Schizophrenia

Active Ingredient: Ziprasidone

Indication for Ziprasidone

Population group: only adults (18 years old or older)
Therapeutic intent: Curative procedure

For this indication, competent medicine agencies globally authorize below treatments:

10 mg every 2 hours or 20 mg initial dose followed by 10 mg after 4 hours, 40 mg maximum daily dose

For:

Dosage regimens

Regimen A: Intramuscular, 10 milligrams ziprasidone, 1 to 4 times daily, over the duration of 1 to 3 days. The maximum allowed total dose is 40 milligrams ziprasidone daily.

Regimen B: Intramuscular, 20 milligrams ziprasidone, one dose, over the duration of 4 hours. Afterwards, intramuscular, 10 milligrams ziprasidone, 0 to 2 doses in total, over the duration of 20 hours. Afterwards, intramuscular, 10 milligrams ziprasidone, 1 to 4 times daily, over the duration of 0 to 2 days. The maximum allowed total dose is 40 milligrams ziprasidone daily.

Detailed description

Treatment with the intramuscular formulation should only be used in patients, where treatment with an oral formulation is considered to be inappropriate.

The recommended dose is 10 mg administered as required up to a maximum dose of 40 mg per day. Doses of 10 mg may be administered every 2 hours. Some patients may require an initial dose of 20mg, which can be followed by a further dose of 10 mg after 4 hours. Thereafter, doses of 10 mg may be given every 2 hours up to the maximum daily dose of 40 mg. Intramuscular administration of ziprasidone for more than 3 consecutive days has not been studied.

If long-term therapy is indicated, oral ziprasidone hydrochloride capsules, up to 80 mg twice daily, should replace the intramuscular administration as soon as possible.

40 mg twice daily

For:

Dosage regimens

Oral, 40 milligrams ziprasidone, 2 times daily to meals.

Detailed description

The recommended dose in acute treatment of schizophrenia is 40 mg twice daily taken with food. Daily dosage may subsequently be adjusted on the basis of individual clinical status up to a maximum of 80 mg twice daily. If indicated, the maximum recommended dose may be reached as early as day 3 of treatment.

It is of particular importance not to exceed the maximum dose as the safety profile above 160 mg/day has not been confirmed and ziprasidone is associated with dose-related prolongation of the QT interval.

In maintenance treatment of schizophrenia patients, ziprasidone should be administered at the lowest effective dose; in many cases, a dose of 20 mg twice daily may be sufficient.

Elderly

A lower starting dose is not routinely indicated but should be considered for those 65 and over when clinical factors warrant.

Dosage considerations

It should be taken with food.

Active ingredient

Ziprasidone

Ziprasidone has been shown to be an antagonist at both serotonin type 2A (5HT2A) and dopamine type 2 (D2) receptors. It is proposed that the therapeutic activity is mediated, in part, through this combination of antagonist activities. Ziprasidone is also a potent antagonist at 5HT2C and 5HT1D receptors, a potent agonist at the 5HT1A receptor and inhibits neuronal reuptake of norepinephrine and serotonin.

Read more about Ziprasidone

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