weeks before you feel the full benefits of this medication
- Must be taken with food
Pharmacist tips for Ziprasidone (Geodon)
- Take ziprasidone (Geodon) twice a day with food to make sure your body absorbs enough of the medication. Make sure to swallow the capsules whole; don't chew or open the capsules.
- If you feel more sleepy while taking ziprasidone (Geodon), try taking your dose in the evening.
- Ziprasidone (Geodon) can cause a drop in blood pressure when moving positions, such as from sitting to standing. This is more common when starting treatment and when your dose changes. Make sure to get up slowly and try to hold onto something for stability. If you end up falling or hitting your head, seek medical help right away.
- Ziprasidone (Geodon) can make you sleepy and dizzy, especially when you first start this medication or when your provider raises your dose. Don't drive or do anything requiring concentration until you know how this medication affects you.
- It's best to avoid alcohol while taking ziprasidone (Geodon) because doing so can worsen certain side effects (e.g., drowsiness, dizziness), as well as worsen symptoms of schizophrenia or bipolar disorder.
- Don't change your dose or suddenly stop taking ziprasidone (Geodon) without talking to your provider first. Doing so can put you at risk for withdrawal symptoms, such as nausea and vomiting.
- Although rare, ziprasidone (Geodon) can cause difficulty swallowing, which can raise the risk for choking. Make sure to take small bites of food and eat slowly to lower your risk for choking.
- Ziprasidone (Geodon) can make it harder for your body to cool down if your body temperature gets too high. This makes it more likely for you to become dehydrated and your body to overheat. Make sure to stay hydrated, especially if it's hot outside. Let your healthcare provider know if you feel very hot or thirsty, notice a change in the amount of sweat or urine you make, or if you notice very dark-colored urine.
Common questions about Ziprasidone (Geodon)
It typically takes about 1 to 2 days for most of ziprasidone (Geodon) to leave you system after you stop taking the medication. Keep in mind that this time frame is an estimate based off the half-life of ziprasidone (Geodon). Because most of this medication is cleared by the liver, it can stay in your body longer if you have liver problems. Talk with your provider if you have questions about how long ziprasidone (Geodon) stays in your system.
In general, you might need to take ziprasidone (Geodon) regularly for several weeks before you see noticeable benefits from this medication. In clinical studies, people saw improvements in symptoms of schizophrenia after taking ziprasidone (Geodon) for 4 to 6 weeks, and improvements in bipolar I disorder after taking this medication for 3 weeks. Keep in mind that each person can respond to ziprasidone (Geodon) differently, and it might take a while before you and your provider find a dose that works best for you. Talk with your provider if you're not sure whether ziprasidone (Geodon) is working.
No, ziprasidone (Geodon) isn't considered a controlled substance because it doesn't have a risk for causing physical and mental dependence. But if you've been taking ziprasidone (Geodon) (or any atypical antipsychotic) regularly for a long period of time, don't suddenly stop taking it without talking to your provider first. Doing so can put you at risk for experiencing withdrawal symptoms, such as nausea, vomiting, and restlessness. If you want to stop taking ziprasidone (Geodon), your provider can help you do so slowly over time.
Ziprasidone (Geodon), like other atypical antipsychotic medications, can cause weight gain as a side effect. But the risk of weight gain from ziprasidone (Geodon) is lower than other similar medications, such as olanzapine (Zyprexa) and risperidone (Risperdal). To limit or manage weight gain from ziprasidone (Geodon), it's best to eat a healthy diet and try to exercise for at least 20 minutes a day. Talk with your provider if you have questions about ziprasidone (Geodon) and weight gain.
Yes, sleepiness is one of the more common side effects of ziprasidone (Geodon). You're more likely to feel sleepy when you first start this medication or when your provider raises your dose. If you feel sleepy from this medication, you can try taking it at night close to bedtime. Don't drink alcohol when you take ziprasidone (Geodon) because doing so can make you feel more sleepy, and also worsen symptoms of your medical condition. If you continue to feel sleepy and it's difficult for you to get through the day, let your provider know. They might need to lower your dose of ziprasidone (Geodon).
Let your provider know if you have any side effects from ziprasidone (Geodon). Depending on what your symptoms are, your provider can let you know if there are ways to manage those side effects or if they'll go away with time. For example, you might experience dizziness and sleepiness more often when you first start ziprasidone (Geodon) or when your provider raises your dose, but these side effects should go away once your body gets used to the medication. But if you experience serious side effects, like uncontrollable muscle movements (tardive dyskinesia), you need to get medical help right away. Your provider might ask you to stop taking ziprasidone (Geodon) to prevent these symptoms from getting worse.
Talk with your provider if you're pregnant or thinking of becoming pregnant. Your provider might suggest that you take ziprasidone (Geodon) if they think the benefits of this medication are greater than its risks of harm. Reports show that babies born to mothers who took antipsychotic medications during pregnancy can have abnormal movements or withdrawal symptoms at birth, such as tremors, agitation, or extreme sleepiness. If you're curious about non-medication treatment options for your condition, ask your provider.
