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Home » Antipsychotics

Zeldox (ziprasidone)

Submitted by on February 7, 2011 – 6:01 pm | 1,292 views

How does Zeldox work? What will it do for me?

Ziprasidone belongs to the class of medications called antipsychotics. It is used to control the symptoms of and related mental health disorders. It works by adjusting the balance of chemicals in the brain that are involved in schizophrenia.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use Zeldox?

The usual starting dose of ziprasidone is 20 mg to 40 mg twice daily with food. The dose can be increased gradually every 2 days up to 80 mg twice daily, as recommended by the doctor. For maintenance treatment, the lowest dose needed to control symptoms should be used. The capsules should be swallowed whole with a glass of water.

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.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose of this medication 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.

Store this medication 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.

What form(s) does Zeldox come in?

20 mg

Each size No. 4 blue/white opaque hard gelatin capsule, imprinted in black with “Pfizer” and “396” or “ZDX 20”, contains ziprasidone hydrochloride, monohydrate equivalent to 20 mg of ziprasidone. Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, magnesium stearate.

40 mg

Each size No. 4 blue/blue opaque hard gelatin capsule, imprinted in black with “Pfizer” and “397” or “ZDX 40”, contains ziprasidone hydrochloride, monohydrate equivalent to 40 mg of ziprasidone. Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, magnesium stearate.

60 mg

Each size No. 3 white/white opaque hard gelatin capsule, imprinted in black with “Pfizer” and “398” or “ZDX 60”, contains ziprasidone hydrochloride, monohydrate equivalent to 60 mg of ziprasidone. Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, magnesium stearate.

80 mg

Each size No. 2 blue/white opaque hard gelatin capsule, imprinted in black with “Pfizer” and “399” or “ZDX 80”, contains ziprasidone hydrochloride, monohydrate equivalent to 80 mg of ziprasidone. Nonmedicinal ingredients: lactose monohydrate, pregelatinized starch, magnesium stearate.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take Zeldox?

Ziprasidone should not be used by anyone who:

is allergic to ziprasidone or to any of the ingredients of the medication

is taking medications such as dofetilide, , , mesoridazine, thioridazine, , droperidol, pimozide, , , moxifloxacin, halofantrine, , pentamidine, , levomethadyl acetate, , probucol, tacrolimus, or any other medication that can cause

has or has a history of QT prolongation (including congenital long QT syndrome)

has recently had a heart attack

has severe heart failure

What side effects are possible with Zeldox?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

abdominal pain






dry mouth


flu-like symptoms

fungal skin infections


increased cough

increased sun sensitivity

leakage of fluid or milk from breasts (women)

loss of appetite  menstrual changes

muscle aches

muscle stiffness or spasm

nausea or upset stomach


respiratory tract infections


runny nose

sensations that the room is spinning

sexual difficulties

slowness of movement


vision changes



weight gain

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

abnormal movements of the face or tongue

abnormal walking

changes in body temperature, or feeling very hot and unable to cool down

chest pain

continuous erection

dizziness, especially when standing from a lying or seated position

high blood pressure

muscle twitching

painful eye movements

Stop taking the medication and seek immediate medical attention if any of the following occur:

abnormal heart rhythms (such as fast or slow heart rate, palpitations), fainting or seizures

confusion, reduced consciousness, high fever, or muscle stiffness

peeling or blistering skin

symptoms of a severe allergic reaction (itching, skin rash, shortness of breath, swelling of the face, lips, or tongue)

symptoms of a stoke such as sudden weakness or numbness of the face, arms, or legs (especially on one side); slurred speech; vision problems

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for Zeldox?

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 this medication.

Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, droperidol, pimozide, gatifloxacin, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, dolasetron mesylate, probucol, tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with 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 hearth 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

Talk to your doctor about the risks and benefits of using this medication if you have any of these risk factors.

Blood sugar: This medication may cause high blood sugar levels. If you experience weakness, increased thirst, increased urination, and increased appetite while taking this medication, contact your doctor.

Body temperature: This medication, 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 this medication.

Drowsiness/reduced alertness: Ziprasidone may interfere with activities requiring mental alertness. People taking this medication should not drive or operate machinery until they know how this medication affects them.

Low blood pressure: Ziprasidone may cause low blood pressure when rising from a sitting or lying position. If you feel dizzy, lightheaded, or feel your pulse racing, or if you faint, call your doctor. While you are taking this medication, get up slowly if you have been sitting or lying down for a prolonged period.

Neuroleptic malignant syndrome (NMS): 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.

Seizures: Ziprasidone may increase the risk of seizures, especially in people who have had seizures in the past. People who are at risk of seizures who take this medication should be closely monitored by their doctor.

Tardive Dyskinesia (TD): TD, a syndrome consisting of potentially irreversible, involuntary, repetitive movements of the face and tongue muscles, may develop in people who take certain antipsychotic medications including ziprasidone. 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.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if ziprasidone passes into breast milk. It is recommended that women taking this medication should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.

Seniors: Medications similar to ziprasidone can increase the risk of death when used to treat seniors with dementia. Ziprasidone should not be used in seniors with dementia.

What other drugs could interact with Zeldox?

There may be an interaction between ziprasidone and any of the following:alcohol


arsenic trioxide

blood-pressure medications



dolasetron mesylate

dopamine agonists (e.g., pramipexole, ropinirole)



ketoconazole     levodopa











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 this medication. 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.

A previous article entitled Antipsychotics provides information... Antipsychotics, Anxiety or agitation ve Aripiprazole

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