GENERIC AVAILABLE: no
PREPARATIONS: Ziprasidone is available as capsules of 20 mg (blue/white), 40 mg (blue/blue), 60 mg (white/white) and 80 mg (blue/white). The injectable form is available in vials containing 20 mg of lyophilized ziprasidone that must be reconstituted with 1.2 ml of sterile water before injection.
STORAGE: Capsules should be stored at room temperature, from 15 C to 30 C (59 F to 86 F).
DOSING: Ziprasidone usually is taken twice a day. The usual starting dose is 20 mg twice daily. The dose may be increased over time to achieve the desired effect. Ziprasidone should be taken with food (for example, shortly after a meal) since when taken on an empty stomach, much less ziprasidone is absorbed.
DRUG INTERACTIONS: Ziprasidone has a modest effect on the electrical activity of the heart which can be seen on the electrocardiogram (EKG) as a prolongation of the QT-interval. (See discussion below.) Other drugs which also affect the QT interval can add to the effects of ziprasidone and lead to serious disturbances in the rhythm of the heart. Due to the potential for such additive effects on the QT interval, ziprasidone should not be taken with thioridazine (Mellaril), quinidine (Quinidex), moxifloxacin (Avelox), pimozide (Orap), sotalol (Betapace), dofetilide (Tikosyn), and sparfloxacin (Zagam).
Carbamazepine (Tegretol) increases the body's ability to eliminate ziprasidone and, therefore, may reduce the levels and lessen the effectiveness of ziprasidone. Conversely, ketoconazole (Nizoral) reduces the body's ability to eliminate ziprasidone and may cause increases in levels of ziprasidone and more side effects. Ketoconazole does this by blocking the enzyme that eliminates ziprasidone, cytochrome P450 3A4. Other drugs that also block this enzyme and may increase the levels of ziprasidone include itraconazole (Sporanox), fluconazole (Diflucan), erythromycin, clarithromycin (Biaxin), nefazodone (Serzone), verapamil (Calan, Isoptin, Verelan), and diltiazem (Cardizem, Tiazac, Dilacor).
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.
Medically reviewed by Eni Williams, PharmD
Reference: FDA Prescribing Information
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