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Risks and warnings for Ziprasidone (Geodon)
Ziprasidone (Geodon) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk of death in older adults with dementia-related psychosis
- Risk factors: Older adults with dementia-related psychosis
People over the age of 65 who also have dementia sometimes have some of the symptoms of schizophrenia, like hallucinations and delusions. This is called dementia-related psychosis, and it should not be treated with atypical antipsychotic medications, such as ziprasidone (Geodon). If ziprasidone (Geodon) is used for dementia-related psychosis, it can cause death. In clinical studies, the cause of death is often linked to stroke, other blood vessel problems, or infections. Let your provider know if you or your loved one has dementia before starting ziprasidone (Geodon).
Risk of suicidal thoughts and behavior
Having schizophrenia or bipolar I disorder can put people at risk for self-harm or suicidal thoughts. If you or anyone around you notice that you have suicidal thoughts or, get medical help right away.
Difficulty controlling muscle movements (tardive dyskinesia)
- Risk factors: Older adults | Female and 65 years or older | Higher than recommended doses of ziprasidone (Geodon) | Taking ziprasidone (Geodon) for a long time
Ziprasidone (Geodon) can cause uncontrolled and possibly permanent muscle movements in the tongue, face, mouth, lips, neck, hands, arms, legs, and feet (tardive dyskinesia). To lower your risk of tardive dyskinesia, take the lowest dose possible for the shortest period of time for your symptoms. Stop taking ziprasidone (Geodon) and talk to your provider right away if you notice any unusual movements you can't control.
Weight gain, higher blood sugar, and higher cholesterol levels
- Risk factors: Diabetes | High cholesterol | Identified as obese
Ziprasidone (Geodon) can raise your blood sugar and cholesterol levels as well as raise your appetite, all of which can lead to weight gain. Your provider will likely order blood tests regularly throughout treatment with ziprasidone (Geodon) to make sure your blood sugar and cholesterol aren't too high. Make sure to have a nutritious and balanced diet low in fat and sugar and maintain a regular exercise routine while receiving ziprasidone (Geodon).
Neuroleptic malignant syndrome
Taking antipsychotic medications like ziprasidone (Geodon) can cause a rare, but life-threatening condition called neuroleptic malignant syndrome. Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. If you experience any of these symptoms while taking ziprasidone (Geodon), get medication attention as soon as possible. You provider will likely have you stop taking ziprasidone (Geodon) and switch you to something else.
Difficulty concentrating and extreme sleepiness
- Risk factors: Taking high doses of ziprasidone (Geodon) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Ziprasidone (Geodon) can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're also taking other medications that can cause drowsiness, such as benzodiazepines, anxiety medications, muscle relaxants, and sleep medications. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from ziprasidone (Geodon).
Changes in blood pressure and higher risk of falls
- Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | High ziprasidone (Geodon) doses | Liver or kidney problems | 65 years or older
Ziprasidone (Geodon) can make you tired, lower your blood pressure, or cause you to lose your balance, which can lead to falls. When standing from a sitting or lying position, make sure to get up slowly and hold onto something. If you experience a fall while taking ziprasidone (Geodon), contact your provider.
Risk of infection (from low white blood cell count)
- Risk factors: Poor immune system
Though rare, ziprasidone (Geodon) can lower your white blood cell counts (WBCs) and put you at risk for developing infections. You might need to get blood tests done regularly during the first few months of taking ziprasidone (Geodon) so your provider can make sure your WBCs are in a safe range. If your WBC count drops too low, you'll likely need to stop taking ziprasidone (Geodon). If you develop any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and they don't go away, contact your provider right away.
Seizures
- Risk factors: History of seizures | Health conditions that make it easier to get seizures
Ziprasidone (Geodon) can potentially cause seizures. Before starting this medication, let your provider know if you have a history of seizures or have a medical condition that puts you at risk for getting seizures.
Serious skin reaction
- Risk factors: Higher doses | Longer treatment with this medication
Some people taking ziprasidone (Geodon) have developed serious skin reactions, including Stevens-Johnson syndrome (SJS) and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Let your provider know right away if you notice have symptoms like fever, swollen lymph nodes, muscle aches, chills, rash, and peeling or blistering skin.
Prolonged and painful erection
Although rare, ziprasidone (Geodon) can cause prolonged and painful erections, which sometimes requires surgery to treat. If you develop a prolonged erection that lasts longer than 4 hours, get medical attention right away.
High prolactin levels
Ziprasidone (Geodon) can cause prolactin hormone levels in your blood to go up. High prolactin levels can lead to symptoms such as milky substances being released from the nipple, enlarged breasts, and absent or irregular menstrual periods. Talk to your healthcare provider if you experience or have any concerns about these symptoms.
