WARNINGS
Elderly patients with psychosis related to dementia (having lost touch with reality due to memory loss and experiencing a decline in day-to-day functioning) who are treated with antipsychotic medications are at an increased risk of death compared to patients treated with a placebo. Fanapt® is not approved for use in people with dementia-related psychosis.
Patients should not use Fanapt® if they have a known allergy to Fanapt or its ingredients. Allergic reactions, including anaphylaxis, rapid swelling of the skin (angioedema) and other symptoms of allergy (eg, throat tightness; swelling of the throat, face, lips, mouth and tongue; hives; rash and itching) have been reported.
An increased risk of stroke has been reported in clinical studies of elderly people with dementia-related psychosis. Fanapt® is not approved for use in people with dementia-related psychosis.
Fanapt may change your heart rhythm (meaning there is more time between heartbeats). Heart rhythm changes have occurred in patients taking Fanapt® and are a risk factor for serious, even life-threatening medical issues. You should tell your healthcare provider if you have or have had heart problems. Contact your healthcare provider right away if you feel faint or have unpleasant feelings of irregular or forceful heartbeats as any of these feelings could be a sign of a rare, but serious side effect that could be fatal. You should not use Fanapt® with other drugs that are known to cause these same heart rhythm issues.
Abnormal or uncontrollable movements of the face, tongue or other parts of the body may be signs of a serious condition called tardive dyskinesia (TD), which could become permanent. The chance of this condition going away decreases, depending on how long and how much medication has been taken. Tell your healthcare provider if you have body movements you can't control.
Fanapt and medicines like it have been associated with metabolic changes (high blood sugar, high cholesterol and triglycerides, and weight gain) that can increase cardiovascular/cerebrovascular risks. Increases in blood sugar levels (hyperglycemia), which in some cases can be serious and associated with coma or death, have been reported in patients taking Fanapt and medicines like it. Changes in cholesterol and triglycerides have been seen in patients taking Fanapt and medicines like it. Some patients may gain weight while taking Fanapt. Your healthcare provider should check your blood sugar, fat levels and weight before you start and regularly while you take Fanapt
Light-headedness or faintness caused by a sudden change in heart rate and blood pressure when rising quickly from a sitting or lying position (orthostatic hypotension) has been reported with Fanapt. This condition is most common when you start therapy, when restarting treatment or when the dose of Fanapt is increased. You should consult your healthcare provider if you have or have had heart problems or conditions that lead to these sudden changes since Fanapt should be used with caution in these patients.
Fanapt may increase the risk of falls, which could cause fractures or other injuries.
Decreases in infection-fighting white blood cells (WBCs) have been reported in some patients taking antipsychotic agents. Patients with a preexisting history of low WBC count or who have experienced a low WBC count due to drug therapy should have their blood tested and monitored during the first few months of therapy. Some (including fatal) cases of agranulocytosis, a serious decrease in specific types of WBCs called neutrophils or granulocytes, have been reported in drugs like Fanapt.
Fanapt can increase the level of the hormone prolactin. Tell your healthcare provider if you experience breast enlargement, breast pain or breast discharge, abnormal menstrual cycles in females or impotence in males. If elevated levels of prolactin persist, this may lead to bone loss.
Medicines like Fanapt can impact your body's ability to reduce your body temperature. You should avoid overheating and dehydration.
Fanapt and medicines like it have been associated with swallowing problems (dysphagia). If you have or have had swallowing problems, you should tell your healthcare provider.
For males, in the rare event you have a painful or prolonged erection (priapism) lasting 4 or more hours, stop using Fanapt® and seek immediate medical attention.
Fanapt® and medicines like it can affect your judgment, thinkingor motor skills. You should not drive or operate hazardous machinery, including automobiles, until you know how Fanapt® affects you.
A condition called intraoperative floppy iris syndrome has been observed in some patients taking drugs like FANAPT®. Please tell your healthcare provider if you take or have taken Fanapt® before cataract or other eye surgeries.
USES
Fanapt (iloperidone) is a prescription medication used for the treatment of schizophrenia and the acute treatment of manic or mixed episodes associated with bipolar I disorder in adults.
The most common side effects for Fanapt® versus placebo in patients with schizophrenia were dizziness, dry mouth, feeling unusually tired or sleepy, stuffy nose, feeling faint/light-headed when standing quickly, racing heartbeat and weight gain. The most common side effects for Fanapt® versus placebo in a clinical study of patients with bipolar I disorder were racing heartbeat, dizziness, dry mouth, increase in liver enzymes, stuffy nose, weight gain, low blood pressure and feeling unusually tired or sleepy. Compared to placebo, the average weight gain in clinical studies in schizophrenia lasting 4 to 6 weeks was 6 poundsand in a clinical study of patients with bipolar I disorder over 4 weeks was 7 pounds. If you experience any of these symptoms, talk with your healthcare provider.
