Precautions and Warnings With Ziprasidone

Some Precautions and Warnings With Ziprasidone

Some warnings and precautions to be aware of with ziprasidone include:
 
  • The U.S. Food and Drug Administration (FDA) has issued a special warning (a "black box warning") about the use of ziprasidone in elderly people with dementia (a condition involving confusion; disorientation; and a loss of memory, intellect, and judgment) or psychosis. Elderly people with dementia (Alzheimer's disease is the most common form of dementia) who are treated with antipsychotics -- including ziprasidone -- are more likely to die (of various causes) than those who were not treated with those medications. Ziprasidone is not approved to treat dementia or dementia-related psychosis, and caution should be used before using ziprasidone in elderly people with dementia.
     
  • Ziprasidone can cause a life-threatening irregular heart rhythm (arrhythmia) called QT prolongation. People with long QT syndrome should not take ziprasidone, and ziprasidone should not be combined with other medications that can prolong the QT interval (see Drug Interactions With Ziprasidone).
     
  • Ziprasidone can cause a life-threatening condition called neuroleptic malignant syndrome (NMS). Some symptoms of NMS include:

 

    • A high fever
    • Stiff muscles
    • Confusion
    • Irregular pulse or blood pressure
    • A fast heart rate (tachycardia)
    • Sweating
    • Irregular heart rhythms (arrhythmias).
Tell your healthcare provider right away if think you might have NMS.
  • Ziprasidone can cause tardive dyskinesia. Tardive dyskinesia is a condition involving unusual, uncontrollable body or face movements. The condition can become permanent (even if ziprasidone is stopped). The best way to prevent it from becoming permanent is to tell your healthcare provider right away if you notice any abnormal movements (including abnormal movements of the tongue) while taking ziprasidone.
     
  • Ziprasidone can cause an increase in blood sugar levels and may increase the risk of developing diabetes. Tell your healthcare provider if you develop signs of diabetes while taking ziprasidone. Possible signs of diabetes can include increased thirst, urination, or hunger. If you have diabetes, your blood sugar should be monitored carefully and regularly during treatment with ziprasidone to make sure that your diabetes is not becoming more severe (see Geodon and Diabetes).
     
  • Ziprasidone can cause a drop in blood pressure when going from a sitting or lying position to standing (known medically as orthostatic hypotension). This can cause a person to have lightheadedness or dizziness, or to faint. Tell your healthcare provider if you have any of these symptoms when standing. Orthostatic hypotension can be especially dangerous in people with heart disease or congestive heart failure (CHF).
     
  • Ziprasidone may increase the risk of seizures in some people. Before starting ziprasidone, tell your healthcare provider if you have epilepsy or a history of seizures.
     
  • Ziprasidone can cause difficultly swallowing, which can lead to inhalation of food (possibly causing pneumonia). Tell your healthcare provider if you notice any problems swallowing while taking ziprasidone.
     
  • Ziprasidone can cause high levels of the hormone prolactin. Let your healthcare provider know if you develop signs of high prolactin, such as breast enlargement or breast discharge, during treatment with ziprasidone.
     
  • Very rarely, ziprasidone can cause priapism (a painful erection of the penis that does not go away). Since priapism is a medical emergency, seek medical care immediately if you believe you may be experiencing priapism (to prevent permanent damage to the penis).
     
  • If you have liver or kidney disease, talk with your healthcare provider before taking ziprasidone.

 

  • Antipsychotics (like ziprasidone) have been reported to cause low white blood cells. Let your healthcare provider know if you develop frequent or persistent infections, as this may be a sign of low white blood cells. If you already have a low white blood cell count (or have had such a problem in the past), your healthcare provider should monitor your white blood cell count frequently during the first few months you take ziprasidone. 

 

  • Ziprasidone is considered a pregnancy Category C medication. This means that it may not be safe to take during pregnancy. Be sure to talk with your healthcare provider about the risks and benefits of using ziprasidone during pregnancy (see Geodon and Pregnancy).
     
  • If is not known if ziprasidone passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using ziprasidone (see Geodon and Breastfeeding for more information).
     
  • Generally, alcohol should be avoided while taking ziprasidone (see Alcohol and Geodon).
     
  • Ziprasidone can interact with certain other medications (see Drug Interactions With Ziprasidone).
     
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