Iloperidone (Oral)

Iloperidone treats the symptoms found in patients who have been diagnosed with a mood or mental disorder including those who have schizophrenia.

Overview

Iloperidone is considered to be an atypical anti-psychotic medication that treats mood and mental disorder symptoms including those found in patients with schizophrenia. Also familiar to some under the marketing name Fanapt or the Fanapt Titration Pack, Iloperidone has been in use since the latter half of the 1990s and continues to be developed in formulation.

The way this and other anti-psychotic medications work isn't specifically known, but the mechanism of action has to do with the way brain and nerve cells communicate with each other. The manufacture and release of chemicals known as neurotransmitters are what enables the nerve cells to communicate. Psychotic disorders are caused by abnormal releases of chemicals that affect the communication of the cells. Anti-psychotic medications such as Iloperidone normalize this communication and regulate the psychotic state.

Schizophrenia is a severe mental health condition that causes a range of different symptoms and psychological problems. Characterized as a form of psychosis, schizophrenia is a long-term disease in which the patient may not always be able to distinguish their dreams, thoughts and ideas from everyday reality. Symptoms of schizophrenia include hallucinations, delusions, muddled thoughts based on these hallucinations or delusions, as well as changes in behavior. Not to be confused with split personality disorder or violent behavior due to drug and alcohol abuse, schizophrenia is not caused by outside substances nor does it develop into other disorders. The cause of schizophrenia is unknown, but experts seem to agree that it is caused by a combination of hereditary factors and environmental influences. It is observed that some people are more vulnerable to stress and emotions, which trigger psychotic episodes that develop into schizophrenia over the long term.

Conditions Treated

Schizophrenic disorders

Type Of Medicine

Atypical antipsychotic

Side Effects

Report the following adverse symptoms should they occur while you are taking Iloperidone:

  • Pounding, rapid heart rhythm
  • Blurry vision
  • Pain or aches in the body
  • Chills
  • Confused demeanor
  • Cough
  • Cold sweats
  • Labored, difficult breathing
  • Difficulty moving or speaking
  • Dizzy, fainting spells or lightheaded symptoms when rising
  • Drooling
  • Congested ears
  • Fever
  • Restlessness
  • Headache
  • No sense of balance
  • Vocal changes or loss
  • Painful, stiff muscles
  • Jerking, trembling muscles
  • Running nose, congestion or sneezing
  • Can't stop moving the body
  • Joint pain
  • Shaking arms, hands, feet or legs
  • Gasping for breath
  • Shuffling when walking
  • Sore throat
  • Sweating
  • Stiff limbs
  • Chest tightness
  • Shaking feet or hands
  • Repetitive, uncontrolled twitching, twisting movements of the face, lips, tongue, legs or arms
  • Face, back or neck move uncontrollably
  • Dull, tired demeanor
  • Sluggish, drowsy feeling
  • Weak muscles
  • Wheezing
  • Stomach feels full
  • Uncomfortable leg sensations like crawling
  • Out of control actions
  • Angry, aggressive moods
  • Agitated, anxious demeanor
  • Forceful, assaultive, attacking demeanor
  • Pain in back
  • Blood in stool or tar-like appearance
  • Bloody nose
  • Urination burning sensation
  • Pins and needles, numb, crawling sensations
  • Painful, uncomfortable feeling in chest
  • Coma
  • Constipation
  • Confused demeanor
  • Convulsions
  • Urine frequency or amount decreases
  • Lack of responsiveness or awareness of surroundings
  • Weight loss
  • Depressed mood
  • Urination is difficult or painful
  • Dribbling while trying to urinate
  • Walking is difficult
  • Veins in neck are dilated
  • Dizzy, fainting spells, lightheaded
  • Dry mouth, hair or skin
  • Extremely thirsty
  • Elevated body temperature
  • Fainting spells
  • Delusional
  • Rapid breathing
  • Cold sensation
  • Gassy, painful abdomen
  • Pain in groin
  • Loss of hair
  • Change in voice
  • Hostile mood
  • Eye paralysis
  • Blinking spastically
  • Irritable mood
  • Lightheaded
  • Appetite is less or gone
  • No control over bladder function
  • Mimicking movement or speech of others
  • Mood swings
  • Cramped, aching muscles
  • Spasms in muscles or twitching
  • Vomiting
  • Nausea
  • Nervous demeanor
  • Raspy, rattling breathing
  • Tingling feet, lips or hands
  • Skin that is clammy or pale
  • Strange grimacing, postures, movements or mannerisms
  • Pounding heart rhythm
  • Gaining weight rapidly
  • Elevation in body temperature that is recurrent
  • Restless demeanor
  • Seizures
  • Extreme drowsiness
  • Slow reflexes or movement
  • Sore tongue or throat
  • White ulcerated sores on mouth or lips
  • Spontaneous sticking out of tongue
  • Stupor
  • Eyes appear sunken
  • Swelling in feet, fingers, lower legs, face or ankles
  • Swollen joints or glands in groin, armpit or neck
  • Tender, swollen prostate
  • Difficulty breathing when at rest or when exerting oneself
  • Feeling, acting or speaking excitedly
  • Thirsty
  • Twisting of body, neck, legs or arms
  • Bruising or bleeding that is unusual
  • Nervous, excited or restless without cause
  • Strange facial expressions
  • Gaining weight
  • Wrinkled skin
  • Yellowed skin or eyes

