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GEODON™ – Package leaflet: Information for the user

Submitted by on November 2, 2016 – 10:05 pm | 13 views
geodon-ziprasidone
GEODON™ – Package leaflet: Information for the user

20 mg, 40 mg, 60 mg, 80 mg capsules, hard

Ziprasidone

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you

– Keep this leaflet. You may need to read it again.

– If you have any further questions, ask your doctor or pharmacist.

– This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.

– If you get any side effects talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

  1. What Geodon capsules are and what they are used for
  2. What you need to know before you use Geodon capsules
  3. How to take Geodon capsules
  4. Possible side effects
  5. How to store Geodon capsules
  6. Contents of the pack and other information
  7. What Geodon Capsules are and what they are used for

Geodon capsules belong to a group of medicines called antipsychotics.

Geodon capsules are used for the treatment of schizophrenia in adults – a mental disorder characterised by the following symptoms: to hear, see and feel things that do not exist, to believe in something not true, , to be absent and have difficulty in establishing social relationships, , depression or .

Geodon capsules are also used for the treatment of manic or mixed episodes of moderate severity in bipolar disorder in adults and children and adolescents aged 10-17 years – a mental disorder characterised by alternate stages of euphoric (mania) or depressed mood states. During mania episodes, the most characteristic symptoms are: elated behaviour, exaggerated self-esteem, increase in energy, decreased need for sleeping, lack of concentration or hyperactivity and repeated high risk-taking behaviour.

  1. What you need to know before you use Geodon Capsules

Do not take Geodon Capsules

– if you are allergic to ziprasidone or any of the other ingredients of this medicine (listed in section 6). Signs of an allergic reaction include , itching, swelling in the face or lips, difficulty in breathing.

– if you suffer or have suffered from heart problems or have recently had a heart attack.

– if you take medicines for heart rhythm problems or that may affect the heart’s rhythm.

Also refer to the section “Other medicines and Geodon Capsules” below.

Warnings and precautions

Talk to your doctor, pharmacist or nurse before taking Geodon capsules

– if you are someone else in your family has a history of blood clots, as medicines like these have been associated with formation of blood clots

– if you have liver problems

– if you suffer or have suffered from seizure or epilepsy

– if you are elderly (over 65 years old) and suffer from dementia and are at risk of having a stroke

– if you have a low resting heart-rate and/or you know that, you may have salt depletion as a rsult of prolonged severe diarrhoea and vomiting (being sick) or usage of diuretics (water tablets)

– if you experience a fast or irregular heartbest, fainting, collapse or dizziness on standing up which may indicate abnormal functioning of the heart rate.

Contact your doctor immediately if you experience any of the following:

  • Severe skin reactions such as rash with blisters which could include ulcers in the mouth, skin

shedding, and target-like spots on the skin that could be symptoms of Stevens-Johnson

syndrome. These skin reactions could potentially be life-threating.

Tell your doctor that you are taking Geodon capsules before you have a laboratory test (such as blood, urine, liver function, heart rate etc) because it may alter the results of the test.

Other medicines and Geodon Capsules

Tell your doctor or pharmacist if you are taking or have recently taken or might take any other medicines, including medicines obtained without a prescription.

Do not take Geodon Capsules if you take medicines for heart rhythm problems or medicines that may affect the heart’s rhythm, such as:

Class IA and III antiarrhythmics, , halofantrine, levomethadyl acetate, mesoridazine, thioridazine, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, dolasetron mesilate, , sertindole or cisapride. These medicines affect the heart rhythm by prolonging the QT interval. If you have any further questions about this you should speak to your doctor.

Talk to your doctor of pharmacist before taking Geodon Capsules

Please tell your doctor or pharmacist if you are taking or have recently taken medicines for the treatment of:

– bacterial infections; these medicines are known as antibiotics; e.g. macrolide antibiotics or rifampin;

– mood swings (ranging from depressive mood to euphoria), agitation and irritation; these are known as mood stabilising medicines e.g. lithium, , valproate;

– depression, including certain serotonergic medicines e.g. SSRI’s such as fluoxetine, paroxetine, ; or herbal medicines or natural remedies containing St John´s Wort;

– epilepsy e.g. phenytoin, phenobarbital, carbamazepine, ethosuximide;

Parkinson’s disease e.g. levodopa, bromocriptine, ropinirol, pramipexole;

– or if you are taking or have recently taken the following medicines: verapamil, quinidine, itraconazole or ritonavir.

Also refer to the section “Do not take Geodon Capsules” above.

Geodon capsules with food and drink

Geodon capsules MUST BE TAKEN DURING A MAIN MEAL.

You should not drink alcohol during treatment with Geodon capsules, as this may increase the risk of side effects.

Pregnancy and breast-feeding

Pregnancy You should not take Geodon capsules during pregnancy unless you are told otherwise by your doctor

because there is a risk that this medicine may harm your baby. Always use effective contraception. Tell your doctor immediately if you become pregnant or are planning to become pregnant whilst taking Geodon capsules.

