Ziprasidone is an antipsychotic medication. It works by changing the effects of chemicals in the brain.

Ziprasidone is used to treat schizophrenia and the manic symptoms of bipolar disorder (manic depression).

Ziprasidone may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Geodon (Ziprasidone)?

Ziprasidone is not for use in psychotic conditions related to dementia. Ziprasidone may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. Do not use this medication if you have a personal or family history of “Long QT syndrome,” if you have recently had a heart attack, or if you have uncontrolled heart failure.

Stop taking ziprasidone and call your doctor right away if you feel dizzy or light-headed, have a fast or pounding heartbeat, or if you faint. This could be signs of a serious heart rhythm problem.

There are many other medicines that can cause serious or life-threatening medical problems if you take them together with ziprasidone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

What should I discuss with my healthcare provider before taking Geodon (Ziprasidone)?

Ziprasidone is not for use in psychotic conditions related to dementia. Ziprasidone may cause heart failure, sudden death, or pneumonia in older adults with dementia-related conditions. Do not use this medication if you are allergic to ziprasidone, or if you have:

• a personal or family history of “Long QT syndrome”;
• history of recent heart attack; or
• uncontrolled or untreated heart failure.

Ziprasidone should never be taken together with any of the following drugs, or a life-threatening heart rhythm disorder could occur:

• arsenic trioxide (Trisenox);
• dolasetron (Anzemet);
• droperidol (Inapsine);
• halofantrine (Halfan);
• mefloquine (Lariam);
• levomethadyl acetate (no longer available in the U.S.);
• tacrolimus (Prograf);
• antibiotics such as gatifloxacin (Tequin), pentamidine (NebuPent, Pentam), moxifloxacin (Avelox), sparfloxacin (Zagam), telithromycin (Ketek);
• heart rhythm medicine such as dofetilide (Tikosyn), disopyramide (Norpace), quinidine (Cardioquin, Quinaglute), or sotalol (Betapace); or
• medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), mesoridazine (Serentil), pimozide (Orap), or thioridazine (Mellaril).

Before taking ziprasidone, tell your doctor if you are allergic to any drugs, or if you have:

• a heart rhythm disorder;
• a history of heart attack or stroke;
• low blood levels of potassium or magnesium;
• diabetes (ziprasidone may raise your blood sugar);
• seizures or epilepsy;
• a history of suicidal thoughts;
• Parkinson’s disease, Alzheimer’s;
• trouble swallowing;
• liver disease; or
• kidney disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take ziprasidone.

Ziprasidone may cause you to have high blood sugar (hyperglycemia). Talk to your doctor if you have any signs of hyperglycemia such as increased thirst or urination, excessive hunger, or weakness. If you are diabetic, check your blood sugar levels on a regular basis while you are taking ziprasidone.

The ziprasidone orally disintegrating tablet may contain phenylalanine. Talk to your doctor before using this form of ziprasidone if you have phenylketonuria (PKU).

FDA pregnancy category C. It is not known whether ziprasidone is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether ziprasidone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine.

How should I take Geodon (Ziprasidone)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

To be sure this medication is not causing harmful effects, your blood will need to be tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss any scheduled appointments.

Take this medicine with food.

It is important to take ziprasidone regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

It may take several weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve. Store ziprasidone at room temperature away from moisture, light, and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical treatment if you think you have used too much of this medicine. Overdose symptoms may include drowsiness, problems with speech, dizziness, feeling light-headed, fainting, fast or pounding heartbeat, or restless muscle movements in your eyes, tongue, jaw, or neck.

Geodon (Ziprasidone) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using ziprasidone and call your doctor at once if you have any of these serious side effects:

• dizziness, feeling light-headed, fainting, fast or pounding heartbeat;
• fever, stiff muscles, confusion, sweating, fast or uneven heartbeats;
• tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;
• agitation, hostility, confusion;
• increased thirst or urination, weakness, extreme hunger; or
• penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

• mild skin rash;
• anxiety, headache, depressed mood;
• dizziness, drowsiness;
• muscle pain or twitching;
• nausea, vomiting, loss of appetite;
• runny or stuffy nose, cough, sore throat; or
• weight gain.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Geodon (Ziprasidone)?

Before taking ziprasidone, tell your doctor if you regularly use any other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by ziprasidone.

Also tell your doctor if you are using any of the following drugs:

• a diuretic (water pill), blood pressure medicine, or heart rhythm medicine;
• carbamazepine (Carbatrol, Tegretol);
• cisapride (Propulsid);
• haloperidol (Haldol);
• narcotic pain medication;
• medicines used to treat Parkinson’s Disease such as levodopa (Dopar, Larodopa, Sinemet, Atamet, others); or
• antibiotics such as azithromycin (Zithromax), clarithromycin (Biaxin), dirithromycin (Dynabac), erythromycin (E-Mycin, E.E.S., Erythrocin, Ery-Tab), ketoconazole (Nizoral), or telithromycin (Ketek).

This list is not complete and there may be other drugs that can interact with ziprasidone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Paroxetine is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paroxetine affects chemicals in the brain that may become unbalanced.

Paroxetine is used to treat depression, obsessive-compulsive disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Paroxetine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Paxil (Paroxetine)?

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Paroxetine may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking paroxetine, do not stop taking the medication without first talking to your doctor. Do not take paroxetine together with pimozide (Orap), thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate).

What should I discuss with my healthcare provider before taking Paxil (Paroxetine)?

Do not use paroxetine if you are using pimozide (Orap), thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with paroxetine. You must wait at least 14 days after stopping an MAO inhibitor before you can take paroxetine. After you stop taking paroxetine, you must wait at least 14 days before you start taking an MAOI.