Other health symptoms, while not dangerous to you, may be annoying but could disappear over time. Check with your physician if you experience the following:

  • Diarrhea
  • Drowsiness
  • Sleepiness
  • Uncomfortable stomach or abdomen
  • Inability to ejaculate
  • Skin rash
  • Nasal stuffiness
  • Irregular or missed menstrual periods
  • Heavy menstrual periods or prolonged duration
  • Vision changes or blindness
  • Pain in breast
  • Burning in stomach or chest
  • Pain in upper abdomen
  • Canker sores in mouth
  • Buzzing, ringing or other noises that are unexplained
  • Decreased sexual interest or ability
  • Paranoia
  • Combative demeanor
  • Dry eyes
  • Vertigo
  • Loss of hearing
  • Erectile dysfunction
  • Bloodshot eyes
  • Appetite increases
  • Increased saliva production
  • Indigestion
  • Mouth soreness
  • No control over bowels
  • Memory loss
  • Eyelids are swollen, itching or red
  • Spinning sensation
  • Upset stomach
  • Missing menstrual periods
  • Inflamed, swollen mouth
  • Breast swelling or soreness
  • Tender stomach or abdomen
  • Eye movements that are out of control

You may have still other changes to your health than those listed. If so, contact your doctor immediately to make sure you are safe to continue taking Iloperidone.

Dosage

Iloperidone comes in a tablet format in strengths from 1 milligram up to 12 milligrams each. Patients will have a prescribed amount based especially on their condition, their age and body mass and other factors taken into account by your physician. Do not take more of this medication than you are prescribed and do not increase the frequency or duration unless your doctor has instructed you to. Increasing the amount of Iloperidone you take will not result in better treatment but can put your life at risk.

In general, adult patients diagnosed with schizophrenia will be prescribed 1 milligram amounts to be taken twice per day. This amount will be adjusted but will not typically exceed a 12 milligram total dose per day. Pediatric patients will have a specific dosage amount determined for them by their physician if this medication is decided to be appropriate treatment.

Missing a dosage of your Iloperidone should not cause you to double dose if it is nearly time for your next scheduled tablet. Skip the missing dose if it is too close in duration to your next one. Check with your doctor's office if you are unsure what to do after missing a dose.

Interactions

Hypersensitivity to other medications or to Iloperidone should be communicated to your doctor. Also let them know what other medications you are taking, if any, and include any over-the-counter, herbal, holistic or vitamin therapies as well. If you have previously experienced adverse reactions to preservatives, perfumes, dyes or certain foods, this should also be something to disclose to your health care provider prior to your treatment.

