QTc prolonging effect of oral Ziprasidone with several other drugs effective in the treatment of schizophrenia was conducted in patient volunteers. In the first phase of the trial, ECGs were obtained at the time of maximum plasma concentration when the drug was administered alone. In the second phase of the trial, ECGs were obtained at the time of maximum plasma concentration while the drug was co-administered with an inhibitor of the CYP4503A4 metabolism of the drug. Its intramuscular injection form is approved for acute agitation in schizophrenic patients for whom treatment with just ziprasidone is appropriate.
Use this on the only. However, not use it on the face or underarms unless directed to do so by your doctor. Some products are meant to be used on the scalp for various conditions. To correctly use these products, follow the directions on the product package. Retrieved October 16, 2016. All reported reactions are included except those already listed in Table 6 or elsewhere in labeling, those reaction terms that were so general as to be uninformative, reactions reported only once and that did not have a substantial probability of being acutely life-threatening, reactions that are part of the illness being treated or are otherwise common as background reactions, and reactions considered unlikely to be drug-related.
It is best to avoid consuming alcoholic beverages while taking Ziprasidone hydrochloride capsules. It is unknown if this drug passes into breast milk. Because of the possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Ziprasidone hydrochloride capsules contain Ziprasidone hydrochloride monohydrate, lactose monohydrate, pregelatinized maize starch, and magnesium stearate. Elderly patients with a diagnosis of psychosis related to dementia. Ziprasidone hydrochloride capsules are not approved for the treatment of these patients.
Check the labels on all your medicines such as allergy or cough-and-cold products because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. Roland Seifert; Thomas Wieland; Raimund Mannhold; Hugo Kubinyi; Gerd Folkers July 17, 2006. Ziprasidone is primarily cleared via three metabolic routes to yield four major circulating metabolites, benzisothiazole BITP sulphoxide, BITP-sulphone, Ziprasidone sulphoxide, and S-methyldihydroZiprasidone. Approximately 20% of the dose is excreted in the urine, with approximately 66% being eliminated in the feces. Unchanged Ziprasidone represents about 44% of total drug-related material in serum. In vitro studies using human liver subcellular fractions indicate that S-methyldihydroZiprasidone is generated in two steps. These studies indicate that the reduction reaction is mediated primarily by chemical reduction by glutathione as well as by enzymatic reduction by aldehyde oxidase and the subsequent methylation is mediated by thiol methyltransferase. In vitro studies using human liver microsomes and recombinant enzymes indicate that CYP3A4 is the major CYP contributing to the oxidative metabolism of Ziprasidone. CYP1A2 may contribute to a much lesser extent. Based on in vivo abundance of excretory metabolites, less than one-third of Ziprasidone metabolic clearance is mediated by cytochrome P450 catalyzed oxidation and approximately two-thirds via reduction. There are no known clinically relevant inhibitors or inducers of aldehyde oxidase.
Using the two medicines together may cause an irregular heartbeat, which may be life-threatening. Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines such as cetirizine, diphenhydramine drugs for sleep or anxiety such as alprazolam, diazepam, zolpidem muscle relaxants, and narcotic pain relievers such as codeine. Since medications of the same drug class as Ziprasidone hydrochloride may interfere with the ability of the body to adjust to heat, it is best to avoid situations involving high temperature or humidity. Tschoner A, Engl J, Rettenbacher M, et al. January 2009. There is a slight risk 1 in 1500 patients that ziprasidone by itself could significantly increase the QT interval. There is an even smaller risk 1 in 4000 patients that it could cause a potentially serious change in the rhythm of the heart. Adverse reactions during exposure were obtained by collecting voluntarily reported adverse experiences, as well as results of physical examinations, vital signs, weights, laboratory analyses, ECGs, and results of ophthalmologic examinations. It affects how you think and behave. This can show up in different ways and at different times, even in the same person. The illness usually starts in late adolescence or young adulthood. Dosage adjustments are generally not required on the basis of age, gender, race, or renal or hepatic impairment. Ziprasidone hydrochloride is not approved for use in children or adolescents. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. The diagnostic evaluation of patients with this syndrome is complicated. Keep all regular medical and laboratory appointments. Ziprasidone hydrochloride capsules contain a monohydrochloride, monohydrate salt of Ziprasidone. Other severe cutaneous adverse reactions, such as Stevens-Johnson syndrome, have been reported with Ziprasidone exposure. Severe cutaneous adverse reactions are sometimes fatal. Discontinue Ziprasidone if severe cutaneous adverse reactions are suspected. This information is generalized and not intended as specific medical advice. Ziprasidone 20 and 60 mg twice daily with placebo, only the 60 mg dose was superior to placebo on the BPRS total score and the CGI severity score. This higher dose group was not superior to placebo on the BPRS psychosis cluster or on the SANS.
