Fanapt (Iloperidone) for Schizophrenia

Fanapt (iloperidone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for treating adults with schizophrenia.

How Fanapt Works and How It’s Taken

Fanapt is a type of antipsychotic drug that works by blocking dopamine and serotonin signals in the brain. The exact way it works in schizophrenia is not fully known.

Doctors prescribe Fanapt to adults with schizophrenia.

Fanapt is given as a tablet by mouth, typically twice daily. It is started at a low dose and slowly increased over seven days.

Typical Dosing for Schizophrenia

The recommended starting dose of Fanapt for schizophrenia is 1 milligram twice daily.

For most people who respond to treatment, the recommended maintenance dose is 6 milligrams to 12 milligrams twice daily. Some people may break down Fanapt more slowly, and they may need lower doses.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Fanapt Side Effects

In clinical studies of Fanapt for schizophrenia in adults, the most common side effects occurred in about 5 percent to 20 percent of people. They include:

Dizziness
Dry mouth
Nausea
Diarrhea
Fatigue (low energy)
Nasal congestion (stuffy nose)
Orthostatic hypotension (a drop in blood pressure when standing up that can cause lightheadedness or fainting)
Somnolence (sleepiness)
Tachycardia (fast heartbeat)
Weight gain

Serious Side Effects and Warnings

Fanapt can cause serious side effects. Some may require immediate medical attention or monitoring. Serious side effects include:

Increased risk of death in older adults with dementia-related psychosis — Fanapt is not approved for dementia-related psychosis.
Stroke and transient ischemic attack (TIA) — These can occur in older adults with dementia-related psychosis and can be fatal.
QT prolongation — This heart rhythm change can lead to dangerous irregular heartbeats, fainting, or palpitations.
Neuroleptic malignant syndrome (NMS) — This rare, life-threatening reaction can cause high fever, severe muscle stiffness, confusion, and unstable blood pressure or heart rate.
Tardive dyskinesia — Uncontrolled, repetitive movements, often of the face or tongue, may not go away.
Metabolic changes — These can include high blood sugar, unhealthy cholesterol or triglycerides, and weight gain.
Severe low blood pressure when standing — Orthostatic hypotension, lightheadedness, or syncope (fainting) can occur.
Increased risk of falls — Sleepiness, low blood pressure, dizziness, or problems with balance can increase this risk.
Seizures — Seizures can occur with Fanapt.
Low white blood cell counts — Leukopenia, neutropenia, or agranulocytosis can raise infection risk.
High prolactin hormone levels — Hyperprolactinemia can affect menstrual periods, sexual function, and bone density.
Problems regulating body temperature — Overheating or dehydration risk can occur.
Trouble swallowing and aspiration — Food or liquid may go into the airway or lungs.
Priapism — A painful erection that lasts a long time can require urgent treatment.
Intraoperative floppy iris syndrome (IFIS) — This eye problem can happen during cataract surgery.

Get medical help right away if you think you are having a serious reaction.

How To Save on Fanapt

Vanda Pharmaceuticals, the manufacturer of Fanapt, offers the Fanapt Savings Card.

To learn more, visit the Fanapt Savings Card website, or call 844-826-3200.

What To Know Before Taking Fanapt

Tell your doctor if you have any allergies to iloperidone or any ingredients in Fanapt. Do not take Fanapt if you have had a serious allergic reaction to iloperidone or any of its ingredients.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements. Some medications may interact with Fanapt, increasing the risk for serious side effects such as QT prolongation or low blood pressure.

Avoid alcohol while taking Fanapt.

Fanapt can affect your judgment, thinking, or motor skills (movement). You should not drive or operate hazardous machinery, including cars, until you know how Fanapt affects you.

Fanapt is also FDA-approved to treat acute manic or mixed episodes associated with bipolar 1 disorder in adults.

There is a pregnancy exposure registry that monitors pregnancy outcomes in those who are exposed to Fanapt during pregnancy. For more information, contact the National Pregnancy Registry for Atypical Antipsychotics at 866-318-1969 or visit the registry website.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Fanapt, talk with your doctor about the risks and benefits. Fanapt may harm your baby if you are pregnant. Taking Fanapt during the third trimester may cause movement-related symptoms and/or withdrawal symptoms in a newborn. Do not breastfeed during treatment with Fanapt.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Fanapt?

In short-term studies of people with schizophrenia, Fanapt improved symptoms more than a placebo (an inactive treatment) over four to six weeks. In one six-week study of 706 adults, doses of 12 milligrams to 16 milligrams per day and 20 milligrams to 24 milligrams per day worked better than placebo based on scores on the Brief Psychiatric Rating Scale.

In another four-week study of 604 adults, a dose of 24 milligrams per day worked better than placebo based on scores on the Positive and Negative Syndrome Scale. In a longer study of more than 12 weeks in adults with schizophrenia, people who kept taking Fanapt stayed well longer before relapse or impending relapse than those who switched to a placebo.

How long does Fanapt take to work for schizophrenia?

In short-term studies of people with schizophrenia, improvements in psychiatric symptom ratings with Fanapt were seen by four to six weeks. It is unclear when people can expect to first notice an improvement in symptoms.

What tests or monitoring are needed with Fanapt for schizophrenia?

While taking Fanapt, your doctor may check your blood sugar, cholesterol, and weight. This is because the medicine can cause high blood sugar, changes in fats in the blood, and weight gain.

Your blood pressure may also be checked, especially when you start the medicine or when your dose is increased. This is because Fanapt can cause a drop in blood pressure when you stand up, which may lead to dizziness or fainting.

If you have a low white blood cell count or a history of this problem, your doctor may check your blood counts during treatment.

What should I do if I miss a dose of Fanapt for schizophrenia?

If you stop taking Fanapt for more than three days, you may need to restart it slowly using the starting dose schedule. This helps lower the risk of low blood pressure when standing up. Talk to your healthcare provider about what to do if you miss one or more doses.