The following symptoms may occur in newborn babies, of mothers that have used Geodon in the last trimester (last three months of their pregnancy): shaking, and/or , sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.

Breast-feeding Do not breast-feed if you are taking Geodon capsules. This is because small amounts may pass into the mother’s milk. If you are planning to breast-feed talk to your doctor before taking this medicine.

Ask your doctor or pharmacists for advice before taking any medicine.

Driving and using machines

Taking Geodon capsules may make you feel drowsy. If you experience this symptom, you should not drive or use tools or machinery until the drowsiness disappears.

Geodon capsules contain lactose

Geodon capsules contain lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking Geodon capsules.

  1. How to use Geodon Capsules

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The capsules should be swallowed whole, not chewed and must be taken with meals. It is important not to chew the capsules as it may affect the extent to which the medicine is absorbed by the gut.

Geodon capsules should be taken twice daily, one capsule in the morning during a full ‘breakfast’ and one in the evening during the ‘evening meal’ (see the blister pack). You should take this medicine at the same time every day.

Adults

The recommended dose is 40-80 mg twice daily to be taken with meals.

In long-term treatments, your doctor may adjust the dose. You should not exceed the maximum dose of 160 mg per day.

Children and adolescents with bipolar mania

The usual starting dose is 20 mg to be taken with a meal, after which your doctor will advise on optimal doses for you. You should not exceed the maximum dose of 80 mg per day in children weighing 45 kg or less, or 160 mg per day in children weighing more than 45 kg.

The safety and efficacy of Geodon in the treatment of schizophrenia in children and adolescents has not been established.

Elderly (over 65 years old)

If you are elderly, your doctor will decide the suitable dose for you. Doses in those over 65 are sometimes lower than those used in younger people. Your doctor will advise you what the right dose is for you.

Patients with liver problems

If you have liver problems you may need to take a lower dose of Geodon capsules. Your doctor will work out the correct dose for you.

If you take more Geodon capsules than you should

Contact your doctor or go to the nearest hospital casualty department immediately. Take your box of Geodon capsules with you.

If you have taken too many Geodon capsules, you may experience drowsiness, shaking, fits and involuntary movements of the head and neck.

If you forget to take, Geodon capsules

It is important you take Geodon capsules regularly at the same time each day. If you forget to take a dose, take it as soon as you remember unless it is time for your next dose. In that case, just take your next dose. Do not take a double dose to make up for a forgotten dose.

If you stop taking Geodon capsules

Your doctor will tell you how long to take Geodon capsules for. You should not stop using Geodon, unless your doctor has told you to.

It is important to continue with your medication, even if you feel better. If you stop the treatment too early, the symptoms may return.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

  1. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them. However, most side effects are transient. It may often be difficult to distinguish the symptoms of your disease from those of side effects.

STOP taking Geodon capsules and contact your doctor immediately if you experience any of the following serious side effects:

Uncommon side effects (may affect up to 1 in 100 people):

  • Fast or irregular heartbeat, dizziness on standing up which may indicate abnormal functioning of the heart. These could be symptoms of a condition known as postural hypotension.
  • Involuntary/unusual movements, especially in your face or tongue.

Not known (frequency cannot be estimated from the available data):

  • Swelling in the face, lips, tongue or throat, swallowing or breathing problems, a nettle rash. These could be symptoms of a serious allergic reaction such as angioedema.
  • Fever, faster breathing, sweating, muscle stiffness, shaking, difficulty swallowing and reduced consciousness. These could be symptoms of a condition known as neuroleptic malignant syndrome.
  • Skin reactions, in particular rash, fever and swollen lymph nodes which could be symptoms of a condition called drug reaction with eosinophilia and systemic symptoms (DRESS). These reactions could be potentially life-threatening.
  • Confusion, agitation, high temperature, sweating, lack of muscle co-ordination, muscle twitching. These could be symptoms of a condition known as serotonin syndrome.
  • Fast, irregular heart beat, fainting which could be symptoms of a life-threatening condition known as Torsades de Pointes.
  • Persistent abnormal and painful erection of the penis.

You may experience any of the following side effects listed below. These potential side effects generally are mild to moderate and may resolve with time. However, if the side effect is severe or persistent, you should contact your doctor.

Common side effects (may affect up to 1 in 10 people):

  • Restlessness
  • Abnormalities of movement including involuntary movements, muscular stiffness and rigidity, slowness of movements, shaking, general weakness and tiredness.
  • Sleepiness
  • Dizziness
  • Headache
  • Constipation, nausea, vomiting and indigestion, dry mouth, increased salivation
  • Blurred vision.

