Iloperidone(il oh pair’ ih dohn)
Fanapt
PREGNANCY CATEGORY C
Drug Classes
Atypical antipsychotic
Benzisoxazole derivative
Therapeutic Actions
Mechanism of action not fully understood; blocks dopamine and serotonin receptors in the brain, depresses the reticular activating system; suppresses many of the negative aspects of schizophrenia, including blunted affect, social withdrawal, lack of motivation, anger.
Indications
Acute treatment of schizophrenia in adults. Consider first using drugs that do not prolong QT interval. Consider need to slowly titrate drug, prolonging time until therapeutic effect is seen; faster-acting drugs may be more appropriate.
Contraindications and Cautions
Contraindicated with hypersensitivity to components of drug, pregnancy, lactation.
Use cautiously with prolonged QT interval, history of seizures, diabetes, suicidal ideation.
Available Forms
Tablets—1, 2, 4, 6, 8 10, 12 mg
Dosages
Adults
Target dose: 12–24 mg/day PO. Titrate based on orthostatic hypotension tolerance—initially, 1 mg PO bid; then 2, 4, 6, 8, 10, and 12 mg PO bid on days 2, 3, 4, 5, 6, and 7, respectively.
Pediatric patients
Safety and efficacy not established.
Patients with hepatic impairment
Not recommended.
Pharmacokinetics
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Metabolism: Hepatic; T1/2: 18–23 hr (31–37 hr for poor metabolizers)
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