ziprasidone, Geodon (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
PREGNANCY: Ziprasidone has not been studied in pregnant women, but studies in animals have shown that ziprasidone causes birth defects. Nevertheless, a physician may chose to use ziprasidone if he/she feels that its benefits outweigh this potential concern.
NURSING MOTHERS: It is not known if ziprasidone is excreted in breast milk. Since most drugs are excreted in breast milk, it is recommended that women receiving ziprasidone should not breast feed their infants.
SIDE EFFECTS: Some of the most common side effects associated with ziprasidone are feeling unusually tired (1 in 7 patients), nausea (1 in 10), constipation (1 in 11), dizziness (1 in 12), restlessness (1 in 12), diarrhea (1 in 20), rash (1 in 20), and a condition with abnormal muscle movements, including tremor, shuffling, and uncontrollable movements (1 in 20).
There is a slight risk (1 in 1500 patients) that ziprasidone by itself could significantly increase the QT interval. There is an even smaller risk (1 in 4000 patients) that it could cause a potentially serious change in the rhythm of the heart.
Ziprasidone causes orthostatic hypotension, a drop in blood pressure upon rising that can cause dizziness or lightheadedness. The risk is about 1 in 200 patients.
Ziprasidone frequently causes tiredness (1 in 7 patients). Therefore, care should be exercised in any activity requiring mental alertness, such as operating a motor vehicle (including automobiles) or operating hazardous machinery. Less common side effects include seizures (1 in 250 patients).
As with other antipsychotics, long-term use of ziprasidone may lead to a potentially irreversible condition called tardive dyskinesia (involuntary movements of the jaw, lips, and tongue).
A potentially fatal complex referred to as neuroleptic malignant syndrome (NMS) has been reported with other anti-psychotic drugs. Patients who develop NMS may have high fevers, muscle rigidity, altered mental status, irregular pulse or blood pressure, rapid heart rate, excessive sweating, and heart arrhythmias.
Although there is no clear link between ziprasidone and diabetes, patients should be tested during treatment for elevated blood-sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.
Reference: FDA Prescribing Information
Last Editorial Review: 1/7/2010
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