thoughtscape NP Psychiatry · Patient education
Iloperidone
Fanapt
The gradual start matters. It gives your body time to adjust, especially your blood pressure.
Draft for review · Clinical content has not been revalidated for this website.
With or without food. Your starting schedule depends on the condition being treated and your other medicines.
What it is used for
Treats schizophrenia and short-term manic or mixed episodes in adults with bipolar I disorder.
It is not approved for bipolar depression or dementia-related psychosis. Ask what your team is aiming to improve.
How it works
It affects dopamine and serotonin signals involved in psychosis and mood. Benefit is judged by your symptoms and daily life.
It also affects blood-vessel signals, which can cause dizziness or fainting when you stand up.
What to expect over time
FIRST DAYS
Follow the gradual dose schedule. Stand up slowly and report significant dizziness.
FIRST WEEKS
Improvement can take time while the dose increases. Keep track of sleep, thoughts, and energy.
ONGOING CARE
Continue follow-up for benefit, weight, blood sugar, and movement changes.
Taking your medication
Take the prescribed tablets twice daily, around the same times, with or without food. Check each tablet strength during titration.
Do not speed up the starting schedule or change the dose yourself. Ask your pharmacist to explain the plan if anything is unclear.
If you have missed several days, contact your prescriber before restarting. Restarting at the old full dose can be unsafe.
When to get help
Emergency help: collapse, seizure, breathing trouble, facial/throat swelling, or fever with severe stiffness and confusion.
Urgent help: fainting or a pounding/irregular heartbeat. A painful or prolonged erection also needs emergency assessment.
Prompt advice: new involuntary movements, fever/infection, severe restlessness, or marked thirst and frequent urination.
Early side effects
Dizziness, sleepiness, fatigue, dry mouth, or a stuffy nose may occur. Report falls or persistent unsteadiness. Avoid driving until you know how it affects you.
Other effects to discuss
Weight, blood sugar, and cholesterol can rise. Report tremor, stiffness, changes in periods, milk production, or sexual function. These deserve a treatment discussion.
What to keep track of
Expect weight, blood-pressure, metabolic, and movement checks. Your team may order an ECG, electrolytes, or blood counts based on your risks. Tell them promptly about fainting or palpitations.
Before you start
Mention heart-rhythm problems, fainting, a recent heart attack, heart failure, seizures, liver disease, low blood counts, diabetes, swallowing trouble, and pregnancy or nursing. Tell your eye surgeon about current or past Fanapt use before cataract or glaucoma surgery.
Medicines & interactions
Some antidepressants, antifungals, and antibiotics
These can raise Fanapt levels. Your prescriber may need to lower the dose; do not make this change yourself.
Heart-rhythm or blood-pressure medicines
Some combinations raise rhythm or fainting risks. Have a pharmacist check the full list before anything is added.
Alcohol, sleep aids, and other sedatives
Avoid alcohol and check sedating combinations. Sleepiness, poor balance, and impaired judgment can add up.
Grapefruit and supplements
Ask your pharmacist about grapefruit and every supplement or nonprescription product you use.
Everyday tips
Rise slowly from lying or sitting. If dizzy, sit or lie down; tell your team if it persists or you feel faint.
Avoid dehydration and overheating. Contact your team after significant vomiting or diarrhea, which can affect heart-risk electrolytes.
Use reminders for both daily doses. Keep a record of missed days so a restart plan can be made safely.
Track sleep, symptoms, and side effects. Bring your questions and medicine list to visits; your experience matters.
Your questions, answered
What about one missed dose?
Take it when remembered unless the next is nearly due; then skip it. Never double. This advice does not cover a gap of several days.
What about a longer gap?
Call before restarting if three or more days were missed. The label requires starting titration again after more than three days off.
Can I stop when I feel better?
Discuss a plan first. Sudden stopping can bring symptoms back. Your team can help adjust treatment if side effects are the problem.
What about pregnancy or nursing?
Call your prescriber if pregnant or planning pregnancy. The US label advises not breastfeeding during Fanapt treatment; make a feeding plan together.
Storage & safety
Store tightly closed at room temperature, away from excess heat, moisture, children and pets. Use a pharmacy take-back service for leftovers; do not share. For extra doses, call Poison Control at 1-800-222-1222. Call 911 for collapse, seizure, breathing trouble, or inability to wake.
About this information
For general information only; not a substitute for individualized medical advice. This sheet does not cover every risk or interaction. Ask your prescriber or pharmacist before changing how you take this medication.
Sources
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.