Iloperidone

Iloperidone Brand Name– Fanapt

What is Iloperidone

Iloperidone is an oral atypical antipsychotic belonging to the benzisoxazole/benzoisothiazol derivatives class.

Iloperidone is used for the acute and maintenance treatment of schizophrenia in adult patients. In a long-term study, iloperidone was effective in delaying time to relapse in patients with schizophrenia who were stabilized on doses ranging from 8 mg/day to 24 mg/day.

Both CYP2D6 and CYP3A4 are involved in iloperidone metabolism; therefore, clinically significant drug interactions may occur with CYP2D6 or CYP3A4 inhibitors.

In clinical trials, iloperidone was associated with QTc prolongation, an effect that was enhanced during concurrent use of potent CYP2D6 or CYP3A4 inhibitors.

Due to the possibility of arrhythmias and sudden death associated with QTc prolongation, consideration should be given to the use of other treatment options prior to iloperidone administration.

As with all antipsychotics, iloperidone carries a boxed warning for increased mortality in elderly patients with dementia-related psychosis.

Indications

  • behavioral or psychological symptoms of dementia
  • schizophrenia

For the treatment of schizophrenia

Side Effects

  1. agranulocytosis
  2. akathisia
  3. amenorrhea
  4. amnesia
  5. anaphylactoid reactions
  6. anemia
  7. angioedema
  8. apnea
  9. appetite stimulation
  10. arrhythmia exacerbation
  11. arthralgia
  12. AV block
  13. blepharedema
  14. blepharitis
  15. blurred vision
  16. bronchospasm
  17. cataracts
  18. cholelithiasis
  19. confusion
  20. conjunctivitis
  21. dehydration
  22. delirium
  23. depression
  24. diabetes mellitus
  25. diabetic ketoacidosis
  26. diarrhea
  27. dizziness
  28. drowsiness
  29. dyskinesia
  30. dyspnea
  31. dystonic reaction
  32. dysuria
  33. edema
  34. ejaculation dysfunction
  35. emotional lability
  36. epistaxis
  37. esophagitis
  38. fatigue
  39. fecal incontinence
  40. fluid retention
  41. galactorrhea
  42. gastritis
  43. gynecomastia
  44. heart failure
  45. hostility
  46. hypercholesterolemia
  47. hyperemia
  48. hyperglycemia
  49. hyperlipidemia
  50. hyperprolactinemia
  51. hypersalivation
  52. hyperthermia
  53. hypertriglyceridemia
  54. hypokalemia
  55. hyponatremia
  56. hypotension
  57. hypothyroidism
  58. impotence (erectile dysfunction)
  59. impulse control symptoms
  60. increased urinary frequency
  61. infection
  62. lethargy
  63. leukopenia
  64. libido decrease
  65. mania
  66. mastalgia
  67. menorrhagia
  68. menstrual irregularity
  69. myalgia
  70. nasal congestion
  71. nasal dryness
  72. nausea
  73. nephrolithiasis
  74. neuroleptic malignant syndrome
  75. neutropenia
  76. nystagmus
  77. ocular inflammation
  78. oral ulceration
  79. orgasm dysfunction
  80. orthostatic hypotension
  81. palpitations
  82. paranoia
  83. paresthesias
  84. peptic ulcer
  85. polydipsia
  86. priapism
  87. prostatitis
  88. pruritus
  89. pseudoparkinsonism
  90. QT prolongation
  91. rash
  92. renal failure (unspecified)
  93. restless legs syndrome (RLS)
  94. restlessness
  95. rhinorrhea
  96. seizures
  97. SIADH
  98. sinus tachycardia
  99. stomatitis
  100. stroke
  101. syncope
  102. tardive dyskinesia
  103. testicular pain
  104. tinnitus
  105. torticollis
  106. tremor
  107. urinary incontinence
  108. urinary retention
  109. urticaria
  110. vertigo
  111. water intoxication
  112. weight gain
  113. weight loss
  114. xerophthalmia
  115. xerostomia

Monitoring Parameters

  • AIMS assessment
  • blood glucose
  • CBC
  • glycosylated hemoglobin A1c (HbA1c)
  • LFTs
  • neurologic function
  • pregnancy testing
  • serum creatinine
  • serum electrolytes
  • serum lipid profile
  • serum prolactin
  • thyroid function tests (TFTs)
  • weight

Contraindications

  • abrupt discontinuation
  • agranulocytosis
  • ambient temperature increase
  • apheresis
  • AV block
  • bradycardia
  • breast cancer
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • cerebrovascular disease
  • children
  • CNS depression
  • coadministration with other CNS depressants
  • dehydration
  • dementia
  • diabetes mellitus
  • diabetic ketoacidosis
  • driving or operating machinery
  • dysphagia
  • ethanol ingestion
  • females
  • fever
  • geriatric
  • heart failure
  • hematological disease
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hypercholesterolemia
  • hyperglycemia
  • hyperlipidemia
  • hyperparathyroidism
  • hyperprolactinemia
  • hyperthermia
  • hypertriglyceridemia
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • hypovolemia
  • infants
  • infertility
  • leukopenia
  • long QT syndrome
  • myocardial infarction
  • neonates
  • neurological disease
  • neutropenia
  • obesity
  • orthostatic hypotension
  • Parkinson’s disease
  • pheochromocytoma
  • poor metabolizers
  • pregnancy
  • pregnancy testing
  • priapism
  • QT prolongation
  • rheumatoid arthritis
  • seizure disorder
  • seizures
  • sickle cell disease
  • sleep deprivation
  • strenuous exercise
  • stroke
  • substance abuse
  • suicidal ideation
  • systemic lupus erythematosus (SLE)
  • tardive dyskinesia

Interactions

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  • Tucatinib
  • Umeclidinium; Vilanterol
  • Valsartan
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Verapamil
  • Voriconazole
  • Vorinostat
  • Zaleplon
  • Ziprasidone
  • Zolpidem
  • Zonisamide
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