Before taking paroxetine, tell your doctor if you are allergic to any drugs, or if you have:

• liver or kidney disease;
• a bleeding or blood clotting disorder;
• seizures or epilepsy; or
• bipolar disorder (manic depression), or a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use this medication.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category D. Paroxetine may cause heart defects or serious, life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking paroxetine, do not stop taking the medication without first talking to your doctor. Paroxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take Paxil (Paroxetine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

Do not crush, chew, or break a controlled-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time. Shake the liquid form of paroxetine well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. It may take up to 4 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 4 weeks of treatment.

You may have withdrawal symptoms (such as agitation, dizziness, numbness or tingling, ringing in your ears, confusion, or behavior changes) after you stop taking paroxetine. Do not stop taking this medication suddenly without first talking to your doctor.

Store paroxetine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, tremor, sweating, decreased urination, blurred vision, rapid heartbeat, confusion, aggression, seizures, and coma.

Paxil (Paroxetine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• seizure (convulsions);
• tremors, shivering, muscle stiffness or twitching;
• problems with balance or coordination;
• agitation, confusion, sweating, fast heartbeat; or
• easy bruising or bleeding (such as a nosebleed).

Less serious side effects may include:

• feeling nervous, restless, or unable to sit still;
• drowsiness, dizziness, weakness;
• sleep problems (insomnia);
• nausea, constipation, loss of appetite;
• weight changes;
• decreased sex drive, impotence, or difficulty having an orgasm; or
• dry mouth, yawning, or ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Paxil (Paroxetine)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with paroxetine may cause you to bruise or bleed easily.

Many drugs can interact with paroxetine. Below is just a partial list. Tell your doctor if you are using:

• a blood thinner such as warfarin (Coumadin);
• cimetidine (Tagamet);
• fosamprenavir (Lexiva);
• linezolid (Zyvox);
• ritonavir (Norvir);
• St. John’s wort;
• tamoxifen (Nolvadex, Soltamox);
• theophylline (Elixophyllin, Theo-24, Uniphyl);
• tramadol (Ultram);
• tryptophan (also called L-tryptophan);
• heart medication such as digoxin (digitalis, Lanoxin), flecainide (Tambocor), quinidine (QuinaGlute, Quinidex, Quin-Release), risperidone (Risperdal), or propafenone (Rhythmol);
• any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or sertraline (Zoloft);
• medicine to treat psychiatric disorders, such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), haloperidol (Haldol), lithium (Lithobid, Eskalith), or perphenazine (Trilafon); or
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with paroxetine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Duloxetine is an antidepressant in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Duloxetine affects chemicals in the brain that may become unbalanced and cause depression.

Duloxetine is used to treat major depressive disorder and general anxiety disorder. It is also used to treat a chronic pain disorder called fibromyalgia, and to treat pain caused by nerve damage in people with diabetes (diabetic neuropathy).

Duloxetine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Cymbalta (Duloxetine)?

Do not take duloxetine together with thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take duloxetine. After you stop taking duloxetine, you must wait at least 5 days before you start taking an MAOI.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Avoid drinking alcohol while taking duloxetine. Alcohol may increase the risk of damage to your liver.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by duloxetine. Tell your doctor if you regularly use any of these other medicines.

Duloxetine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before taking Cymbalta (Duloxetine)?

Do not use duloxetine together with thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with duloxetine. You must wait at least 14 days after stopping an MAO inhibitor before you can take duloxetine. After you stop taking duloxetine, you must wait at least 5 days before you start taking an MAOI. Do not use this medication if you are allergic to duloxetine, or if you have untreated or uncontrolled glaucoma.

Before taking duloxetine, tell your doctor if you are allergic to any drugs, or if you have:

• liver or kidney disease;
• seizures or epilepsy;
• a bleeding or blood clotting disorder;
• glaucoma;
• bipolar disorder (manic depression); or
• a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take duloxetine.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. Duloxetine may be harmful to an unborn baby, and may cause problems in a newborn baby if the mother takes the medication late in pregnancy (during the third trimester). Tell your doctor if you are pregnant or plan to become pregnant during treatment. Duloxetine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the side effects of this medication.

Do not give duloxetine to anyone younger than 18 years old without the advice of a doctor.

How should I take Cymbalta (Duloxetine)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

Do not crush, chew, break, or open a delayed-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. It may take 4 weeks or longer for your symptoms to improve. For best results, keep using the medication as directed. Do not stop using duloxetine without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store duloxetine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, diarrhea, agitation, confusion, hallucinations, fast heart rate, feeling light-headed, or fainting.

Cymbalta (Duloxetine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
• restlessness, overactive reflexes, hallucinations, loss of coordination, fainting, coma;
• nausea, vomiting, diarrhea, fever, and fast heartbeat;
• painful or difficult urination;
• easy bruising or bleeding, nosebleeds, or
• black, bloody, or tarry stools.

Less serious side effects may include:

• dry mouth;
• drowsiness, dizziness, headache;
• diarrhea, constipation;
• sleep problems (insomnia);
• weight changes;
• feeling anxious or nervous, increased sweating; or
• decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Cymbalta (Duloxetine)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with duloxetine may cause you to bruise or bleed easily.

Before taking duloxetine, tell your doctor if you are using any of the following medicines:

• a blood thinner such as warfarin (Coumadin);
• cimetidine (Tagamet);
• a diuretic (water pill);
• fluvoxamine (Luvox);
• linezolid (Zyvox);
• lithium (Lithobid, Eskalith);
• St. John’s wort;
• tramadol (Ultram);
• tryptophan (sometimes called L-tryptophan);
• an antibiotic such as ciprofloxacin (Cipro) or enoxacin (Penetrex);
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
• any other antidepressant such as desipramine (Norpramin), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), and others.

This list is not complete and there may be other drugs that can interact with duloxetine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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