Mood disorders:
Indications for: GEODON
Acute treatment of manic or mixed episodes in bipolar disorder as monotherapy; or as an adjunct to lithium or valproate for maintenance treatment.
Adult Dosage:
Take with food. Initially 40mg twice daily; may increase on day 2 to 60mg or 80mg twice daily; usual range 40–80mg twice daily. Elderly: consider lower initial dose, slower titration.
Children Dosage:
Not established.
GEODON Contraindications:
History of QT prolongation. Congenital long QT syndrome. Recent acute MI. Uncompensated heart failure. Concomitant drugs that cause QT prolongation, including dofetilide, sotalol, quinidine, other Class Ia and III antiarrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl, dolasetron, probucol, tacrolimus.
Boxed Warning:
Increased mortality in elderly patients with dementia-related psychosis.
GEODON Warnings/Precautions:
Increased mortality in elderly with dementia-related psychosis (not approved use). Concomitant use of oral and IM forms: not recommended. Renal (IM form) or hepatic impairment (both forms). Discontinue if QTc >500 msec persists, neuroleptic malignant syndrome, unexplained rash occurs, or if severe skin reactions (eg, Stevens-Johnson syndrome or DRESS) are suspected; consider discontinuing if tardive dyskinesia occurs. Conditions that increase risk of torsade de pointes (eg, bradycardia, hypokalemia, hypomagnesemia). Monitor potassium, magnesium, others if risk of electrolyte disturbances (eg, diarrhea); correct imbalance before starting. Avoid in significant cardiovascular disease (eg, arrhythmias). Evaluate cardiac function if symptoms of torsade de pointes occur (eg, dizziness, palpitations, syncope). Cardio- or cerebrovascular disease. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Diabetes; monitor for hyperglycemia. Monitor weight. Risk of hypotension or seizures. History of breast cancer. Dysphagia. Exposure to extreme heat. Perform fall risk assessments when initiating and recurrently on long-term therapy. Reevaluate periodically. Write ℞ for smallest practical amount. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.
GEODON Classification:
Serotonin and dopamine antagonist.
GEODON Interactions:
See Contraindications. May potentiate CNS drugs, antihypertensives. May antagonize levodopa, dopamine agonists. Extent of absorption and/or plasma levels may be affected by CYP3A4 inducers (eg, carbamazepine) or inhibitors (eg, ketoconazole). Correct hypokalemia, hypomagnesemia due to diuretics.
Adverse Reactions:
Somnolence, extrapyramidal syndrome, respiratory disorder, dizziness, akathisia, abnormal vision, asthenia, vomiting, nausea, rash, dystonia, postural hypotension, QTc prolongation, headache, weight gain, hyperprolactinemia, dyslipidemia, hyperglycemia; rare: priapism, leukopenia, neutropenia, agranulocytosis (may be fatal).
Drug Elimination:
Half-life: 7 hours (oral); 2–5 hours (IM).
Generic Drug Availability:
YES
How Supplied:
Caps—60
Psychosis:
Indications for: GEODON
Schizophrenia.
Adult Dosage:
Take with food. Initially 20mg twice daily; may increase at intervals of at least 2 days; max 80mg twice daily. Elderly: consider lower initial dose, slower titration.
Children Dosage:
Not established.
GEODON Contraindications:
History of QT prolongation. Congenital long QT syndrome. Recent acute MI. Uncompensated heart failure. Concomitant drugs that cause QT prolongation, including dofetilide, sotalol, quinidine, other Class Ia and III antiarrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl, dolasetron, probucol, tacrolimus.
Boxed Warning:
Increased mortality in elderly patients with dementia-related psychosis.
GEODON Warnings/Precautions:
Increased mortality in elderly with dementia-related psychosis (not approved use). Concomitant use of oral and IM forms: not recommended. Renal (IM form) or hepatic impairment (both forms). Discontinue if QTc >500 msec persists, neuroleptic malignant syndrome, unexplained rash occurs, or if severe skin reactions (eg, Stevens-Johnson syndrome or DRESS) are suspected; consider discontinuing if tardive dyskinesia occurs. Conditions that increase risk of torsade de pointes (eg, bradycardia, hypokalemia, hypomagnesemia). Monitor potassium, magnesium, others if risk of electrolyte disturbances (eg, diarrhea); correct imbalance before starting. Avoid in significant cardiovascular disease (eg, arrhythmias). Evaluate cardiac function if symptoms of torsade de pointes occur (eg, dizziness, palpitations, syncope). Cardio- or cerebrovascular disease. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Diabetes; monitor for hyperglycemia. Monitor weight. Risk of hypotension or seizures. History of breast cancer. Dysphagia. Exposure to extreme heat. Perform fall risk assessments when initiating and recurrently on long-term therapy. Reevaluate periodically. Write ℞ for smallest practical amount. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.
See Also:
GEODON Classification:
Serotonin and dopamine antagonist.
GEODON Interactions:
See Contraindications. May potentiate CNS drugs, antihypertensives. May antagonize levodopa, dopamine agonists. Extent of absorption and/or plasma levels may be affected by CYP3A4 inducers (eg, carbamazepine) or inhibitors (eg, ketoconazole). Correct hypokalemia, hypomagnesemia due to diuretics.
Adverse Reactions:
Somnolence, extrapyramidal syndrome, respiratory disorder, dizziness, akathisia, abnormal vision, asthenia, vomiting, nausea, rash, dystonia, postural hypotension, QTc prolongation, headache, weight gain, inj site reactions, hyperprolactinemia, dyslipidemia, hyperglycemia; rare: priapism, leukopenia, neutropenia, agranulocytosis (may be fatal).
Drug Elimination:
Half-life: 7 hours (oral); 2–5 hours (IM).
Generic Drug Availability:
YES
How Supplied:
Caps—60; Single-use vials—10