Appropriate data has not been provided as the result of specific studies on the way Iloperidone works in pediatric patients, nor have these patients been determined to have a higher risk of adverse effects. Use in this age group is up to the individual doctor deciding based on circumstances.

Geriatric patients may have age-related conditions that would put them at a higher risk for adverse effects on their health resulting from treatment with Iloperidone. For this reason, use of this medication on geriatric patients should be done with dosage related controls and monitoring for safety.

Women who are pregnant have not been studied with regard to the safety risks to their unborn children or effectiveness of Iloperidone on their condition. Use of this medication in pregnant women or those that may become pregnant is not advised unless absolutely necessary.

Women who are breastfeeding have not been studied to determine if they pass on Iloperidone to their infants through their breast milk. To be on the safe side, it is not recommended that nursing mothers be treated with this drug. If you are breastfeeding, inform your doctor who may advise you to stop for this drug therapy.

Medications can be combined for a thorough treatment regimen and overall good health. Other medications should never be used together as they can cause adverse effects and even life-threatening situations when combined. The following medications should not be used with Iloperidone, so be sure your doctor knows if you are currently taking:

  • Amifampridine
  • Bepridil
  • Amisulpride
  • Cisapride
  • Bromopride
  • Fluconazole
  • Dronedarone
  • Mesoridazine
  • Ketoconazole
  • Nelfinavir
  • Metoclopramide
  • Piperaquine
  • Pimozide
  • Saquinavir
  • Posaconazole
  • Terfenadine
  • Sparfloxacin
  • Ziprasidone
  • Thioridazine

While not entirely advised, the following medications may be used in combination with Iloperidone, but will most likely require an adjustment to dosage or frequency by your physician to be safe. Let your doctor know if you are currently taking:

  • Ajmaline
  • Acecainide
  • Alfuzosin
  • Alfentanil
  • Amitriptyline
  • Amiodarone
  • Anagrelide
  • Amoxapine
  • Aripiprazole
  • Apomorphine
  • Artemether
  • Arsenic Trioxide
  • Astemizole
  • Asenapine
  • Azimilide
  • Atazanavir
  • Bedaquiline
  • Azithromycin
  • Bretylium
  • Blinatumomab
  • Buserelin
  • Buprenorphine
  • Ceritinib
  • Butorphanol
  • Chlorpromazine
  • Chloroquine
  • Citalopram
  • Ciprofloxacin
  • Clomipramine
  • Clarithromycin
  • Cobicistat
  • Clozapine
  • Crizotinib
  • Codeine
  • Dabrafenib
  • Cyclobenzaprine
  • Degarelix
  • Dasatinib
  • Desipramine
  • Delamanid
  • Dihydrocodeine
  • Deslorelin
  • Dofetilide
  • Disopyramide
  • Domperidone
  • Dolasetron
  • Droperidol
  • Donepezil
  • Erythromycin
  • Efavirenz
  • Fentanyl
  • Escitalopram
  • Flecainide
  • Fingolimod
  • Gatifloxacin
  • Fluoxetine
  • Golimumab
  • Gemifloxacin
  • Goserelin
  • Gonadorelin
  • Halofantrine
  • Granisetron
  • Hydrocodone
  • Histrelin
  • Hydroquinidine
  • Hydromorphone
  • Hydroxyzine
  • Hydroxychloroquine
  • Idelalisib
  • Ibutilide
  • Indinavir
  • Imipramine
  • Ivabradine
  • Itraconazole
  • Leuprolide
  • Lapatinib
  • Lumefantrine
  • Levofloxacin
  • Meperidine
  • Mefloquine
  • Metronidazole
  • Methadone
  • Morphine
  • Mifepristone
  • Moxifloxacin
  • Morphine Sulfate Liposome
  • Nefazodone
  • Nafarelin
  • Norfloxacin
  • Nilotinib
  • Octreotide
  • Nortriptyline
  • Ondansetron
  • Ofloxacin
  • Oxymorphone
  • Oxycodone
  • Panobinostat
  • Paliperidone
  • Pazopanib
  • Pasireotide
  • Perflutren Lipid Microsphere
  • Pentazocine
  • Pitolisant
  • Pimavanserin
  • Prochlorperazine
  • Procainamide
  • Propafenone
  • Promethazine
  • Quetiapine
  • Protriptyline
  • Ranolazine
  • Quinine
  • Ritonavir
  • Secukinumab
  • Remifentanil
  • Sevoflurane
  • Salmeterol
  • Sodium Phosphate
  • Sematilide
  • Sodium Phosphate, Dibasic
  • Siltuximab
  • Solifenacin
  • Sodium Phosphate, Monobasic
  • Sotalol
  • Sorafenib
  • Sulpiride
  • Sufentanil
  • Tacrolimus
  • Sunitinib
  • Tedisamil
  • Tapentadol
  • Telithromycin
  • Telavancin
  • Tizanidine
  • Tetrabenazine
  • Tramadol
  • Toremifene
  • Trifluoperazine
  • Trazodone
  • Triptorelin
  • Trimipramine
  • Vardenafil
  • Vandetanib
  • Vinflunine
  • Vemurafenib
  • Zuclopenthixol
  • Voriconazole

