What volume of sterile water for injection (SWFI) should be mixed with Geodon (Ziprasidone) 20mg intramuscularly (IM) for an adult patient with schizophrenia or bipolar disorder?

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Geodon 20mg IM Reconstitution

Add 1.2 mL of Sterile Water for Injection to the vial of Geodon 20mg for intramuscular administration. 1

Reconstitution Instructions

  • Add exactly 1.2 mL of Sterile Water for Injection (SWFI) to the single-dose vial and shake vigorously until all drug is completely dissolved 1
  • After reconstitution, each mL of solution contains 20 mg of ziprasidone 1
  • For a 20 mg dose, draw up the full 1.0 mL of reconstituted solution 1
  • For a 10 mg dose, draw up 0.5 mL of the reconstituted solution 1

Critical Administration Points

  • Use strict aseptic technique during preparation, as no preservative or bacteriostatic agent is present in this product 1
  • Do not mix with any other medications or solvents other than Sterile Water for Injection 1
  • Discard any unused portion immediately after drawing up the required dose 1
  • Inspect the solution visually for particulate matter and discoloration before administration 1

Dosing Context for IM Administration

  • The recommended IM dose for acute agitation is 10-20 mg as required, up to a maximum of 40 mg per day 1
  • Doses of 20 mg may be administered every 4 hours; doses of 10 mg may be administered every 2 hours 1
  • The 20 mg IM dose provides optimal response with onset of action within 15 minutes for acute agitation 2, 3
  • Intramuscular administration should not exceed 3 consecutive days; transition to oral ziprasidone as soon as clinically appropriate 1

Common Pitfall to Avoid

  • Never administer ziprasidone IM intravenously - this formulation is intended for intramuscular use only 1

References

Guideline

Off-Label Uses of Ziprasidone

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Ziprasidone Treatment Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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