Gilman's The Pharmacological Basis of Therapeutics 12th Edition. China: McGraw-Hill. The government is spying on you. Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Because of this, Ziprasidone hydrochloride should be used only after your doctor has considered this risk for Ziprasidone hydrochloride against the risks and benefits of other medications available for treating schizophrenia. In the second phase of the study, the effect of Ziprasidone on QTc length was not augmented by the presence of a metabolic inhibitor ketoconazole 200 mg twice daily. citalopram
If you have any health problems, consult your doctor or pharmacist before using this product. In vivo studies have revealed no effect of Ziprasidone on the pharmacokinetics of estrogen or progesterone components. This drug has also been used in combination with other medication to treat depression. While these symptoms can occur at low doses, they occur more frequently and with greater severity with high potency and at higher doses of first generation antipsychotic drugs. An elevated risk of acute dystonia is observed in males and younger age groups. This is more common when you first start taking ziprasidone. This medication can decrease hallucinations and help you to think more clearly and positively about yourself, feel less agitated, and take a more active part in everyday life. Many drugs besides ziprasidone may affect the heart rhythm QT prolongation including amiodarone, dofetilide, moxifloxacin, pimozide, procainamide, quinidine, sotalol, tacrolimus, thioridazine, among others. Taking ziprasidone with other agents that can affect your heart rhythm may increase your risk of an irregular heartbeat, which may be life-threatening. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. There are some medications that may be unsafe to use when taking Ziprasidone hydrochloride, and there are some medicines that can affect how well Ziprasidone hydrochloride works. Ziprasidone hydrochloride is a type of prescription medicine called a psychotropic, also known as an atypical antipsychotic. Ziprasidone hydrochloride can be used to treat symptoms of schizophrenia. Withdrawal of antipsychotic drugs after long-term therapy should always be gradual and closely monitored to avoid the risk of acute withdrawal syndromes or rapid relapse. European Journal of Pharmacology. This medication may rarely cause a very serious condition called neuroleptic malignant syndrome NMS. purchase cheap enalapril payment uk enalapril
Ziprasidone 20, 60, and 100 mg twice daily with placebo, all three dose groups were superior to placebo on the PANSS total score, the BPRS total score, the BPRS psychosis cluster, and the CGI severity score. Only the 100 mg twice daily dose group was superior to placebo on the PANSS negative subscale score. There was no clear evidence for a dose-response relationship within the 20 mg twice daily to 100 mg twice daily dose range. If you have schizophrenia, you are more likely to develop diabetes than people who do not have schizophrenia, and taking ziprasidone or similar medications may increase this risk. Tell your doctor immediately if you have any of the following symptoms while you are taking ziprasidone: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important to call your doctor as soon as you have any of these symptoms, because high blood sugar that is not treated can cause a serious condition called ketoacidosis. Ketoacidosis may become life-threatening if it is not treated at an early stage. Symptoms of ketoacidosis include dry mouth, nausea and vomiting, shortness of breath, breath that smells fruity, and decreased consciousness. Hyperglycemia and diabetes mellitus, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, have been reported in patients treated with atypical antipsychotics. There have been few reports of hyperglycemia or diabetes in patients treated with Ziprasidone hydrochloride. Although fewer patients have been treated with Ziprasidone hydrochloride, it is not known if this more limited experience is the sole reason for the paucity of such reports. Assessment of the relationship between atypical antipsychotic use and glucose abnormalities is complicated by the possibility of an increased background risk of diabetes mellitus in patients with schizophrenia and the increasing incidence of diabetes mellitus in the general population. Given these confounders, the relationship between atypical antipsychotic use and hyperglycemia-related adverse reactions is not completely understood. Precise risk estimates for hyperglycemia-related adverse reactions in patients treated with atypical antipsychotics are not available. These metabolic changes include hyperglycemia, dyslipidemia, and body weight gain. While all of the drugs in the class have been shown to produce some metabolic changes, each drug has its own specific risk profile. Based on in vitro studies utilizing human liver enzymes, Ziprasidone is not a substrate for CYP1A2; smoking should therefore not have an effect on the pharmacokinetics of Ziprasidone. Consistent with these in vitro results, population pharmacokinetic evaluation has not revealed any significant pharmacokinetic differences between smokers and nonsmokers. Stahl; Chiara Mattei; Maria Paola Rapagnani February 2011.
