Geodon (Intramuscular)

Ziprasidone injection is used to treat agitation that happens with schizophrenia. It should not be used to treat behavioral issues in elderly patients who have dementia. Ziprasidone works by altering some chemicals in the brain that are involved in schizophrenia.

This medicine is to be given only by or under the direct supervision of your doctor.

Your doctor will monitor your progress after you receive this medicine to ensure it is effective. Blood tests might be necessary to check for unwanted effects.

Do not use this medicine with amiodarone (Cordarone®), arsenic trioxide, chlorpromazine (Thorazine®), disopyramide (Norpace®), dofetilide (Tikosyn®), dolasetron mesylate (Anzemet®), droperidol (Inapsine®), gatifloxacin (Tequin®), halofantrine, levomethadyl acetate, mefloquine (Lariam®), mesoridazine (Serentil®), moxifloxacin (Avelox®), pentamidine (Nebupent®), pimozide (Orap®), probucol, procainamide (Pronestyl®), quinidine (Cardioquin®), sotalol (Betapase®), sparfloxacin (Zagam®), tacrolimus (Prograf®), or thioridazine (Mellaril®). Using these medicines together may cause serious unwanted effects.

This medicine can change your heart rhythm, possibly leading to a condition called QT prolongation. It may alter your heartbeat and cause fainting or serious side effects. Inform your doctor immediately if you notice any signs of heart rhythm issues, such as fast, pounding, or irregular heartbeats.

Contact your doctor right away if you experience any of the following symptoms: convulsions (seizures), trouble breathing, a fast heartbeat, high fever, high or low blood pressure, excessive sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could indicate a serious condition known as neuroleptic malignant syndrome (NMS).

If you develop a skin rash, hives, or any allergic reaction to this medicine, contact your doctor as soon as possible.

Inform your doctor right away if you have a fever, chills, cough, sore throat, swollen, painful, or tender lymph nodes in the neck, armpit, or groin, or yellowing of the skin or eyes while using this medicine. These could be symptoms of a serious condition called drug reaction with eosinophilia and systemic symptoms (DRESS).

Serious skin reactions can happen with this medicine. Contact your doctor immediately if you experience blistering, peeling, or loose skin, red skin lesions, severe acne or rash, sores or ulcers on the skin, or fever or chills while using this medicine.

This medicine may cause tardive dyskinesia (a movement disorder). Reach out to your doctor right away if you notice lip smacking or puckering, puffing of the cheeks, rapid or worm-like tongue movements, uncontrolled chewing, or uncontrolled movements of the arms and legs while using this medicine.

This medicine may raise your blood sugar levels. Contact your doctor immediately if you notice increased thirst or urination. If you have diabetes, you may see changes in your urine or blood sugar test results. If you have any questions, talk to your doctor.

Ziprasidone can temporarily decrease the number of white blood cells in your blood, which can increase the risk of infections. If possible, avoid close contact with people who are sick. Contact your doctor immediately if you think you might have an infection, or if you experience fever or chills, a cough or hoarseness, lower back or side pain, or painful or difficult urination.

This medicine may cause drowsiness or dizziness in some people, or may affect thinking and body movement control, leading to falls, fractures, or injuries. Make sure you understand how this medicine affects you before driving, operating machinery, or doing anything that requires alertness, coordination, or good thinking.

Dizziness, lightheadedness, or fainting may happen, especially when you stand up suddenly from lying or sitting. Getting up slowly may help. If the issue continues or worsens, consult your doctor.

Ziprasidone injection may lead to agitation, irritability, or other unusual behaviors in some individuals. It may also cause suicidal thoughts and tendencies in some people. If you or your caregiver notice any of these side effects, inform your doctor immediately.

You may be more prone to overheating while using this medicine. Be cautious if you exercise frequently or are in high temperatures or humidity. Drink plenty of water and stay out of the sun.

Avoid alcohol while using this medicine.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription and nonprescription (over-the-counter [OTC]) medicines, as well as herbal or vitamin supplements.

