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Overview: Ziprasidone is used to treat schizophrenia or bipolar disorder. It is available as a capsule you take by mouth or as an injection that is given by a health care provider. Common side effects include sleepiness, nausea, constipation, or dizziness. Ziprasidone can affect your alertness or coordination. Ziprasidone may also cause a rare but serious heart rhythm problem called QT prolongation. Tell your health care provider right away if you have any palpitations or if you faint while taking ziprasidone.

Uses

What is ziprasidone used for?

Ziprasidone is commonly used for the following mental health conditions.

Ziprasidone may also be used for other conditions as determined by your health care provider.

How does ziprasidone work (mechanism of action)?

Ziprasidone belongs to a group of medicines called second-generation (atypical) antipsychotics. It is thought to work by balancing brain chemicals called serotonin and dopamine. These chemicals are known to affect thoughts and mood.

How is ziprasidone supplied (dosage forms)?

Brands and other names

  • Geodon

Dosage forms and strengths

  • 20 mg oral capsules 
  • 40 mg oral capsules
  • 60 mg oral capsules
  • 80 mg oral capsules

Ziprasidone is also available in an injectable form that is given by a health care provider.

How should I store ziprasidone?

Oral Capsule. Ziprasidone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store it in a cool, dry place. 

Injection. Ziprasidone injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of ziprasidone?

The most common side effects of ziprasidone are listed below. These side effects may vary depending on the condition being treated and the dosage form you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Drowsiness
  • Infection in the nose or throat, sore throat, or common cold symptoms
  • Movement problems
  • Restlessness (akathisia)
  • Dizziness
  • Feeling unusually weak or tired
  • Abnormal vision
  • Rash (see below)
  • Nausea, vomiting, or upset stomach
  • Constipation or diarrhea
  • Headache

There may be other side effects of ziprasidone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of ziprasidone?

While less common, the most serious side effects of ziprasidone are described below, along with what to do if they happen.

Severe Allergic Reactions. Ziprasidone may cause allergic reactions, including a serious specific type of allergic reaction called DRESS. DRESS stands for drug reaction with eosinophilia and systemic symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking ziprasidone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, throat, feet, ankles, or legs
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Rash or Severe Skin Reactions. Ziprasidone can cause severe skin reactions, such as Stevens-Johnson syndrome (SJS), that can lead to death if not treated. If you get a rash, stop ziprasidone and call your health care provider right away. Get emergency help if you have any of the following symptoms.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms including fever, chills, and muscle aches

Heart Rhythm Changes. Ziprasidone may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Metabolism Changes. Ziprasidone can cause high blood sugar levels or diabetes, high cholesterol levels, and weight gain. Keep all appointments with your health care provider to check your bloodwork and weight. Call your health care provider if you gain weight or have the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Your breath smelling fruity

Uncontrolled Movements. Ziprasidone can cause some people to have movements that they cannot control. This condition, called tardive dyskinesia (TD), can cause jerky movements of the face, tongue, or body. TD can be permanent. Call your health care provider right away if you have any of the following symptoms of TD.

  • Tongue sticking out
  • Lip smacking or puckering
  • Grimacing
  • Rapid eye blinking
  • Jerking or twisting motion of the arms, legs, or trunk

Low Blood Pressure Upon Standing (Orthostatic Hypotension) and Falls. Ziprasidone may cause a sudden drop in blood pressure when you stand up from a seated or lying position. Some people faint or even fall when this happens. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your health care provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Trouble Swallowing. Ziprasidone can cause trouble swallowing (dysphagia), which can increase your risk of choking while eating or drinking. Eat small amounts of food, and chew your food well. Get emergency help if you are choking or have food stuck in your esophagus that is not passing.

Seizures. Some people who have taken ziprasidone have reported having seizures. There are many types of seizures, and some of them are not easy to recognize. Stop taking ziprasidone and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Decreased Alertness or Coordination. Ziprasidone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how ziprasidone affects you.

Blood Disorders. Ziprasidone can cause blood disorders, such as low white blood cell levels (leukopenia, neutropenia, or agranulocytosis). Stop using ziprasidone and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Body Temperature Regulation. Ziprasidone can affect your ability to regulate your body temperature. This could make you become very hot, especially in hot weather or after exercising a lot. You should drink water and avoid overheating and dehydration. Call your health care provider right away if you are severely ill and have the following symptoms of dehydration.

  • Excessive or no sweating
  • Dry mouth
  • Feeling very hot
  • Feeling thirsty 
  • Not able to pee

Neuroleptic Malignant Syndrome (NMS). Antipsychotic medicines, like ziprasidone, may cause a rare but serious condition called neuroleptic malignant syndrome. NMS can lead to death. Stop taking ziprasidone and contact your health care provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Confusion 
  • Changes in your breathing or heart rate
  • Increased sweating

High Prolactin Level (Hyperprolactinemia). Ziprasidone may cause an increased level of the hormone prolactin in your blood. High levels of prolactin could lead to fertility or bone problems. Contact your health care provider if you have any of the following symptoms.