Uncommon side effects (may affect up to 1 in 100 people):

  • Increased appetite
  • Difficulty in controlling movements
  • Feeling agitated or anxious, throat tightness, nightmares
  • Seizures, involuntary eyes movements into a fixed position, clumsiness, speech disorder, numbness, pins and needles sensation, reduced ability to concentrate, drooling, excessive daytime sleepiness, exhaustion
  • Palpitation, a feeling of faint when getting up, breathlessness
  • Sensitivity to light, buzzing in the ears
  • Sore throat, difficulty in swallowing, swollen tongue, diarrhoea, wind, stomach discomfort.
  • Itchy skin rash, acne
  • Muscle cramp, stiff or swollen joints
  • Thirst, pain, chest discomfort, abnormal walk

Rare side effects (may affect up to 1 in 1,000 people):

  • Runny nose
  • Decrease in calcium levels in the blood
  • Panic attack, feeling depressed, slowed thinking, lack of emotions
  • Unusual position of head (Wry-neck or torticollis), paralysis, restless legs
  • Partial or complete loss of vision in one eye, itchy eyes, dry eyes, vision disturbances
  • Ear pain
  • Hiccups
  • Acid reflux
  • Loose stools
  • Hair loss, swelling of the face, skin irritations
  • Inability to open mouth
  • Urinary incontinence, pain or difficulty urinating
  • Reduced or increased erection, reduced orgasm, abnormal breast milk production
  • Breast enlargement in both men and women
  • Feeling hot, fever
  • Decrease or increase in white blood cells (in blood test)
  • Abnormal liver function test results
  • High blood pressure
  • Abnormal blood, or heart rate test results
  • Patches of raised and inflamed red skin covered by a white scale known as psoriasis

Not known (frequency cannot be estimated from the available data):

  • Serious allergic reaction
  • In elderly people with dementia, a small increase in the number of deaths has been reported for patients taking antipsychotics compared with those not receiving antipsychotics.
  • Blood clots in the veins especially in the legs (symptoms include swelling, pain and redness in the leg), which may travel through blood vessels to the lungs causing chest pain and difficulty in breathing. If you notice any of these symptoms seek medical advice immediately.
  • Difficulty sleeping, involuntary urinating
  • Extremely high mood energy, strange thinking patterns and hyperactivity
  • Loss of consciousness
  • Large wheals (hives) with severe itching
  • Facial droop
  • Drug withdrawal syndrome in newborn babies

If you get any side effects talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via HPRA Pharmacovigilance, Earlsfort Terrace, IRL-Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie; e-mail: medsafety@hpra.ie. By reporting side effects you can help provide more information on the safety of this medicine.

  1. How to store Geodon Capsules

Keep this medicine out of the sight and reach and sight of children

Do not store above 30ºC.

Do not use this medicine after the expiry date, which is stated on the carton. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

  1. Contents of the pack and other information

What Geodon capsules contain

  • The active substance is ziprasidone. Each capsule contains 20 mg, 40 mg, 60 mg or 80 mg of ziprasidone as ziprasidone hydrochloride monohydrate.
  • The other ingredients are: lactose monohydrate, pregelatinised maize starch, magnesium stearate, gelatin, titanium dioxide (E171), sodium laurilsulfate (sodium dodecylsulphate) and indigotin (E132) for capsules containing blue (20, 40 and 80 mg), shellac, ethyl alcohol anhydrous, isopropyl alcohol, n-butyl alcohol, propylene glycol, purified water, ammonium hydroxide, potassium hydroxide and black iron oxide (E172).

What Geodon capsules look like and contents of the pack

Geodon capsules are hard gelatin capsules.

Geodon capsules 20 mg are blue/white and marked “Pfizer” and ZDX 20.

Geodon capsules 40 mg are blue and marked “Pfizer” and ZDX 40.

Geodon capsules 60 mg are white and marked “Pfizer” and ZDX 60.

Geodon capsules 80 mg are blue/white and marked “Pfizer” and ZDX 80.

Pack sizes:

Aluminium PVC/PVA blisters containing 14, 20, 30, 50, 56, 60 or 100 capsules.

Plastic bottle (HDPE) with drying agent and child-proof screw cap containing 100 capsules.

A heat induction seal may be used as a closure, in which case no drying agent is included

Not all pack sizes may be marketed.

Marketing Authorisation Holder

Pfizer Limited, Sandwich, Kent, CT13 9NJ, UK.

Manufacturer:

R-Pharm Germany GmbH

Heinrich-Mack-Str. 35, 89257 Illertissen, Germany

You can also telephone the following national helplines for more advice on schizophrenia:

Schizophrenia Ireland: 01 860 1620

Mental Health Association of Ireland: 01 284 1166

This medicinal product is authorised in the Member States of the EEA under the following names:

EU COUNTRIES

Capsules

Austria, Denmark, Finland, Germany, Iceland, Italy, Norway, Portugal, Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia

ZELDOX

Ireland

GEODON

Greece, Spain, Sweden

ZELDOX, GEODON

This leaflet was last revised in 01/2016

Ref: GE 16_0

A previous article entitled ATYPICAL ANTIPSYCHOTICS provides information... 5-ht1a receptors, 5-HT2 receptors ve 9-hydroxy-risperidone

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