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Combining ziprasidone, 500-kcal meal maximizes absorption.

VIENNA -- Taking oral ziprasidone with a meal of at least 500 kcal is necessary to minimize pharmacokinetic variability and optimize absorption, Dr. Sheldon H. Preskorn reported at the annual congress of the European College of Neuropsychopharmacology.

Dr. Preskorn performed a series of three randomized crossover pharmacokinetic studies (two in healthy volunteers and one in adults with schizophrenia) which also established that the fat composition of the meals did not influence ziprasidone (Geodon) absorption.

It's known that a minimum of 60% of brain dopamine [D.sub.2] receptors need to be occupied by ziprasidone in order for the drug's antipsychotic efficacy to be realized. That corresponds to a trough plasma drug concentration of 50 ng/mL or more. Taking 80 mg of oral ziprasidone twice daily with a meal of at least 500 kcal resulted in a mean trough level of 70 ng/mL and ensured linear pharmacokinetics.

In contrast, when ziprasidone was taken with a 250-kcal meal, drug absorption wasn't much better than in a fasting state, according to Dr. Preskorn of the University of Kansas, Wichita.

At present, the Physicians' Desk Reference merely states that ziprasidone capsules should be taken "with food." Dr. Preskorn's studies were conducted in order to provide more specific guidance with respect to meal size and fat content.

He is a consultant to Pfizer Inc., which is the manufacturer of Geodon and supported his pharmacokinetic studies.
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Title Annotation:Adult Psychiatry
Author:Jancin, Bruce
Publication:Clinical Psychiatry News
Article Type:Medical condition overview
Date:Jan 1, 2008
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