In deciding to use a medication, the risks of using the drug must be weighed against the beneficial it will do. This is a decision you and your clinician will make. For this medicine, the following should be considered:

Allergies

Inform your physician if you have ever had any unusual or allergic reaction to this medication or any other drugs. Also inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of ziprasidone injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ziprasidone injection in the elderly. However, this medicine should not be used for behavioral problems in older adults with dementia.

Breast Feeding

There are no adequate studies in women for determining infant chance when using this medication during breastfeeding. Weigh the potential benefits against the potential risks prior to taking this drug while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different drugs 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 receiving this drug, it is especially important that your healthcare professional know if you are using 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 drugs is not advised. Your doctor may decide not to treat you with this drug or change some of the other medications 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
• Clothiapine
• Clozapine
• Crizotinib
• Cyclobenzaprine
• Dabrafenib
• Dasatinib
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Doxepin
• Dronedarone
• Droperidol
• Ebastine
• Efavirenz
• Encorafenib
• Entrectinib
• Eribulin
• Erythromycin
• Escitalopram
• Etrasimod
• Famotidine
• Felbamate
• Fexinidazole
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Formoterol
• Foscarnet
• Fosphenytoin
• Fostemsavir
• Galantamine
• Gatifloxacin
• Gemifloxacin
• Gepirone
• Glasdegib
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydroquinidine
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imipramine
• Inotuzumab Ozogamicin
• Itraconazole
• Ivabradine
• Ivosidenib
• Ketoconazole
• Lapatinib
• Lenvatinib
• Leuprolide
• Levofloxacin
• Levoketoconazole
• Lofexidine
• Lumefantrine
• Macimorelin
• Mefloquine
• Mesoridazine
• Methadone
• Metoclopramide
• Metronidazole
• Mirtazapine
• Mizolastine
• Mobocertinib
• Moxifloxacin
• Nafarelin
• Nelfinavir
• Nilotinib
• Norfloxacin
• Octreotide
• Ofloxacin
• Olanzapine
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Pacritinib
• Paliperidone
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Pentamidine
• Perphenazine
• Pimavanserin
• Pimozide
• Pipamperone
• Piperaquine
• Pitolisant
• Ponesimod
• Posaconazole
• Probucol
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Ranolazine
• Relugolix
• 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

Using this medicine with any of the following medicines is normally not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how frequently you use one or both of the medicines.

• Abametapir
• Adagrasib
• Alfentanil
• Almotriptan
• Amineptine
• Amitriptylinoxide
• Amoxapine
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Brompheniramine
• Buprenorphine
• Buspirone
• Butorphanol
• Carbamazepine
• Chlorpheniramine
• Cobicistat
• Cocaine
• Codeine
• Conivaptan
• Darunavir
• Desvenlafaxine
• Dextroamphetamine
• Dextromethorphan
• Dibenzepin
• Dihydrocodeine
• Duloxetine
• Eletriptan
• Fedratinib
• Fenfluramine
• Fentanyl
• Fluvoxamine
• Fosnetupitant
• Frovatriptan
• Furazolidone
• Hydrocodone
• Hydromorphone
• Hydroxyamphetamine
• Hydroxytryptophan
• Iproniazid
• Isocarboxazid
• Lasmiditan
• Lefamulin
• Levomilnacipran
• Levorphanol
• Linezolid
• Lisdexamfetamine
• Lithium
• Lofepramine
• Lorcaserin
• Mavacamten
• Melitracen
• Meperidine
• Metaxalone
• Methamphetamine
• Methylene Blue
• Mifepristone
• Milnacipran
• Moclobemide
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Naratriptan
• Nefazodone
• Netupitant
• Nialamide
• Nortriptyline
• Omaveloxolone
• Opipramol
• Oxycodone
• Oxymorphone
• Ozanimod
• Pentazocine
• Phenelzine
• Phenobarbital
• Primidone
• Procarbazine
• Quizartinib
• Rasagiline
• Remifentanil
• Rizatriptan
• Selegiline
• Sibutramine
• Siponimod
• St John's Wort
• Sufentanil
• Sumatriptan
• Tapentadol
• Tianeptine
• Tramadol
• Tranylcypromine
• Tryptophan
• Vilazodone
• Vortioxetine
• Zolmitriptan

