GEODON for INJECTION Rx
Generic Name and Formulations:
Ziprasidone (as mesylate) 20mg/mL; pwd for IM inj after reconstitution; preservative-free.
Indications for GEODON for INJECTION:
Rapid control of acute agitation.
10–20mg IM as needed, max 40mg/day (10mg every 2hrs; or 20mg every 4hrs); usual max 3 days. Switch to oral form as soon as possible.
History of QT prolongation. Congenital long QT syndrome. Recent acute MI. Uncompensated heart failure. Concomitant drugs that cause QT prolongation, including dofetilide, sotalol, quinidine, other Class Ia and III antiarrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl, dolasetron, probucol, tacrolimus.
Increased mortality in elderly with dementia-related psychosis (not approved use). Concomitant use of oral and IM forms: not recommended. Renal (IM form) or hepatic impairment (both forms). Discontinue if QTc >500 msec persists, neuroleptic malignant syndrome, unexplained rash occurs, or if severe skin reactions (eg, Stevens-Johnson syndrome or DRESS) are suspected; consider discontinuing if tardive dyskinesia occurs. Conditions that increase risk of torsade de pointes (eg, bradycardia, hypokalemia, hypomagnesemia). Monitor potassium, magnesium, others if risk of electrolyte disturbances (eg, diarrhea); correct imbalance before starting. Avoid in significant cardiovascular disease (eg, arrhythmias). Evaluate cardiac function if symptoms of torsade de pointes occur (eg, dizziness, palpitations, syncope). Cardio- or cerebrovascular disease. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Diabetes; monitor for hyperglycemia. Monitor weight. Risk of hypotension or seizures. History of breast cancer. Dysphagia. Exposure to extreme heat. Perform fall risk assessments when initiating and recurrently on long-term therapy. Reevaluate periodically. Write ℞ for smallest practical amount. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. May potentiate CNS drugs, antihypertensives. May antagonize levodopa, dopamine agonists. Extent of absorption and/or plasma levels may be affected by CYP3A4 inducers (eg, carbamazepine) or inhibitors (eg, ketoconazole). Correct hypokalemia, hypomagnesemia due to diuretics.
Serotonin and dopamine antagonist.
Somnolence, extrapyramidal syndrome, respiratory disorder, dizziness, akathisia, abnormal vision, asthenia, vomiting, nausea, rash, dystonia, postural hypotension, QTc prolongation, headache, weight gain, inj site reactions, hyperprolactinemia, dyslipidemia, hyperglycemia; rare: priapism, leukopenia, neutropenia, agranulocytosis (may be fatal).
Caps—60; Single-use vials—10