Zeldox

For the treatment of schizophrenia, the usual adult starting dose of Zeldox (Ziprasidone) is 40 mg twice daily, although a lower dose may be used. The dose can be increased gradually every 2 days up to 80 mg twice daily, as recommended by the doctor.

For the treatment of the manic phase of bipolar disorder, the recommended adult starting dose is 40 mg twice daily for 1 day, then increased to 60 mg or 80 mg twice daily.

For maintenance treatment, your doctor will recommend an appropriate dose for you.

The capsules should be swallowed whole with a glass of water. Take Zeldox (Ziprasidone) with food at the same time every day.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Continue to take Zeldox (Ziprasidone) regularly, even if you feel better. This will prevent the symptoms from returning. It is important to take Zeldox (Ziprasidone) exactly as prescribed by your doctor. If you miss a dose by only a few hours, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Zeldox (Ziprasidone) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause constipation - to prevent this, drink plenty of water or juice, and eat more dietary fibre; it may cause indigestion; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

20 mg
Each size No. 4 blue or white opaque hard gelatin capsule, imprinted in black with "Pfizer" and "ZDX 20", contains Zeldox (Ziprasidone) hydrochloride, monohydrate equivalent to 20 mg of Zeldox (Ziprasidone). Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, and magnesium stearate.

40 mg
Each size No. 4 blue or blue-opaque hard gelatin capsule, imprinted in black with "Pfizer" and "ZDX 40", contains Zeldox (Ziprasidone) hydrochloride, monohydrate equivalent to 40 mg of Zeldox (Ziprasidone). Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, and magnesium stearate.

60 mg
Each size No. 3 white or white-opaque hard gelatin capsule, imprinted in black with "Pfizer" and "ZDX 60", contains Zeldox (Ziprasidone) hydrochloride, monohydrate equivalent to 60 mg of Zeldox (Ziprasidone). Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, and magnesium stearate.

80 mg
Each size No. 2 blue or white-opaque hard gelatin capsule, imprinted in black with "Pfizer" and "ZDX 80", contains Zeldox (Ziprasidone) hydrochloride, monohydrate equivalent to 80 mg of Zeldox (Ziprasidone). Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, and magnesium stearate.

Do not take Zeldox (Ziprasidone) if you:

• are allergic to Zeldox (Ziprasidone) or any ingredients of the medication
• are taking medications such as dofetilide, Sotalol, quinidine, mesoridazine, thioridazine, Chlorpromazine, droperidol, Pimozide, moxifloxacin, halofantrine, Mefloquine, pentamidine, arsenic trioxide, levomethadyl acetate, probucol, Tacrolimus, or any other medication that can cause QT prolongation (a specific type of heart arrhythmia)
• have, or have a history of, QT prolongation (including congenital long QT syndrome)
• have recently had a Heart Attack
• have severe heart failure

There may be an interaction between Zeldox (Ziprasidone) and any of the following:

• alcohol
• Alfuzosin
• amantadine
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antiseizure medications (e.g., Carbamazepine, Clobazam, Levetiracetam, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• antipsychotic medications (e.g., Haloperidol, Risperidone, Quetiapine)
• arsenic trioxide
• azelastine
• "azole" antifungals (e.g., fluconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• brimonidine
• Bromocriptine
• Buprenorphine
• Buspirone
• Buserelin
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Verapamil)
• cannabis
• Capecitabine
• chloral hydrate
• chloroquine
• Degarelix
• Dextromethorphan
• diabetes medications (e.g., chlorpropamide Dapagliflozin, Glyburide, insulin, Metformin, Rosiglitazone)
• Disopyramide
• diuretics (e.g., Furosemide, Hydrochlorothiazide)
• dofetilide
• Domperidone
• dopamine agonists (e.g., Pramipexole, Ropinirole)
• Dronedarone
• Fingolimod
• Flecainide
• Galantamine
• HIV protease inhibitors (e.g., indinavir, atazanavir, lopinavir, nelfinavir, ritonavir)
• Indacaterol
• Leuprolide
• levodopa
• lithium
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• mefloquine
• Methadone
• Methylphenidate
• Metoclopramide
• mifepristone
• Mirabegron
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Phenelzine, Selegiline, Tranylcypromine)
• muscle relaxants (e.g., Cyclobenzaprine, methocarbamol, orphenadrine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Octreotide
• pentamidine
• Primaquine
• procainamide
• Propafenone
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin, Norfloxacin)
• rilpivirine
• Romidepsin
• St. John's wort
• salmeterol
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (antinausea medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• Solifenacin
• sotalol
• tacrolimus
• Tamoxifen
• Tapentadol
• Tetrabenazine
• Tolterodine
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine)
• tyrosine kinase inhibitors (e.g., Dasatinib, imatinib, Nilotinib, Sunitinib)
• "triptan" migraine medications (e.g., Eletriptan, Sumatriptan)
• Triptorelin
• Tryptophan
• Vardenafil
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zeldox (Ziprasidone). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Zeldox (Ziprasidone).

Abnormal heart rhythms: Zeldox (Ziprasidone) can cause abnormal heart rhythms. Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, pimozide, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, probucol, tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with Zeldox (Ziprasidone). You are more at risk for this type of abnormal heart rhythm and its complications if you:

• are female
• are older than 65 years of age
• have a family history of sudden cardiac death
• have a history of heart disease or abnormal heart rhythms
• have a slow heart rate
• have congenital prolongation of the QT interval
• have Diabetes
• have had a stroke
• have low potassium, magnesium, or calcium levels
• have nutritional deficiencies

If you have any of these risk factors, discuss with your doctor how Zeldox (Ziprasidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zeldox (Ziprasidone), and whether any special monitoring is needed.