Heart rhythm problems
- Risk factors: History of heart problems | Taking other drugs that also cause heart rhythm changes | Low potassium | Low magnesium
Ziprasidone (Geodon) can raise your risk of having heart rhythm changes. This risk is higher for people who are taking other medications that can affect heart rhythm. Because of this, you might not be able to take ziprasidone (Geodon) if you have certain heart conditions, like a recent heart attack. Your provider might order tests to check your heart rhythm and electrolyte levels before you start taking ziprasidone (Geodon) and during treatment.
Ziprasidone (Geodon) dosage
Capsule| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 60 capsules | $28.03 | $0.47 |
| 40mg | 30 capsules | $17.81 | $0.59 |
| 60mg | 60 capsules | $29.60 | $0.49 |
| 80mg | 60 capsules | $28.25 | $0.47 |
Typical dosage for Ziprasidone (Geodon)
- Schizophrenia: The typical starting dose is 20 mg by mouth twice a day with food. If needed, your provider might raise the dose every few days. The maximum recommended dose is 80 mg twice daily.
- Bipolar I disorder: The typical starting dose is 40 mg by mouth twice a day with food. If needed, your provider might raise the dose every few days. The typical maintenance dose ranges from 40 mg to 80 mg twice daily.
Please note: Ziprasidone (Geodon) is also available as an injection that's given into the muscles by a healthcare provider to treat agitation in schizophrenia.
More on Ziprasidone (Geodon) dosage
Interactions between Ziprasidone (Geodon) and other drugs
More on Ziprasidone (Geodon) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Alfuzosin
- Amiodarone
- Amisulpride
- Amitriptyline
- Anagrelide
- Apomorphine
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Artemether
- Asenapine
- Astemizole
- Atazanavir
- Azithromycin
- Bedaquiline
- Bepridil
- Bromopride
- Buserelin
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Dasatinib
- Degarelix
- Delamanid
- Desipramine
- Deslorelin
- Deutetrabenazine
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Doxepin
- Dronedarone
- Droperidol
- Ebastine
- Efavirenz
- Encorafenib
- Entrectinib
- Eribulin
- Erythromycin
- Escitalopram
- Famotidine
- Felbamate
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Formoterol
- Foscarnet
- Fosphenytoin
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Inotuzumab Ozogamicin
- Itraconazole
- Ivabradine
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lenvatinib
- Leuprolide
- Levofloxacin
- Lofexidine
- Lumefantrine
- Macimorelin
- Mefloquine
- Mesoridazine
- Methadone
- Metoclopramide
- Metronidazole
- Mirtazapine
- Mizolastine
- Moxifloxacin
- Nafarelin
- Nelfinavir
- Nilotinib
- Norfloxacin
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Pimavanserin
- Pimozide
- Pipamperone
- Piperaquine
- Pitolisant
- Ponesimod
- Posaconazole
- Probucol
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Risperidone
- Ritonavir
- Saquinavir
- Selpercatinib
- Sertindole
- Sertraline
- Sevoflurane
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sorafenib
- Sotalol
- Sparfloxacin
- Sulpiride
- Sultopride
- Sunitinib
- Tacrolimus
- Tamoxifen
- Telaprevir
- Telavancin
- Telithromycin
- Terfenadine
- Tetrabenazine
- Thioridazine
- Tolterodine
- Toremifene
- Trazodone
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Vilanterol
- Vinflunine
- Voclosporin
- Voriconazole
- Vorinostat
- Zotepine
- Zuclopenthixol
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Alfentanil
- Almotriptan
- Amineptine
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Brompheniramine
- Buprenorphine
- Buspirone
- Butorphanol
- Carbamazepine
- Chlorpheniramine
- Cocaine
- Codeine
- Conivaptan
- Desvenlafaxine
- Dextroamphetamine
- Dextromethorphan
- Dibenzepin
- Dihydrocodeine
- Duloxetine
- Eletriptan
- Fenfluramine
- Fentanyl
- Fluvoxamine
- Fosnetupitant
- Fostemsavir
- Frovatriptan
- Furazolidone
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Iproniazid
- Isocarboxazid
- Lasmiditan
- Lefamulin
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lorcaserin
- Melitracen
- Meperidine
- Metaxalone
- Methamphetamine
- Methylene Blue
- Mifepristone
- Milnacipran
- Moclobemide
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Naratriptan
- Nefazodone
- Netupitant
- Nialamide
- Nortriptyline
- Opipramol
- Oxycodone
- Oxymorphone
- Ozanimod
- Pentazocine
- Phenelzine
- Procarbazine
- Rasagiline
- Remifentanil
- Rizatriptan
- Selegiline
- Sibutramine
- Siponimod
- St John's Wort
- Sufentanil
- Sumatriptan
- Tapentadol
- Tianeptine
- Tramadol
- Tranylcypromine
- Tryptophan
- Vilazodone
- Vortioxetine
- Zolmitriptan
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Ziprasidone (Geodon) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Ziprasidone (Geodon) will not be safe for you to take.
- Heart rhythm problems (QT prologation)
- Taking other medications that can cause heart rhythm problems
- Recent heart attack
- Heart failure with symptoms not under control
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