iloperidone FANAPT

Class: Second Generation Antipsychotic/​Benzisoxazole
FDA Indications: Schizophrenia
Off-Label Use: Agitation In Dementia
Prescribing
Forms: 1, 2, 4, 6, 8, 10, 12mg tablet
Dose Range: 12-24 mg/day
Starting: 1 mg bid; titrate no faster than 2 mg bid (4 mg qd) q24°; recommended dosage range: 6-12 mg bid (maximum: 24 mg/day)
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis
Monitoring:

NAMI drug fact sheet

Precautions
Serious Side Effects: , , ,
Possible Risk of TdP, Drugs to Avoid in Congenital Long QT
Side Effects: sedation/somnolence, dizziness, xerostomia, diarrhea, fatigue, tachycardia, orthostatic hypotension, EPS, weight gain (>7%), nasopharyngitis
Pharmacodynamics
1° MOA: 5HT2A–D2 antagonist
Target: Antagonism at: Partial agonist at Postsynaptic 5HT1A
Pharmacokinetics
t½: 18 (24-33)° TMAX: 2-4°
Substrate of: 2D6, 3A4
Inhibits: ∅ ; Induces:
Active Metabolites: P88, P95
DDIs
Misc
  • - very low level of EPS
  • - low level of dyslipidemia
  • - moderate weight gain
  • - strong α1 blockade may confer some efficacy in treating traumatic nightmares (similar to prazosin)
Special Populations

Category CGDM may be a problem with all SGAs; may cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure

It is not known if iloperidone is excreted in breast milk. Breast-feeding is not recommended by the manufacturer.

All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo; caution in elderly due to its strong α1 activity and orthostasis and associated fall risk

There are no dosage adjustments required


Mild-moderate impairment: No dosage adjustment necessary. Severe hepatic impairment: Use is not recommended.

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Last updated January 20 2018 15:32:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.