- Primarily a Serotonin 2A Antagonist (Dopamine D2 Antagonist activity is much less)
- Oral
- Start: 20 mg orally twice daily taken with meals (at least 500 kcal)
- Titrate dose as often as every 2-3 days to effective dose twice daily
- Maximum: 80 mg orally twice daily
-
Parenteral (acute Agitation)
- Ziprasidone 10 to 20 mg IM
- May repeat 10 mg every 2 hours (or 20 mg every 4 hours) up to cummulative maximum of 40 mg/day
- Maximum: 40 mg/day
- Start 40 mg orally twice daily taken with meals (at least 500 kcal)
- May increase to 60 to 80 mg orally twice daily after the first 1-2 days
- Target dose: 40 to 80 mg orally twice daily
- Maximum: 80 mg orally twice daily
- Minimal weight gain than with other Atypical Antipsychotics
- Lower risk of diabetes than with other Atypical Antipsychotics
- Must be taken with meals of at least 500 kcals to ensure adequate absorption
- Metabolized by CYP3A4
- Increase Antipsychotic levels (toxicity risk): Monitor for toxicity
- Clarithromycin
- Erythromycin
- Grapefruit juice
- Fluconazole
- Itraconazole
- Ketoconazole
- Decrease Antipsychotic levels (lower efficacy)
- Carbamazepine
- Phenytoin
- Pregnancy Category C
- Avoid in Lactation
- (2016) Med Lett Drugs Ther 58(1510): 160-5
- Glauser and Peters (2016) Crit Dec Emerg Med 30(4): 17-27
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 42-3
loading