| Bipolar I disorder
Fanapt vs Lybalvi
Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.Deep comparison between: Fanapt vs Lybalvi 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 signalsLybalvi has a higher rate of injection site reactions vs Fanapt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Lybalvi but not Fanapt, including UnitedHealthcare
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Category
Fanapt
Lybalvi
At A Glance
Oral
Twice daily
D2/5-HT2 antagonist
Oral
Once daily
Atypical antipsychotic + opioid 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 5 or 10 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
Bipolar I disorder - monotherapy (manic or mixed episodes) Initiate at 10 or 15 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
Bipolar I disorder - adjunct to lithium or valproate Initiate at 10 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
Contraindications
- Known hypersensitivity reaction to iloperidone or any excipient in FANAPT
- Current opioid use
- Acute opioid withdrawal
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%) Weight increased, somnolence, dry mouth, headache
Serious Neuroleptic malignant syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), metabolic changes (hyperglycemia, dyslipidemia, weight gain), tardive dyskinesia, orthostatic hypotension and syncope, leukopenia, neutropenia, agranulocytosis, dysphagia, seizures
Postmarketing Anaphylactoid reaction, angioedema, cholestatic or mixed liver injury, hepatitis, jaundice, diabetic coma, diabetic ketoacidosis, DRESS, fecal incontinence, hyperlipidemia, neutropenia, pancreatitis, priapism, rash, rhabdomyolysis, SIADH, somnambulism, stuttering, venous thromboembolic events
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.
The efficacy of olanzapine in schizophrenia and bipolar I disorder may be mediated through combined dopamine and serotonin type 2 (5HT2) antagonism; samidorphan is an opioid antagonist whose mechanism could be mediated through mu-, kappa-, and delta-opioid receptor 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)
Lybalvi
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (6/12) · Qty limit (10/12)
UnitedHealthcare
Fanapt
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (2/8)
Lybalvi
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (1/8) · Qty limit (1/8)
Humana
Fanapt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Lybalvi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Fanapt.
Cost estimate not availableHealthWell: Schizophrenia - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.