Buy Ziprasidone HCl (Geodon) online
How and where to order Geodon (Ziprasidone Hydrochloride) 20 mg, 40 mg, 80 mg capsules or tablets online:
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Indications and usage:
Ziprasidone is an atypical antipsychotic. In choosing among treatments, prescribers should be aware of the capacity of Geodon to prolong the QT interval and may consider the use of other drugs first.
Geodon (Ziprasidone Hydrochloride) capsules and tablets are indicated for the:
Geodon (Ziprasidone Mesylate) for injection is indicated for the:
Dosage and administration:
Administer capsules orally with food. Do not open, crush, or chew.
Schizophrenia: initiate at 20 mg twice daily. Daily dosage may be adjusted up to 80 mg twice daily. Dose adjustments should occur at intervals of not less than 2 days. Safety and efficacy has been demonstrated in doses up to 100 mg twice daily. The lowest effective dose should be used.
Acute treatment of manic/mixed episodes of bipolar I disorder: initiate at 40 mg twice daily. Increase to 60 mg or 80 mg twice daily on day 2 of treatment. Subsequent dose adjustments should be based on tolerability and efficacy within the range of 40-80 mg twice daily.
Maintenance treatment of bipolar I disorder as an adjunct to lithium or valproate: continue treatment at the same dose on which the patient was initially stabilized, within the range of 40-80 mg twice daily.
Acute treatment of agitation associated with schizophrenia (intramuscular administration): 10 mg-20 mg up to a maximum dose of 40 mg per day. Doses of 10 mg may be administered every 2 hours. Doses of 20 mg may be administered every 4 hours.
In case of acute ziprasidone overdosage, establish and maintain an airway and ensure adequate oxygenation and ventilation. Intravenous access should be established, and gastric lavage (after intubation, if patient is unconscious) and administration of activated charcoal together with a laxative should be considered. The possibility of obtundation, seizure, or dystonic reaction of the head and neck following overdose may create a risk of aspiration with induced emesis.
Cardiovascular monitoring should commence immediately and should include continuous electrocardiographic monitoring to detect possible arrhythmias. If antiarrhythmic therapy is administered, disopyramide, procainamide, and quinidine carry a theoretical hazard of additive QT-prolonging effects that might be additive to those of ziprasidone.
Hypotension and circulatory collapse should be treated with appropriate measures such as intravenous fluids. If sympathomimetic agents are used for vascular support, epinephrine and dopamine should not be used, since beta stimulation combined with alpha-1 antagonism associated with ziprasidone may worsen hypotension. Similarly, it is reasonable to expect that the alpha-adrenergic-blocking properties of bretylium might be additive to those of ziprasidone, resulting in problematic hypotension.
In cases of severe extrapyramidal symptoms, anticholinergic medication should be administered. There is no specific antidote to ziprasidone, and it is not dialyzable. The possibility of multiple drug involvement should be considered. Close medical supervision and monitoring should continue until the patient recovers.
Dosage forms and strengths:
Warnings and precautions:
Adverse reactions, side effects:
Commonly observed adverse reactions (incidence >= 5% and at least twice the incidence for placebo) were:
To report suspected side effects of Geodon (Ziprasidone) pills and injections contact Pfizer pharmaceutical company or your local FDA.
Use in specific populations:
May cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure.
Limited data from a published case report indicate the presence of ziprasidone in human milk.
The safety and effectiveness of this drug have not been established in pediatric patients.
Ziprasidone was studied in one 4-week, placebo-controlled trial in patients 10 to 17 years of age with bipolar I disorder. However, the data were insufficient to fully assess the safety of Geodon in pediatric patients. Therefore, a safe and effective dose for use could not be established.
Of the total number of subjects in clinical studies of ziprasidone, 2.4% were 65 and over. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Nevertheless, the presence of multiple factors that might increase the pharmacodynamic response to ziprasidone, or cause poorer tolerance or orthostasis, should lead to consideration of a lower starting dose, slower titration, and careful monitoring during the initial dosing period for some elderly patients.
Geodon (Ziprasidone Mesylate) intramuscular has not been systematically evaluated in elderly patients (65 years and over).
Intramuscular ziprasidone should be administered with caution to patients with impaired renal function as the cyclodextrin excipient is cleared by renal filtration.
Age and gender effects
In a multiple-dose (8 days of treatment) study involving 32 subjects, there was no difference in the pharmacokinetics of ziprasidone between men and women or between elderly (>65 years) and young (18 to 45 years) subjects. Additionally, population pharmacokinetic evaluation of patients in controlled trials has revealed no evidence of clinically significant age or gender-related differences in the pharmacokinetics of ziprasidone. Dosage modifications for age or gender are, therefore, not recommended.
Based on in vitro studies utilizing human liver enzymes, ziprasidone is not a substrate for CYP1A2; smoking should therefore not have an effect on the pharmacokinetics of ziprasidone. Consistent with these in vitro results, population pharmacokinetic evaluation has not revealed any significant pharmacokinetic differences between smokers and nonsmokers.
Drug abuse and dependence:
Ziprasidone (Geodon) has not been systematically studied, in animals or humans, for its potential for abuse, tolerance, or physical dependence. While the clinical trials did not reveal any tendency for drug-seeking behavior, these observations were not systematic and it is not possible to predict on the basis of this limited experience the extent to which ziprasidone will be misused, diverted, and/or abused once marketed. Consequently, patients should be evaluated carefully for a history of drug abuse, and such patients should be observed closely for signs of ziprasidone misuse or abuse (e.g., development of tolerance, increases in dose, drug-seeking behavior).
Patient counseling information:
Administration information for capsules
Advise patients to take Geodon (Ziprasidone Hydrochloride) capsules and tablets whole. Do not open, crush, or chew the capsules. Instruct patients to take Geodon capsules with food for optimal absorption. The absorption of ziprasidone is increased up to two-fold in the presence of food.
Advise patients to inform their health care providers of the following: history of QT prolongation; recent acute myocardial infarction; uncompensated heart failure; prescription of other drugs that have demonstrated QT prolongation; risk for significant electrolyte abnormalities; and history of cardiac arrhythmia.
Instruct patients to report the onset of any conditions that put them at risk for significant electrolyte disturbances, hypokalemia in particular, including but not limited to the initiation of diuretic therapy or prolonged diarrhea. In addition, instruct patients to report symptoms such as dizziness, palpitations, or syncope to the prescriber.
Severe cutaneous adverse reactions
Instruct patients to report to their health care provider at the earliest onset any signs or symptoms that may be associated with Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) or with severe cutaneous adverse reactions, such as Stevens-Johnson syndrome.
Advise pregnant women to notify their healthcare provider if they become pregnant or intend to become pregnant during treatment with Geodon. Advise patients that this medication may cause extrapyramidal and/or withdrawal symptoms (agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder) in a neonate. Advise patients that there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ziprasidone during pregnancy.
Advise breastfeeding women using this drug to monitor infants for excess sedation, irritability, poor feeding, and extrapyramidal symptoms (tremors, and abnormal muscle movements) and to seek medical care if they notice these signs.
Advise females of reproductive potential that Geodon may impair fertility due to an increase in serum prolactin levels. The effects on fertility are reversible.
Where to buy ziprasidone online:
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Here is a list of popular medications containing ziprasidone as a main active pharmaceutical ingredient; their trade names, forms, doses, companies - manufacturers, distributors, suppliers, researchers and developers:
|Trade name of the drug
|Pharmaceutical forms and doses