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iloperidone; hoperidone (Fanapt)
FDA-approved in 2009
Indications:
- treatment of schizophrenia
- depression [3]
- psychosis & agitation in the elderly [4]
Contraindications:
- not approved for patients with dementia-related psychosis
Dosage:
- usual dose 6-12 mg PO BID
- 4-day titration pack to get to 6 mg BID, then increase by 2 mg BID each day up to 12 mg BID if needed [2]
Pharmacokinetics:
- metabolized in the liver by CYP2D6 & CYP3A4
Adverse effects:
- most common: dizziness, dry mouth, fatigue, nasal congestion, orthostatic hypotension, drowsiness, tachycardia
- weight gain mid-range for atypical antipsychotics
- sedation about same as risperidone
- tardive dyskinesia,
- seems to cause less restlessness & movement disorders than risperidone or olanzapine
- minimal effects on glucose & lipids
- cardiovascular events, stroke
- sleep disturbance
- hyperglycemia
- hyperprolactinemia
- priapism,
- hyperthermia,
- neuroleptic malgnant syndrome
- QT prolongation
- agranulocytosis
- seizures
- aspiration pneumonia
- cognitive impairment
- black box warning [1]
- increased risk of hyperglycemia
- increased risk of cerebrovascular events
- increased risk of mortality in patients with dementia
Drug interactions:
- drugs that inhibit CYP2D6 or CYP3A4 may increase levels of iloperidone
Mechanism of action:
- dopamine receptor anagonist
- alpha-adrenergic receptor anagonist
- serotonin receptor antagonist
Interactions
drug adverse effects of antipsychotic agents
monitor with atypical antipsychotic agents
General
atypical antipsychotic agent; second generation antipsychotic
Database Correlations
PUBCHEM cid=71360
References
- FDA News release, May 6, 2009
FDA Approves Fanapt to Treat Schizophrenia
http://www.fda.gov/bbs/topics/NEWS/2009/NEW02009.html
- Prescriber's Letter 17(2): 2010
Comparison of Atypical Antipsychotics
Detail-Document#: 260206
(subscription needed) http://www.prescribersletter.com
- Deprecated Reference
- Geriatric Review Syllabus, 8th edition (GRS8)
Durso SC and Sullivan GN (eds)
American Geriatrics Society, 2013
- Nicholas A Cummings, Janet L Cummings
Refocused Psychotherapy as the First Line Intervention in
Behavioral Health
http://books.google.com/books