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Issues

The presence of other medical issues may affect the use of this medicine. Make sure you inform your clinician if you have any other medical problems, especially:

• Blood or bone marrow issues (eg, agranulocytosis, leukopenia, neutropenia) or
• Diabetes or
• Hyperglycemia (high blood sugar) or
• Hyperprolactinemia (high prolactin in the blood) or
• Neuroleptic malignant syndrome (NMS), history of or
• Priapism (painful or prolonged erection of the penis) or
• Seizures, history of—Use with caution. May make these conditions worse.

• Bradycardia (slow heartbeat) or
• Dehydration or
• Heart or blood vessel disease or
• Hypokalemia (low potassium in the blood) or
• Hypomagnesemia (low magnesium in the blood) or
• Hypotension (low blood pressure) or
• Hypovolemia (low amount of blood) or
• Stroke, history of or
• Trouble with swallowing—May cause side effects to become worse.

• Heart attack, recent acute or
• Heart failure, uncompensated or
• Heart rhythm issues (eg, congenital long QT syndrome, QT prolongation)—Should not be used in patients with these conditions.

• Kidney disease—Use with caution. The effects may be increased since of slower removal of the medicine from the body.

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 or nurse immediately if any of the following side effects occur:

More common

• Chills
• cold sweats
• confusion

Less common

• Anxiety
• bleeding or bloody stools
• blurred vision
• breathing too fast
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• change in personality
• chest pain or discomfort
• cough
• diarrhea
• difficulty with speaking
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• drooling
• dry mouth
• feeling of warmth or heat
• feeling, seeing, or hearing things that are not there
• fever
• flushing or redness of the skin, especially on the face and neck
• general feeling of discomfort or illness
• irritability
• joint pain
• loss of appetite
• loss of balance control
• multiple swollen and inflamed skin lesions
• muscle aches and pains
• muscle discomfort
• muscle tension or tightness
• muscle trembling, jerking, or stiffness
• nausea
• painful or prolonged erection of the penis
• pounding in the ears
• restlessness
• rigid or stiff muscles
• runny nose
• severe mood or mental changes
• shaking
• shivering
• shuffling walk
• slow or fast heartbeat
• sore throat
• stiffness of the limbs or muscles
• sweating
• trouble sleeping
• twisting movements of the body
• uncontrolled movements, especially of the face, neck, and back
• unusual behavior
• unusual tiredness or weakness
• vomiting

Rare

• Actions that are out of control
• convulsions
• difficulty with breathing
• high fever
• high or low blood pressure
• hives or itching
• lip smacking or puckering
• loss of bladder control
• overactive reflexes
• poor coordination
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid or worm-like movements of the tongue
• talking or acting with excitement you cannot control
• trembling
• twitching
• unexpected or excess milk flow from the breasts
• unusually pale skin

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

• Pain at the site of injection
• sleepiness or unusual drowsiness

Less common

• Acid or sour stomach
• back pain
• belching
• constipation
• cramps
• heartburn
• heavy bleeding
• inability to sit still
• indigestion
• need to keep moving
• pain
• sneezing
• stomach discomfort, upset, or pain
• stuffy nose
• tooth disorder
• weight loss

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.

In the U.S.

• Geodon

Available Dosage Forms:

• Powder for Solution

Therapeutic Class: Antipsychotic

Chemical Class: Benzisothiazoyl

A nurse or other trained health professional will give you this medicine in a clinic or hospital setting. This medicine is given as a shot into one of your muscles.

Your doctor will give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

• What drugs cause tardive dyskinesia?