  • Vaginal dryness
  • Irregular or no periods
  • Production of breast milk when not pregnant or nursing
  • Inability to get or keep an erection
  • Enlarged breast size (gynecomastia)
  • Decreased muscle and body hair

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Ziprasidone can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Warnings & Precautions

Who should not use ziprasidone?

Allergies to Ingredients. People who are allergic to any of the following should not take ziprasidone.

  • Ziprasidone
  • Geodon
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific ziprasidone products they stock.

Drug Interactions. Ziprasidone should not be used while you are using certain other medicines. Before using ziprasidone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Heart Problems. People who have certain heart conditions should not take ziprasidone. Tell your health care provider about any heart problems that you have or have had, including the following.

  • Heart Rhythm Changes or QT Prolongation. QT prolongation or long QT syndrome is a rare but dangerous heart rhythm problem.
  • Recent Heart Attack. A heart attack is a medical emergency that happens when blood flow to the heart is blocked. 
  • Severe Heart Failure. Heart failure is a condition where the heart is not pumping as well as it should. 

What should I know about ziprasidone before using it?

Do not take ziprasidone unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share ziprasidone with other people, even if they have the same condition as you. It may harm them.

Keep ziprasidone out of the reach of children.

Do not chew, open, or crush ziprasidone capsules. Swallow the capsules whole.

Because ziprasidone can make it hard for you to regulate your body temperature, try to avoid becoming too hot or dehydrated. Drink plenty of water, limit your exposure to the heat and sun, do not overexercise, and wear light and breathable clothing.

Tell your health care provider if you are losing fluids because of diarrhea, vomiting, or other illness. Your health care provider may want to check your bloodwork if you are sick. Also tell your health care provider right away if you have any palpitations, dizziness, or fainting. 

Keep all appointments with your health care provider to check your bloodwork. This will help make sure that it is safe for you to take ziprasidone and that you are not having side effects from the medicine. 

People who are 65 or older can be at greater risk of some side effects from ziprasidone. Talk to your health care provider about your risks if you are in this age group.

If you can become pregnant, taking ziprasidone may make this more difficult. These effects likely go away after you stop taking ziprasidone. Talk to your health care provider if you have any concerns.

What should I tell my health care provider before using ziprasidone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if ziprasidone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Psychosis Related to Dementia. There is a higher risk of death, stroke, or ministroke in older adults who take ziprasidone or another antipsychotic and have memory loss or psychosis related to dementia. Ziprasidone is not approved to treat dementia-related psychosis.

Pregnancy. Ziprasidone taken later in pregnancy may lead to a higher risk of certain problems in your newborn. Tell your health care provider if you are pregnant or plan to become pregnant while taking ziprasidone. Your health care provider will advise you if you should take ziprasidone while you are pregnant or trying to get pregnant. If you become pregnant while taking ziprasidone, you can register with the National Pregnancy Registry for Atypical Antipsychotics by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry. This registry collects safety information about the use of psychiatric medicines during pregnancy.

Breastfeeding. Ziprasidone can pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take ziprasidone while breastfeeding.

Interactions

Does ziprasidone interact with foods or drinks?

You should take ziprasidone capsules with food to help the medicine be best absorbed by your body.

It is best to avoid drinking alcohol while taking ziprasidone. Drinking alcohol while taking ziprasidone could increase your risk of sleepiness, dizziness, feeling lightheaded, or fainting upon standing.

Does ziprasidone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using ziprasidone.

  • Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as chlorpromazine, dofetilide, moxifloxacin, pimozide, quinidine, sotalol, tacrolimus, thioridazine, and others
  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, or a serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which are medicines commonly used for anxiety and depression
  • A triptan – such as eletriptan (Relpax), sumatriptan (Imitrex and others), and others – which is a medicine commonly used to treat migraines
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • An opioid – such as fentanyl, meperidine, methadone, or tramadol – which is a medicine used to treat certain types of pain
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Buspirone or lithium, which are medicines used for certain mental health conditions
  • Itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
  • A medicine for high blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • An amphetamine, which is a stimulant medicine commonly used to treat attention deficit hyperactivity disorder (ADHD)
  • Levodopa or a dopamine agonist, such as apomorphine (Apokyn), pramipexole (Mirapex ER), ropinirole, or rotigotine (Neupro), which are medicines that may be used for Parkinson’s disease or restless legs syndrome (RLS)
  • St. John’s wort, which is a supplement that may be used for depression
  • Tryptophan, which is a supplement that may be used to help the body make proteins and certain brain-signaling chemicals
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety

Many other medicines may alter the blood levels of ziprasidone. Tell your health care provider about all medicines that you take or have recently taken.

This is not a complete list of medicines that can interact with ziprasidone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much ziprasidone?

If you or someone else has used too much ziprasidone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of ziprasidone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.