Ziprasidone Capsules

What is this medication?

ZIPRASIDONE (zi PRAY si done) treats schizophrenia and bipolar disorder. It works by balancing the levels of dopamine and serotonin in your brain, substances that help regulate mood, behaviors, and thoughts. It belongs to a group of medications called antipsychotics. Antipsychotic medications can be used to treat several kinds of mental health conditions.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Geodon

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Dementia
• Diabetes
• Heart disease
• Heart failure
• History of breast cancer
• History of irregular heartbeat or rhythm
• History of heart attack or stroke
• Liver disease
• Low blood pressure
• Low levels of potassium or magnesium in your blood
• Parkinson disease
• Seizures
• Suicidal thoughts, plans, or attempt by you or a family member
• Trouble swallowing
• An unusual or allergic reaction to ziprasidone, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

Take this medication by mouth with water. Take it as directed on the prescription label at the same time every day. Do not cut, crush, or chew this medication. Swallow the capsules whole. Take it with food. Keep taking it unless your care team tells you to stop.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Bedaquiline
• Cisapride
• Levoketoconazole
• MAOIs, such as Marplan, Nardil, and Parnate
• Mefloquine
• Methadone
• Methylene blue
• Pentamidine
• Pimozide
• Some antibiotics, such as linezolid or moxifloxacin
• Some medications for cancer, such as arsenic trioxide, nilotinib, panobinostat, toremifene, vandetanib
• Some medications for fungal infections, such as fluconazole, ketoconazole, posaconazole, voriconazole
• Some medications for irregular heartbeat, such as amiodarone, disopyramide, dofetilide, dronedarone, ibutilide, procainamide, quinidine, sotalol
• Some medications for nausea and vomiting, such as chlorpromazine, dolasetron, droperidol, metoclopramide
• Tacrolimus
• Thioridazine

This medication may also interact with the following:

• Alcohol
• Certain antihistamines
• Certain medications for depression, anxiety, or other mental health conditions
• Certain medications for migraines, such as sumatriptan
• Certain medications for seizures, such as carbamazepine, phenobarbital, primidone
• Medications for blood pressure
• Medications that cause drowsiness before a procedure, such as propofol
• Medications that help you fall asleep
• Medications that relax muscles
• Opioids
• Other medications that cause heart rhythm changes
• Phenothiazines, such as perphenazine or prochlorperazine
• Some medications for Parkinson disease, such as levodopa
• Stimulant medications for ADHD, weight loss, or staying awake
• Supplements, such as St. John's wort or tryptophan

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

This medication may cause serious skin reactions. They can happen weeks to months after starting the medication. Talk to your care team right away if you have fevers or flu-like symptoms with a rash. The rash may be red or purple and then turn into blisters or peeling of the skin. Or you might notice a red rash with swelling of the face, lips, or lymph nodes in your neck or under your arms.

Serotonin syndrome is when your body has too much serotonin in it. This happens when this medication is used with other ones that increase serotonin levels. Common medications that increase serotonin levels are antidepressants, some medications for migraines, and some antibiotics. The symptoms of serotonin syndrome include irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, and diarrhea. Contact your care team right away if you think you have serotonin syndrome.

This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication.

This medication may make it hard for your body to regulate its temperature so that you feel cold or warm. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. Do not exercise too much. Stay indoors during hot weather. Do not wear too much or heavy clothing. Stay out of the sun. Do not wear too much or heavy clothing. Make sure you stay hydrated. Drink water often. Eat fruits and veggies that have a high water content. Drink more water when it is hot or you are active.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
• High prolactin level—unexpected breast tissue growth, discharge from the nipple, change in sex drive or performance, irregular menstrual cycle
• Infection—fever, chills, cough, or sore throat
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Pain or trouble swallowing
• Prolonged or painful erection
• Rash, fever, and swollen lymph nodes
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth
• Thoughts of suicide or self-harm, worsening mood, feelings of depression
• Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Constipation
• Dizziness
• Drowsiness
• Headache
• Nausea
• Upset stomach
• Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, take the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.