Retrieved June 19, 2015. Retrieved October 6, 2016. Extrapyramidal Symptoms EPS The incidence of reported EPS which included the adverse reaction terms extrapyramidal syndrome, hypertonia, dystonia, dyskinesia, hypokinesia, tremor, paralysis and twitching for Ziprasidone-treated patients in the short-term, placebo-controlled schizophrenia trials was 14% vs. 8% for placebo. Objectively collected data from those trials on the Simpson-Angus Rating Scale for EPS and the Barnes Akathisia Scale for akathisia did not generally show a difference between Ziprasidone and placebo. Read the Patient Information Leaflet if available from your pharmacist before you start taking ziprasidone and each time you get a refill. If you have any questions, ask your doctor or pharmacist. One case of priapism was reported in the premarketing database. While the relationship of the reaction to Ziprasidone use has not been established, other drugs with alpha-adrenergic blocking effects have been reported to induce priapism, and it is possible that Ziprasidone may share this capacity. Severe priapism may require surgical intervention. Ziprasidone was documented in 10 patients. All of these patients survived without sequelae. HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking ziprasidone and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Older adults may be more sensitive to the side effects of this drug, especially dizziness, uncontrolled movements, and QT prolongation see above. Class Effect: Symptoms of dystonia, prolonged abnormal contractions of muscle groups, may occur in susceptible individuals during the first few days of treatment. Ziprasidone hydrochloride capsules, 40 mg are size '4' capsules with dark blue opaque cap and dark blue opaque body, imprinted axially with "LU" on cap and "V52" on body in black ink, containing off-white to pinkish granular powder. Oro Valley, AZ 85755. November 17, 2015. Ziprasidone hydrochloride is available as capsules Ziprasidone hydrochloride for oral administration. Ziprasidone is a psychotropic agent that is chemically unrelated to phenothiazine or butyrophenone antipsychotic agents. It has a molecular weight of 412. Ziprasidone frequently causes 1 in 7 patients. Therefore, care should be exercised in any activity requiring mental alertness, such as operating a motor vehicle including automobiles or operating hazardous machinery. Less common side effects include 1 in 250 patients. This drug may also rarely cause significant weight gain and a rise in your blood cholesterol or triglyceride levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. This list is not complete and there may be other drugs that should not be taken at the same time as ziprasidone. Tell your doctor about all medicines you use. mail order allopurinol shop uk allopurinol
As with other antipsychotics, long-term use of ziprasidone may lead to a potentially irreversible condition called tardive dyskinesia involuntary movements of the jaw, lips, and tongue. Salmi P, Ahlenius S April 2000. "Sedative effects of the dopamine D1 receptor agonist A 68930 on rat open-field behavior. The absolute bioavailability of a 20 mg dose under fed conditions is approximately 60%. You might have to take different kinds of drugs for other symptoms, too. In animal studies Ziprasidone demonstrated developmental toxicity, including possible teratogenic effects at doses similar to human therapeutic doses. buy co-amoxiclav pill
Ziprasidone hydrochloride capsules, 80 mg are size '2' capsules with dark blue opaque cap and white opaque body, imprinted axially with "LU" on cap and "V54" on body in black ink, containing off-white to pinkish granular powder. Ziprasidone is similar chemically to Risperidone. In 1987, Ziprasidone was first synthesized on the central research campus in Groton, Connecticut. The risk is about 1 in 200 patients. Remember to keep taking your capsules, even when you feel better. In the first phase of the study, the mean change in QTc from baseline was calculated for each drug, using a sample-based correction that removes the effect of heart rate on the QT interval. The mean increase in QTc from baseline for Ziprasidone ranged from approximately 9 to 14 msec greater than for four of the comparator drugs risperidone, olanzapine, quetiapine, and haloperidol but was approximately 14 msec less than the prolongation observed for thioridazine.
