| Bipolar I disorder
Fanapt vs Geodon
Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.Deep comparison between: Fanapt vs Geodon with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsGeodon has a higher rate of injection site reactions vs Fanapt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Geodon but not Fanapt, including UnitedHealthcare
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Category
Fanapt
Geodon
At A Glance
Oral
Twice daily
D2/5-HT2 antagonist
Oral / IM injection
Twice daily
D2/5HT2 antagonist
Indications
- Schizophrenia
- Bipolar I disorder
- Schizophrenia
- Bipolar I disorder
Dosing
Schizophrenia Titrate from 1 mg twice daily; recommended dosage 6 mg to 12 mg twice daily orally, with or without food.
Bipolar I disorder Titrate from 1 mg twice daily; recommended dosage 12 mg twice daily orally, with or without food.
Schizophrenia Initiate at 20 mg twice daily with food; may adjust up to 80 mg twice daily at intervals of not less than 2 days.
Schizophrenia (acute agitation, IM) 10-20 mg IM as needed up to 40 mg/day; 10 mg may be given every 2 hours, 20 mg every 4 hours; limit to 3 consecutive days, then transition to oral.
Bipolar I disorder (acute manic/mixed episodes) Initiate at 40 mg twice daily with food; increase to 60 or 80 mg twice daily on day 2; subsequent doses adjusted within 40-80 mg twice daily range based on tolerability and efficacy.
Bipolar I disorder (maintenance, adjunct to lithium or valproate) Continue at the same dose on which the patient was initially stabilized, within the range of 40-80 mg twice daily with food.
Contraindications
- Known hypersensitivity reaction to iloperidone or any excipient in FANAPT
- Known history of QT prolongation, including congenital long QT syndrome
- Recent acute myocardial infarction
- Uncompensated heart failure
- Concomitant use with drugs that prolong the QT interval (e.g., dofetilide, sotalol, quinidine, Class Ia and III anti-arrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl acetate, dolasetron mesylate, probucol, tacrolimus)
- Known hypersensitivity to ziprasidone or any excipient
- Concomitant use of MAOIs, or use within 14 days of stopping an MAOI
Adverse Reactions
Most common (>=2%) Dizziness, somnolence, tachycardia, dry mouth, nasal congestion, fatigue, weight increased, nausea, orthostatic hypotension, diarrhea
Serious Increased mortality in elderly patients with dementia-related psychosis, cerebrovascular adverse reactions, QT prolongation, neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, orthostatic hypotension and syncope, falls, seizures, leukopenia/neutropenia/agranulocytosis, hyperprolactinemia
Postmarketing Retrograde ejaculation, hypersensitivity reactions including anaphylaxis, angioedema, throat tightness, urticaria, rash, and pruritus
Most common (>=5%) Somnolence, extrapyramidal symptoms, akathisia, dizziness, nausea, constipation, respiratory tract infection, headache, asthenia, abnormal vision
Serious QT prolongation, neuroleptic malignant syndrome, serotonin syndrome, tardive dyskinesia, DRESS, leukopenia, neutropenia, agranulocytosis, seizures
Postmarketing Torsade de pointes, facial droop, galactorrhea, priapism, somnambulism, angioedema, urinary incontinence, postural hypotension, syncope
Pharmacology
Iloperidone is an atypical antipsychotic whose efficacy is believed to be mediated through combined antagonism at dopamine D2 and serotonin 5-HT2 receptors; it also has high affinity for norepinephrine NE-alpha1 receptors and forms an active metabolite, P88, with a similar receptor binding profile.
Ziprasidone is a dopamine D2/D3 and serotonin 5HT2A/5HT2C antagonist with agonist activity at 5HT1A receptors and inhibition of synaptic reuptake of serotonin and norepinephrine; its antipsychotic and antimanic effects are thought to be mediated through combined D2 and 5HT2 antagonism.
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Most Common Insurance
Anthem BCBS
Fanapt
- Covered on 5 commercial plans
- PA (8/12) · Step Therapy (8/12) · Qty limit (2/12)
Geodon
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (6/12) · Qty limit (0/12)
UnitedHealthcare
Fanapt
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (2/8)
Geodon
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Fanapt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Geodon
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Fanapt.
No savings programs available for Geodon.
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FanaptView full Fanapt profile
GeodonView full Geodon profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.