Certain adverse health effects may be increased if you take Iloperidone with Paroxetine, so be sure your doctor is given the opportunity to adjust your doses and avoid the ill effects with use of these drugs together.

Certain health conditions can also affect the way Iloperidone works for you, can increase the adverse health effect risks of taking this drug or can even become worse themselves. Make sure your physician is aware of your full medical history prior to taking this medication and include the following diagnoses, if applicable:

  • Blood vessel conditions
  • Slow heart rhythm
  • Dehydration
  • Alzheimer's disease
  • Heart attack or heart failure history
  • Heart problems of any kind including rhythm
  • Low blood potassium or magnesium levels
  • Low blood pressure
  • Low blood amount
  • Stroke
  • Bone marrow or blood problems
  • Breast cancer that is prolactin-dependent
  • Diabetes
  • High blood sugar
  • High blood prolactin levels
  • Neuroleptic malignant syndrome
  • History of seizures
  • Liver disease

Warnings

Your physician will schedule regular follow-up appointments to monitor the status of your condition and to check if you're having any ill effects related to treatment with Iloperidone. Be sure to keep all appointments or reschedule as closely as possible to your original date if required. You may receive blood tests that will help monitor your condition.

Iloperidone could affect the way your heart functions in that it could change the rhythm. Long QT syndrome is a condition that could result from use of this medication. Symptoms such as fainting, dizziness, pounding heart or irregular rhythm to your heart should be reported to your doctor immediately.

Discontinue use of Iloperidone and notify your physician if you experience seizures or convulsions, have difficulty breathing, notice a rapid heartbeat, elevated body temperature, blood pressure levels are lower or higher than normal, sweating has increased, bladder control is gone, muscles are stiff, skin is pale or you are more fatigued than normal. NMS is at a higher risk rate with uses of Iloperidone and these are all symptoms of this condition that should prompt you to seek medical help.

A movement problem known as tardive dyskinesia is at a higher risk for patients being treated with Iloperidone. Your doctor should be notified if you have any strange facial movements, puckering your lips, puffing your cheeks, worm-like tongue movements, chewing for no reason or spastic arm or leg movements.

Your blood glucose levels could increase with use of Iloperidone, so if you are diabetic, make sure you are aware of how this medication affects you and take appropriate steps to treat your condition accordingly. Your doctor can advise you on how to adjust for this medication if you are diabetic.

You may gain weight while on Iloperidone, which is a health concern that can cause long-term adverse effects. Your doctor will monitor your weight while you are on this medication and may suggest a diet and exercise regimen to combat the effects of the drug on your weight.

