Geodon (Ziprasidone) for Hiccups: Not Recommended
There is no established evidence supporting the use of Geodon (ziprasidone) for treating hiccups, and this indication does not appear in any clinical guidelines or FDA-approved uses. The available evidence exclusively addresses ziprasidone's use for schizophrenia, acute agitation, and schizoaffective disorder—not hiccup management 1, 2, 3.
Why This Question Likely Arose
You may be confusing ziprasidone with other dopamine-blocking agents that have documented antiemetic properties. While ziprasidone does have dopamine-receptor blocking effects similar to phenothiazines used for nausea/vomiting in gastroparesis 1, hiccup treatment is not among its recognized off-label uses.
Established Ziprasidone Dosing (For Reference Only)
Since no hiccup indication exists, here are the actual approved and off-label uses:
FDA-Approved Indications
- Acute agitation in schizophrenia: 10-20 mg IM, with 20 mg showing more significant agitation reduction; can repeat every 2-4 hours up to maximum 40 mg/day 2, 4
- Schizophrenia maintenance: 40-80 mg orally twice daily with food 3, 5
Documented Off-Label Uses
- Emergency agitation (psychiatric, alcohol, substance-induced): 20 mg IM with onset within 15 minutes 1, 2
- Antiemetic for gastroparesis: Used for nausea/vomiting due to dopamine-blocking effects 1
Critical Safety Concerns
If you were considering ziprasidone for any reason, be aware:
- QTc prolongation risk: Contraindicated in recent MI, baseline QT prolongation, or concurrent QT-prolonging medications 1
- Cardiac monitoring required: Particularly important given the cardiac risks 1, 6
- Food requirement for oral dosing: Must take with 500 kcal meal or absorption drops substantially 5
What You Should Use for Hiccups Instead
While not covered in the provided evidence, standard hiccup treatments in clinical practice include:
- Chlorpromazine (the only FDA-approved medication for hiccups)
- Metoclopramide (which IS mentioned in the evidence for other indications 7)
- Baclofen
- Gabapentin
Bottom line: Do not use ziprasidone for hiccups. There is zero evidence supporting this use, and the cardiac risks outweigh any theoretical benefit.