Ziprasidone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication. The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Nevertheless, the presence of multiple factors that might increase the pharmacodynamic response to Ziprasidone, or cause poorer tolerance or orthostasis, should lead to consideration of a lower starting dose, slower titration, and careful monitoring during the initial dosing period for some elderly patients. Ziprasidone is not approved for use in psychotic conditions related to dementia. Ziprasidone may increase the risk of death in older adults with dementia-related conditions. Weight gain is also less of a concern with Ziprasidone compared to other atypical antipsychotics. Ziprasidone should be used with particular caution in patients with known cardiovascular disease history of myocardial infarction or ischemic heart disease, heart failure or conduction abnormalities cerebrovascular disease, or conditions which would predispose patients to hypotension dehydration, hypovolemia, and treatment with antihypertensive medications. Ziprasidone hydrochloride capsules are indicated for the treatment of schizophrenia. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Let your doctor know right away if you notice an irregular heartbeat or have any dizziness or fainting episodes. Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. Group, BMJ, ed. March 2009. Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. Ziprasidone and other drugs that prolong the QT interval have not been performed. An additive effect of Ziprasidone and other drugs that prolong the QT interval cannot be excluded. It is not known whether this drug passes into milk when applied to the skin. You'll learn to test whether you're having delusions and how to ignore voices inside your head. disulfiram purchase now online mastercard
There are many products available. Many can be purchased without a prescription. Some products require a prescription. Consult your doctor or on the choice of the product that is best for you. Ziprasidone, and all patients experiencing these reactions were reported to recover completely. Upon appearance of rash for which an alternative etiology cannot be identified, Ziprasidone should be discontinued. Because of its potential for inducing hypotension, Ziprasidone may enhance the effects of certain antihypertensive agents. Take Ziprasidone hydrochloride capsules with food. In case of an overdose, call your doctor or poison control center right away or go to the nearest emergency room. The efficacy of oral Ziprasidone in the treatment of schizophrenia was evaluated in 5 placebo-controlled studies, 4 short-term 4- and 6-week trials and one maintenance trial. All trials were in adult inpatients, most of whom met DSM III-R criteria for schizophrenia. Each study included 2 to 3 fixed doses of Ziprasidone as well as placebo. Four of the 5 trials were able to distinguish Ziprasidone from placebo; one short-term study did not. Although a single fixed-dose haloperidol arm was included as a comparative treatment in one of the three short-term trials, this single study was inadequate to provide a reliable and valid comparison of Ziprasidone and haloperidol. Consult your doctor before breast-feeding. What brand names are available for ziprasidone? This sheet is only a summary. Ziprasidone hydrochloride capsules are prescription medicine and only your doctor can decide if it is right for you. If you have any questions or want more information about Ziprasidone hydrochloride capsules, talk with your doctor or pharmacist, address medical related queries to www. Geodon ziprasidone hydrochloride US prescribing information. Pfizer Inc. Its biological half-life time is 10 hours at doses of 80-120 milligrams. enus.info ranolazine
