Zeldox (ziprasidone)

Zeldox (ziprasidone)
Brand name: Zeldox®
Active ingredient name: Ziprasidone
Type of drug: Atypical antipsychotic
Available in Canada from: Pfizer Canada Inc.
Form: Oral capsules
Generic: No
Listed on Ontario formulary: Yes

What is Zeldox used for?
Zeldox is used to treat symptoms of schizophrenia and related psychotic illnesses in adults. It may also be used to treat symptoms of bipolar disorder.  Zeldox is sometimes used to treat other conditions.  Talk to your doctor to understand why you are taking Zeldox.
 
How should I take Zeldox?
Zeldox should be taken with food to increase the absorption of the medication into the bloodstream.  It is best taken after a full meal versus after a small snack.  Zeldox is most often taken twice daily, however it can be given once daily in some cases.
 
How much Zeldox should I take?
Zeldox is available in 20, 40, 60, and 80 mg capsules. 
The dose range for Zeldox is 20-80 mg twice daily.  Your doctor may prescribe doses higher than 160 mg per day based on your clinical situation.  If your dose is above this range discuss the reasons with your doctor.
 
Warnings/Precautions
Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics.  Most deaths appear to be either cardiovascular or infectious.  Zeldox is not approved for the treatment of dementia-related psychosis.  Some individuals with dementia may however be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.
 
Also, in early studies with Zeldox it was found to impact conduction in the heart.  This may increase the risk of arrhythmia in certain individuals. If you have any of the following heart conditions, you should discuss the risks and benefits of taking Zeldox with your doctor:

  • Long QT syndrome (a specific heart rhythm problem)
  • A recent heart attack
  • Severe heart failure
New safety information in the United States indicates that ziprasidone may be associated with rare but serious skin reactions. If you develop a fever with a rash and/or swollen lymph glands you should seek medical attention.  A medical assessment is important to determine if your symptoms may be due to your medication or to another cause.

What are the common side effects seen with Zeldox? 
The most common side effects of Zeldox include:
  • Feeling unusually tired or sleepy
  • Nausea or upset stomach
  • Constipation
  • Dizziness
  • Headache
  • Abnormal movements (extrapyramidal side effects)
What are rare, but potentially serious side effects seen with Zeldox?
  • Decrease in white blood cell count (agranulocytosis)
  • Cerebrovascular event (stroke)
  • Anaphylactic reaction (severe allergy)
  • Sudden Cardiac Death       
  • Torsades de pointes (serious heart arrhythmia)
  • Diabetic ketoacidosis (DKA)
  • Neuroleptic malignant syndrome (NMS) 
What medications interact with Zeldox?
Tell all your doctors, pharmacists, and dentists that you are taking Zeldox. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription and herbal and vitamin products.

 
The following types of medication may interact with Zeldox:
  • Certain medications for  allergies (e.g., Benadryl [diphenhydramine])
  • Certain medications for sleep (e.g., lorazepam, zopiclone)
  • Certain medications for pain (e.g., fentanyl)
Avoid drinking alcohol or using illegal drugs while taking Zeldox.
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