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.
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.
Source:Â DailyMed
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.
Taken by mouth
Less likely to weight gain than other similar medications
Available as a lower-cost generic medication
Taken twice daily
Might take several weeks before you feel the full benefits of this medication
Must be taken with food
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.
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.
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).
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.
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.
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).
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.
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).
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 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.
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.
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.
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.
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.
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.
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.
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.
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.
Heart rhythm problems (QT prologation)
Taking other medications that can cause heart rhythm problems
Recent heart attack
Heart failure with symptoms not under control
Tourette syndrome in children
Depression (add-on treatment)
Irritability associated with autistic disorder in children
Schizophrenia - people ages 13 years and older
Manic or mixed episodes associated with bipolar I disorder - people ages 10 years and older
Irritability associated with autism - children ages 5 to 17 years old
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Bouchette, D., et al. (2022). Ziprasidone. StatPearls.
Chartwell RX, LLC. (2023). Ziprasidone capsule; ziprasidone capsule [package insert]. DailyMed.
Roerig. (2022). Geodon- ziprasidone hydrochloride capsule; ziprasidone mesylate injection, powder, lyophilized, for solution; ziprasidone capsule [package insert]. DailyMed.
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