Fanapt Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Fanapt (iloperidone) is an oral tablet belonging to the atypical antipsychotic class. It is used in adults to treat schizophrenia and for acute treatment of manic or mixed episodes in bipolar I disorder. Fanapt works by affecting dopamine and serotonin receptors in the brain and is taken by mouth twice daily with a gradual dose increase.

What is Fanapt Tablet

Fanapt is an oral tablet medicine belonging to a group called atypical antipsychotics. It is used to help manage symptoms of schizophrenia and bipolar I disorder in adults.

Fanapt Tablet uses

• Treatment of schizophrenia in adults
• Acute treatment of manic or mixed episodes associated with bipolar I disorder in adults
• Treats schizophrenia in adults
• Provides long-term maintenance treatment
• Helps reduce hallucinations
• Helps reduce delusions
• Helps prevent relapse of schizophrenia symptoms

Benefits of Fanapt Tablet

• Helps reduce symptoms of schizophrenia such as hallucinations and disorganized thinking
• Helps control manic or mixed episode symptoms in bipolar I disorder
• In a long-term study, helped delay relapse of schizophrenia symptoms compared to placebo
• Provides medication coverage for 3 months per injection
• Reduces the need for daily tablets

How Fanapt Tablet works

Fanapt is thought to work by blocking certain dopamine and serotonin receptors in the brain, which helps balance brain chemicals involved in thoughts and mood.

Fanapt Tablet dosage

Fanapt is taken by mouth twice daily and can be taken with or without food. The dose is slowly increased (titrated) over about a week to help avoid a drop in blood pressure upon standing. If you miss a dose, take it as soon as you remember, but skip it if it's almost time for your next dose - do not double up. If treatment is stopped for more than 3 days, the slow starting dose schedule should be restarted when treatment resumes. People who break down this medicine more slowly in their body (poor metabolizers) may need a different dosing schedule, as determined by a doctor.

Available forms and strengths

• 1 mg tablet
• 2 mg tablet
• 4 mg tablet
• 6 mg tablet
• 8 mg tablet
• 10 mg tablet
• 12 mg tablet

Side effects of Fanapt Tablet

Common

• Dizziness
• Dry mouth
• Fatigue/tiredness
• Nasal congestion (stuffy nose)
• Sleepiness/drowsiness (somnolence)
• Fast heartbeat (tachycardia)
• Weight gain
• Low blood pressure when standing (orthostatic hypotension)
• Nausea
• Diarrhea
• Increased liver enzymes (more with bipolar mania treatment)

Serious

• Severe allergic reactions (swelling of face/lips/mouth/tongue, trouble breathing or swallowing, hives)
• Heart rhythm changes (QT prolongation, risk of dangerous arrhythmia)
• Metabolic changes (high blood sugar/diabetes, high cholesterol, weight gain)
• Tardive dyskinesia (uncontrolled, possibly permanent movements)
• Orthostatic hypotension and falls
• Trouble swallowing (dysphagia)
• Seizures
• Blood disorders (leukopenia, neutropenia, agranulocytosis)
• Problems regulating body temperature/overheating
• Neuroleptic malignant syndrome (NMS)
• High prolactin levels (hyperprolactinemia)
• Priapism (prolonged, painful erection)
• Increased risk of death in elderly patients with dementia-related psychosis
• Cerebrovascular events (stroke, transient ischemic attack) in elderly patients with dementia-related psychosis
• Intraoperative floppy iris syndrome during cataract surgery

Warnings and precautions

• Elderly patients with dementia-related psychosis who take antipsychotic drugs like Fanapt have a higher risk of death. Fanapt is not approved to treat dementia-related psychosis.
• Fanapt can prolong the QT interval of the heart, which may lead to dangerous and potentially fatal irregular heartbeats. It should not be combined with other medicines that also prolong the QT interval.
• A potentially fatal condition called Neuroleptic Malignant Syndrome (NMS) has occurred with antipsychotic drugs including Fanapt, and requires immediate medical attention and stopping the drug.
• Fanapt may cause tardive dyskinesia, a movement disorder that can be permanent, especially with long-term use.
• Fanapt can cause serious drops in blood pressure upon standing, which may cause dizziness, fainting, or falls, especially when starting or increasing the dose.
• Fanapt can lower white blood cell counts, which raises the risk of infection; people with low counts should have regular blood tests.
• Cases of priapism (a painful, prolonged erection) have been reported, which can require surgery if not treated promptly.
• Fanapt may cause floppy iris syndrome during cataract surgery, so surgeons should be informed of its use even if treatment has stopped.
• Fanapt should be used during pregnancy only if clearly needed, since taking it in the third trimester may cause abnormal muscle movements or withdrawal symptoms in the newborn after birth.
• Women taking Fanapt are advised not to breastfeed because it is not known how the medicine affects a nursing infant.
• No routine dosage adjustment is needed based on kidney function, since kidney problems alone are unlikely to significantly change how the medicine works in the body.
• No dose change is needed for mild liver problems. People with moderate liver impairment may need a lower dose, and Fanapt is not recommended for those with severe liver impairment.
• Patients should avoid drinking alcohol while taking Fanapt, as it may worsen side effects like drowsiness.
• Fanapt can affect judgment, thinking, and motor skills, so patients should be careful about driving or operating machinery until they know how the medicine affects them.

Storage

• Store FANAPT tablets at controlled room temperature, 25°C (77°F); excursions permitted to 15° to 30 °C (59° to 86°F).
• Protect FANAPT tablets from exposure to light and moisture.

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as swelling of the face, lips, mouth or throat, trouble breathing or swallowing, or a serious skin rash.
• Call your doctor right away if you faint, feel like you might faint, or notice a fast or irregular heartbeat, since this could be a sign of a dangerous heart rhythm problem.
• Seek medical help immediately if you develop high fever, severe muscle stiffness, confusion, or irregular heartbeat, which could indicate neuroleptic malignant syndrome.
• Contact your doctor if you notice uncontrollable movements of your face, tongue, or body, which could be signs of tardive dyskinesia.
• Get emergency help if you have an erection lasting more than 4 hours, as this requires urgent treatment to avoid permanent damage.
• Seek medical attention if you notice signs of a blood disorder such as fever, frequent infections, or unusual tiredness.
• Call your doctor if you experience symptoms of high blood sugar, such as excessive thirst, frequent urination, increased hunger, or unusual tiredness.

Alternatives

• Invega Sustenna
• Invega Hafyera
• Paliperidone tablets