Ziprasidone: Formula, Indications, Mechanism of Action, Dosage, Side Effects, Warnings, Contraindications and Interactions

It belongs to a class of drugs called atypical antipsychotics and neuroleptics.

Ziprasidone does not cure schizophrenia or bipolar disorder, but it can help control symptoms and help prevent further episodes.

Taking antipsychotic or neuroleptic medications like ziprasidone may also allow you to try psychological therapies when recommended by your doctor.

Ziprasidone is used as a short-term treatment for manic phases.

Chemical formula

  • C21H21ClN4OS.


20, 40, 60 and 80 mg capsules and 30 mg powder for solution for intramuscular administration.


It is used to control the symptoms of schizophrenia and bipolar affective disorder .

Mechanism of action

Mental wellness is related in part to maintaining a balance between naturally occurring chemicals in the brain called neurotransmitters.

Ziprasidone is believed to modify the actions of several neurotransmitters, thereby restoring the proper function of chemical systems in the brain that are out of balance in people with schizophrenia.


  • Ziprasidone dosage varies widely from one individual to another.
  • A common starting dose is ziprasidone 20 mg twice a day.
  • The dose is gradually increased until the symptoms of schizophrenia disappear .
  • Doses of up to 100 mg can be taken twice a day.
  • Ziprasidone should be taken with food.

Side effects

The most common reason ziprasidone is stopped is due to the development of a rash, and drowsiness is the most common side effect.

Other side effects that can occur are abnormal, involuntary contractions and breathing disorders.

Nausea, constipation, indigestion, and dizziness due to low blood pressure occur in more than 5% of people taking ziprasidone.

Other less common side effects are fast heartbeat, low blood pressure, agitation, tremor, confusion, amnesia, dry mouth, increased salivation, joint pain, and abnormal vision.

The incidence of some adverse effects, such as low blood pressure, anorexia, abnormal involuntary movements, drowsiness, tremor, cold symptoms, rash, abnormal vision, dry mouth, or increased salivation, appears to increase at higher doses.

People taking ziprasidone should alert their doctor immediately if they develop a rash or hives, as this could indicate a potentially serious adverse reaction.

Patients should also notify them immediately if they experience abnormal involuntary muscle movements.

Warnings and Contraindications


This side effect usually gets worse when the medication is started and becomes less severe with continued use.

People who perform tasks that require mental alertness, such as driving or operating machinery, should refrain from doing so until they see how the drug affects them.


Do not take this medicine if the patient is hypersensitive or has had an allergic reaction to ziprasidone or any of the ingredients in the medicine.

Heart problems

Ziprasidone can alter your heart rhythm.

Due to the risk of irregular heartbeat or even death, it should not be taken by people with a history of prolonged or irregular heartbeat (long QT syndrome), people with heart failure, or people who have recently had a heart attack.

People with a history of heart disease should discuss the risks and benefits of treatment with their doctor before starting ziprasidone.

Ziprasidone can lower blood pressure to dangerously low levels, causing the patient to pass out.

It should not be taken by people who have a slow heartbeat and those with low levels of potassium or magnesium in the blood.


People with a history of seizures, including seizures caused by drug or alcohol abuse, should use ziprasidone with caution and with doctor’s supervision, as it may increase the risk of having seizures.

Body temperature

Ziprasidone can raise body temperature to dangerously high levels. For example, for people who exercise vigorously, those who are exposed to extreme heat, those who take drugs with anticholinergic effects (this includes many common antidepressants).

People prone to dehydration should use the drug with caution and be alert to dehydration-related side effects.


Older people at increased risk of developing pneumonia should be carefully monitored while taking ziprasidone.

Suicidal behavior

Because there is a high incidence of suicide in all patients with psychotic illnesses, people using ziprasidone should be watched carefully for signs of suicidal behavior.


Like most atypical antipsychotic / neuroleptic medications, the use of ziprasidone is not recommended during pregnancy.

For women of childbearing potential, appropriate contraception is recommended.


It is not known if ziprasidone passes into breast milk, so it is recommended to consult a doctor about its use in nursing mothers.


Ziprasidone is not recommended for children under 18 years of age as there is not enough information on its effects in this age group.


Ziprasidone interacts with many other drugs.

It is necessary to review all the medicines that are taken with the doctor, before starting to use this medicine.

Since ziprasidone can alter the heart rhythm, people who are also taking medications such as quinidine, dofetilide, pimozide, sotalol, erythromycin, thioridazine, moxifloxacin, and sparfloxacin should not take it.

These medications can also affect the properties of the heart, and taken with ziprasidone increases the risk of irregular heart rhythms and other heart problems.

Because ziprasidone causes drowsiness, it should be used in moderation and with caution with other drugs that also have a tendency to make people drowsy, such as antidepressants, antihistamines , some pain relievers, and alcohol.

Ziprasidone can lower blood pressure to the point where people feel dizzy or faint.

People taking medications to regulate their blood pressure should monitor their blood pressure and modify treatment as needed.

Ziprasidone can also decrease the effects of medications used to treat Parkinson’s disease, such as levodopa.

Other medicines taken in combination with ziprasidone can alter the effects of ziprasidone.

For example, medications such as carbamazepine , which are used to treat seizures, increase the metabolism of the liver and can make ziprasidone less effective.

Alternatively, medications such as ketoconazole decrease liver metabolism and can increase the negative side effects associated with ziprasidone.