N/A
OVERDOSE
In pre-marketing trials involving over 3,522 patients, accidental or intentional overdose of FANAPT was documented in 8 patients ranging from 48 mg to 576 mg taken at once and 292 mg taken over a 3-day period. No fatalities were reported from these cases. The largest confirmed single ingestion of FANAPT was 576 mg; no adverse physical effects were noted for this patient. The next largest confirmed ingestion
MISSED DOSE
Please call your healthcare provider for more information.
STORAGE
Store FANAPT tablets at controlled room temperature, 25-degrees C (77-degrees F); excursions permitted to 15-degrees C to 30-degrees C (59-degrees F to 86-degrees F). Protect FANAPT tablets from exposure to light and moisture.
NOTES
Medication Guide: revision date 03/2026
Prescribing Information: revision date 04/2024
1.) Strong CYP2D6 Inhibitors
Clinical Impact: Coadministration of fluoxetine with iloperidone increased exposure (area under curve, [AUC]) of iloperidone and its metabolite P88, by about 2- to 3-fold, and decreased the AUC of its metabolite P95 by one-half.
Coadministration of paroxetine with iloperidone resulted in increased mean steady-state peak concentrations of iloperidone and its metabolite P88, by about 1.6- fold, and decreased mean steady-state peak concentrations of its metabolite P95 by one-half.
Intervention: Reduce the dose of FANAPT by one-half when administered with strong CYP2D6 inhibitors. When a strong CYP2D6 inhibitor is withdrawn from the combination therapy, the iloperidone dose should be returned to the previous level.
2.) Strong CYP3A4 Inhibitors
Clinical Impact: Co-administration of ketoconazole with iloperidone, increased the AUC of iloperidone and its metabolites P88 and P95 by 57%, 55%, and 35%, respectively.
Intervention: Reduce the dose of FANAPT by one-half when administered with strong CYP3A4 inhibitors. When the CYP3A4 inhibitor is withdrawn from the combination therapy, the FANAPT dose should be returned to the previous level.
3.) Concomitant use of Strong CYP2D6 and Strong CYP3A4 Inhibitors
Clinical Impact: Coadministration of iloperidone with paroxetine and ketoconazole resulted in a 1.4- fold increase in steady-state concentrations of iloperidone and its metabolite P88 and a 1.4- fold decrease in the P95 in the presence of paroxetine.
Intervention: Coadministration of FANAPT with inhibitors of both CYP2D6 and CYP3A4 did not add to the effect of either inhibitor given alone. Reduce the dose of FANAPT by about one-half if administered concomitantly with both a CYP2D6 and CYP3A4 inhibitor same as if it is coadministered with only one inhibitor. When the inhibitors of CYP2D6 and CYP3A4 are withdrawn from the combination therapy, the FANAPT dose should be returned to the previous level.
4.) Drugs that Prolong the QT Interval
Concomitant use of drugs that prolong the QT interval may add to the QT effects of FANAPT and increase the risk of cardiac arrhythmia. Avoid the use of FANAPT in combination with any other drugs that prolong the QT interval [see the sections WARNINGS and PRECAUTIONS above].
5.) Drugs that Lower Blood Pressure
Concomitant use of FANAPT with medications that lower blood pressure could potentially cause symptomatic hypotension. Avoid coadministration of FANAPT with alpha-adrenergic blocking agents and adjust medications that affect blood pressure as needed [see the sections WARNINGS and PRECAUTIONS above].
Tell your healthcare provider if you have some or all of the following symptoms: very high fever, rigid muscles, shaking, confusion, sweating or increased heart rate and blood pressure. These may be signs of a condition called neuroleptic malignant syndrome (NMS), a rare but serious side effect that could be fatal. This may happen with Fanapt® or drugs like it.
Tell your healthcare provider about any medical conditions that you have, including problems with your liver. Fanapt® is not recommended for patients with severe liver problems.
Tell your healthcare provider if you have a history of or have a condition that may increase your risk for seizures before you begin taking Fanapt®.
When taking Fanapt®, you should avoid drinking alcohol and you should not breastfeed.
You should notify your healthcare provider if you become pregnant or intend to become pregnant while taking Fanapt®.
Tell your healthcare provider about all prescription and non-prescription medicines and supplements you are taking. Some medications may interact with Fanapt®.