Fainting spells, being dizzy or feeling lightheaded may occur when you are taking Iloperidone. These can be especially pronounced when you rise from a seated position or when you are lying down. Rise slowly from prone positions and let your physician know if this condition becomes worse or problematic.

Your white blood cell levels may be decreased while you are being treated with Iloperidone, leaving you more susceptible to infections. Take precautions such as avoiding people who have colds or flu symptoms and avoid touching your eyes, face or nose unless you have recently washed your hands. Let your physician know right away if you think you've contracted an infection of any kind.

You may experience an overheated body temperature while taking Iloperidone, which is evident during workouts or in hot weather conditions. Avoid heat stroke by staying hydrated and taking time to cool off when required.

Some patients experience mood swings that include irritability, agitation or other abnormal behavior. Other patients have suicidal thoughts or tendencies or become depressed. If your mood changes or your caregiver notices your mood swings, alert your physician to this fact right away.

Drowsiness, confusion, uncontrolled body movements or vision problems can occur with use of Iloperidone, so avoid driving or operating tools or machinery until you know how you are affected.

Do not drink alcoholic beverages while you are taking Iloperidone, as the effects of alcohol could become amplified to the point you are unaware of yourself. Avoid other medications while you are on this drug including those that are available without a prescription, herbal supplements and vitamins.

Be sure to disclose your full medical history to your physician prior to being treated with Iloperidone. Include any symptoms you may be having that are undiagnosed as well as any family history of cancer or heart conditions.

Storage

To properly and safely store Iloperidone, keep it in the original packaging with the container closed at room temperature. Do not expose Iloperidone to excessive heat, light or moisture and never allow it to freeze. This and all medications should be kept out of sight and reach of children. When it comes time to dispose of expired or unused Iloperidone, consult your doctor or pharmacist for the safest way to do so.

Summary

Iloperidone is an atypical anti-psychotic drug that is prescribed to patients who have been diagnosed with schizophrenia. Schizophrenic patients often experience hallucinations, delusions or thoughts that are abnormal and behavioral issues that are difficult to live with. Untreated, schizophrenic patients can have psychotic episodes that render them unable to function in the real world. They may even have suicidal thoughts or tendencies. It is thought that the way neurotransmitters act to send and receive information is abnormal in function in these patients. Drugs such as Iloperidone normalize these communications and alleviate the symptoms.

Iloperidone is an oral tablet form of medication that patients are typically prescribed in 1-milligram doses twice daily to begin with. This dosage is adjusted depending on the patient's symptoms, which are monitored on a regular basis when treated with this drug. Typical dosage does not exceed 12 milligrams total per day. Pediatric patients, women who are pregnant or breastfeeding are typically not prescribed Iloperidone. Geriatric patients should be able to safely take this drug unless they have age-related conditions that are susceptible to certain health effects.

Patients have reported feeling dizzy, having a runny or stuffy nose and a dry mouth and gaining weight on Iloperidone. There is an increased risk of heart irregularities, seizure conditions and movement disorders with use of this mediation that patients should be on the alert for symptoms of. Increases in weight and in blood glucose levels are also at a higher risk. Patients may also be at a higher risk of infection due to lower white blood cell levels as the result of this medication.

Any changes to health or overall demeanor while being treated with Iloperidone should be communicated to your health care professional right away. This medication has been reported to cause a high level of agitated, irritable moods or other abnormal behaviors including suicidal thoughts and actions in some patients. Make sure your caregiver knows of these possible effects so that they can help protect your health while you're being treated with this drug.

Avoid people who are infected with colds, flu or other diseases while taking this medication. Be aware of your body temperature when exercising or on hot days, as Iloperidone could have an effect on how your body cools itself, increasing the risk of heat stroke. Avoid operating machinery or tools or driving until you know the level of effect this medication has on your alertness, your muscle coordination and your thinking. Do not drink alcohol or take other medications, even those available without a prescription while taking Iloperidone. Store and dispose of unused medication safely as directed by your physician or by your pharmacist.