Blood Clots: Zeldox (Ziprasidone) may increase the risk of blood clots, especially in the lower leg. Talk to your doctor or pharmacist if you have risk factors for developing blood clots (e.g., a family history of blood clots, recent major surgery, immobility due to air travel, or other reason).

Blood sugar: Zeldox (Ziprasidone) may cause high blood sugar levels and a loss of blood glucose control. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Zeldox (Ziprasidone). If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Zeldox (Ziprasidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zeldox (Ziprasidone), and whether any special monitoring is needed. If you experience weakness, increased thirst, increased urination, and increased appetite while taking Zeldox (Ziprasidone), contact your doctor.

Body temperature: Zeldox (Ziprasidone), like other antipsychotic medications, can disrupt the body's ability to control body temperature. People who exercise vigorously, who are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., Benztropine, Oxybutynin) are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool down while taking Zeldox (Ziprasidone).

Drowsiness/reduced alertness: Zeldox (Ziprasidone) may interfere with activities requiring mental alertness. Avoid driving or potentially hazardous activities until you know how Zeldox (Ziprasidone) affects you.

Lactose: Zeldox (Ziprasidone) contains lactose. If you have hereditary problems of galactose intolerance, lactase deficiency, or glucose-galactose malabsorption discuss the appropriateness of Zeldox (Ziprasidone) with your doctor.

Liver function: Liver disease or reduced liver function may cause Zeldox (Ziprasidone) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Zeldox (Ziprasidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zeldox (Ziprasidone), and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Zeldox (Ziprasidone).

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Low Blood Pressure: Zeldox (Ziprasidone) may cause low blood pressure when rising from a sitting or lying down position. If you feel dizzy, lightheaded, feel your pulse racing, or if you faint, call your doctor. While you are taking Zeldox (Ziprasidone), get up slowly after you have been sitting or lying down.

Neuroleptic malignant syndrome (NMS): Zeldox (Ziprasidone), like other antipsychotic medications, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Prolactin levels: As with other antipsychotics, Zeldox (Ziprasidone) can elevate levels of the hormone prolactin. This may lead to symptoms such as spontaneous flow of milk from the breast, irregular menstruation, breast enlargement in males, diminished sexual function in males, and decreased bone strength. If you experience any of these symptoms, contact your doctor.

Seizures: Zeldox (Ziprasidone) may increase the risk of seizures, especially in people who have had seizures in the past. If you have a seizure disorders or a history of seizures, discuss with your doctor how Zeldox (Ziprasidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zeldox (Ziprasidone), and whether any special monitoring is needed.

Serotonin syndrome: Severe reactions are possible when Zeldox (Ziprasidone) is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors, which are used to treat Depression. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking antidepressants, discuss with your doctor how Zeldox (Ziprasidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zeldox (Ziprasidone), and whether any special monitoring is needed.

Suicidal behaviour: People with mental illness may experience feelings of wanting to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Zeldox (Ziprasidone), contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Zeldox (Ziprasidone).

Tardive dyskinesia (TD): Zeldox (Ziprasidone), like some other antipsychotic medications may cause tardive dyskinesia (TD) to develop. TD is a potentially irreversible syndrome of involuntary, repetitive movements of the face and tongue muscles. Although TD appears most commonly in seniors, especially women, it is impossible to predict who will develop TD. The risk of developing TD increases with higher doses and long-term treatment. If you experience muscle twitching or abnormal movements of the face or tongue, contact your doctor as soon as possible.

White blood cells: As with other antipsychotics, Zeldox (Ziprasidone) can lower the number of infection-fighting white blood cells in your blood. This can increase your risk of infections. If you experience frequent colds or other infections, contact your doctor. Your doctor will monitor your white blood cell levels with blood tests during treatment with Zeldox (Ziprasidone).

Pregnancy: Zeldox (Ziprasidone) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Zeldox (Ziprasidone), contact your doctor immediately.

Babies born to mothers who take Zeldox (Ziprasidone) in the last 3 months of pregnancy may experience withdrawal symptoms after they are born, including breathing problems, difficulty feeding or irritability. If you have been taking Zeldox (Ziprasidone) during pregnancy, make sure you tell everyone involved in caring for you and your baby.

Breast-feeding: It is not known if Zeldox (Ziprasidone) passes into breast milk. If you are a breast-feeding mother and are taking Zeldox (Ziprasidone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Zeldox (Ziprasidone) have not been established for children less than 18 years of age.

Seniors: The safety of using Zeldox (Ziprasidone) has not been established for adults 65 years of age or older. The increased risk of liver, kidney, and heart conditions increases the risk of side effects with the use of Zeldox (Ziprasidone).

There may be a higher risk of strokes, heart attacks, and deaths associated with the use of Zeldox (Ziprasidone) by seniors with Dementia. Seek medical attention immediately if you notice the signs and symptoms of a stroke (e.g., sudden weakness or numbness, speech problems, vision problems, dizziness, confusion, sudden severe headache) or a heart attack (e.g., discomfort or pain in the chest, back, neck, jaw, arms; sweating; shortness of breath; nausea; lightheadedness) or infection (e.g., pneumonia). Zeldox (Ziprasidone) should not be used by seniors with dementia.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. This medication is more effective if taken with food. Always take it with a meal or a snack. This product may intensify the effect of alcohol. Limit alcohol consumption to an occasional intake.