Why is this drug prescribed?

Geodon is a medication prescribed to treat schizophrenia and short-term treatment of manic episodes in bipolar disorder.

Researchers believe that it works by opposing the action of serotonin and dopamine, two of the brain's major chemical messengers. Because of its potentially serious side effects, Geodon is typically prescribed only after other medications have proved inadequate.

Geodon is usually taken in capsule form. An injectable version is available for quick relief of agitated patients. Injectable Geodon is generally used for no more than a few days.

Important Facts About Geodon

In some people with heart problems or a slow heartbeat, Geodon can cause serious and potentially fatal heartbeat irregularities. The chance of a problem is greater if you are taking a water pill (diuretic) or a medication that prolongs a part of the heartbeat known as the QT interval. Many of the drugs prescribed for heartbeat irregularities prolong the QT interval and should never be combined with Geodon. Other drugs to avoid when taking Geodon include Anzemet, Avelox, Halfan, Inapsine, Lariam, Mellaril, Nebupent, Orap, Orlaam, Pentam, Probucol, Prograf, Serentil, Tequin, Thorazine, Trisenox, and Zagam. If you're uncertain about the risks of any drug you're taking, be sure to check with your doctor before combining it with Geodon.

How Should You Take Geodon?

Geodon capsules should be taken twice a day with food.

If you miss a dose

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

Storage instructions

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Geodon.

More common side effects may include:

Accidental injury, cold symptoms, constipation, cough, diarrhea, dizziness, drowsiness, dry mouth, headache, indigestion, involuntary muscle contractions, muscle tightness, nausea, rash, stuffy and runny nose, upper respiratory infection, vision problems, vomiting, weakness.

Why should this drug not be prescribed?

Do not take Geodon if you have the heartbeat irregularity known as QT prolongation, have had a recent heart attack, or suffer from heart failure. You'll also need to avoid this drug if it gives you an allergic reaction.

Special Warnings About Geodon

Remember that Geodon can cause dangerous -- even fatal -- heartbeat irregularities. Warning signs include dizziness, palpitations, and fainting. Tell your doctor immediately if you experience any of these symptoms. Be careful to avoid drugs that prolong the QT interval of the heartbeat. Check with your doctor before combining any other medication with Geodon.

Particularly during the first few days of therapy, Geodon can cause low blood pressure, with accompanying dizziness, fainting, and rapid heartbeat. Tell your doctor if you experience any of these side effects. To minimize such problems, your doctor will increase your dose gradually. If you are prone to low blood pressure, take blood pressure medicine, become dehydrated, or have heart disease or poor circulation in the brain, use Geodon with caution.

Geodon may cause drowsiness and can impair your judgment, thinking, and motor skills. Use caution while driving and don't operate potentially dangerous machinery until you know how this drug affects you.

Geodon poses a very slight risk of seizures, especially if you are over age 65, have a history of seizures, or have Alzheimer's disease.

Drugs such as Geodon sometimes cause a condition called Neuroleptic Malignant Syndrome (NMS). Symptoms include high fever, muscle rigidity, irregular pulse or blood pressure, rapid heartbeat, excessive perspiration, and changes in heart rhythm. If these symptoms appear, tell your doctor immediately. You'll need to stop taking Geodon while the condition is under treatment.

There also is the risk of developing tardive dyskinesia, a condition marked by slow, rhythmical, involuntary movements. This problem is more likely to occur in mature adults, especially older women. When it does, use of Geodon is usually stopped.

Geodon can suppress the cough reflex; you may have trouble clearing your airway. Some people taking Geodon also develop a rash. Tell your doctor when this happens. If the rash doesn't clear up with treatment, you may have to discontinue the drug.

Other antipsychotic medications have been known to interfere with the body's temperature-regulating mechanism, causing the body to overheat. Although this problem has not occurred with Geodon, caution is still advisable. Avoid exposure to extreme heat, strenuous exercise, and dehydration. There also is a remote chance that this medication may cause abnormal, prolonged and painful erections.

Certain antipsychotic drugs are associated with an increased risk of developing high blood sugar, which on rare occasions has led to coma or death. There have been only a few reports of diabetes or blood sugar problems occurring in people using Geodon. Still, it's important to see your doctor if you develop signs of high blood sugar, including dry mouth, unusual thirst, increased urination, and tiredness. If you have diabetes or have a high risk of developing it, see your doctor regularly for blood sugar testing.

Geodon is prescribed for the short-term treatment of rapid-onset bipolar mania; it is not approved for preventing future episodes. The effectiveness of the drug for treating mania for more than 3 weeks has not been studied.

Animal studies suggest that Geodon may increase the risk of breast cancer, although human studies have not confirmed such a risk. If you have a history of breast cancer, see your doctor regularly for checkups.

The safety and effectiveness of Geodon have not been studied in children.

Possible food and drug interactions

If Geodon is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Geodon with the following:

• Carbamazepine (Tegretol)
  
• Certain blood pressure medications
  
• Drugs that boost the effects of dopamine such as Mirapex, Parlodel, Permax, and Requip
  
• Drugs that affect the brain and nervous system, such as sedatives, tranquilizers, and antidepressants
  
• Ketoconazole (Nizoral)
  
• Levodopa (Larodopa, Sinet)
  

Special information if you are pregnant or breastfeeding

It is not known whether Geodon appears in breast milk, and breastfeeding is not recommended.

Recommended Dosage

Adults

The usual starting dose is 20 milligrams twice a day. If needed, the dosage may be increased at several-week intervals up to a maximum of 80 milligrams twice a day.

Bipolar Disorder (Short-term Treatment of Acute Manic Episodes)

Adults

For the first day of treatment, the usual dose is 40 milligrams twice a day. The doctor will then increase the dose on the second day to 60 or 80 milligrams twice a day. Based on your body's response, the dose can be adjusted as needed within the range of 40 to 80 milligrams twice a day.

Overdosage