Several instruments were used for assessing psychiatric signs and symptoms in these studies. The Brief Psychiatric Rating Scale BPRS and the Positive and Negative Syndrome Scale PANSS are both multi-item inventories of general psychopathology usually used to evaluate the effects of drug treatment in schizophrenia. The BPRS psychosis cluster conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content is considered a particularly useful subset for assessing actively psychotic schizophrenic patients. A second widely used assessment, the Clinical Global Impression CGI reflects the impression of a skilled observer, fully familiar with the manifestations of schizophrenia, about the overall clinical state of the patient. In addition, the Scale for Assessing Negative Symptoms SANS was employed for assessing negative symptoms in one trial. Ziprasidone hydrochloride capsules, 60 mg are size '3' capsules with white opaque cap and white opaque body, imprinted axially with "LU" on cap and "V53" on body in black ink, containing off-white to pinkish granular powder. QT prolongation and arrhythmia. Hypokalemia may result from diuretic therapy, diarrhea, and other causes. Woosley RL, Romero KA. www. Monti JM March 2010. "Serotonin 5-HT2A receptor antagonists in the treatment of insomnia: present status and future prospects. Ziprasidone hydrochloride capsules have not been shown to be safe or effective in the treatment of children and teenagers under the age of 18 years old. British Journal of Clinical Pharmacology.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using ziprasidone, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems heart failure, recent heart attack, slow heartbeat, QT prolongation in the EKG family history of certain heart problems QT prolongation in the EKG, sudden cardiac death. GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. If you show a response to Ziprasidone hydrochloride capsules, your symptoms may improve. If you continue to take Ziprasidone hydrochloride capsules there is less chance of your symptoms returning. Do not stop taking the capsules even when you feel better without first discussing it with your doctor. Hypotension and circulatory collapse should be treated with appropriate measures such as intravenous fluids. If sympathomimetic agents are used for vascular support, epinephrine and dopamine should not be used, since beta stimulation combined with α 1 antagonism associated with Ziprasidone may worsen hypotension. Similarly, it is reasonable to expect that the alpha-adrenergic-blocking properties of bretylium might be additive to those of Ziprasidone, resulting in problematic hypotension. The following adverse reactions have been identified during post approval use of Ziprasidone hydrochloride. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. buy fludrocortisone online amazon
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If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away. Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur. Esophageal dysmotility and aspiration have been associated with antipsychotic drug use. Aspiration pneumonia is a common cause of morbidity and mortality in elderly patients, in particular those with advanced Alzheimer's dementia. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. citalopram
Ziprasidone functioned as an antagonist at the D 2, 5HT 2A, and 5HT 1D receptors, and as an agonist at the 5HT 1A receptor. Ziprasidone inhibited synaptic reuptake of serotonin and norepinephrine. Alan F. Schatzberg; Charles B. Nemeroff February 10, 2006. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away. Stinging, burning, irritation, dryness, or redness at the application site may occur. In the rat study, there was no evidence of an increased incidence of tumors compared to controls. In male mice, there was no increase in incidence of tumors relative to controls.
If you become pregnant while taking ziprasidone, call your doctor. Ziprasidone may cause problems in newborns following delivery if it is taken during the last months of pregnancy. You should not breastfeed if you are taking ziprasidone. CBC monitored frequently during the first few months of therapy and should discontinue Ziprasidone hydrochloride at the first sign of decline in WBC in the absence of other causative factors. Sacher J, Mossaheb N, Spindelegger C, et al. June 2008. Many people using this medication not have serious side effects.
The recommends a gradual withdrawal when discontinuing antipsychotic treatment to avoid acute withdrawal syndrome or rapid relapse. Ziprasidone hydrochloride capsules, 20 mg are size '4' capsules with dark blue opaque cap and white opaque body, imprinted axially with "LU" on cap and "V51" on body in black ink, containing off-white to pinkish granular powder. Some side effects can be serious.