| Schizophrenia
Fanapt vs Invega Sustenna
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Fanapt vs Invega Sustenna 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 signalsInvega Sustenna has a higher rate of injection site reactions vs Fanapt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Invega Sustenna but not Fanapt, including UnitedHealthcare
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Category
Fanapt
Invega Sustenna
At A Glance
Oral
Twice daily
D2/5-HT2 antagonist
IM injection
Every 4 weeks
D2/5HT2A antagonist
Indications
- Schizophrenia
- Bipolar I disorder
- Schizophrenia
- Schizoaffective 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 Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; recommended monthly maintenance 117 mg (range 39-234 mg) in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Schizoaffective Disorder Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; monthly maintenance 78-234 mg adjusted for tolerability and/or efficacy in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Mild renal impairment (creatinine clearance >=50 mL/min) Initiation: 156 mg deltoid on Day 1, 117 mg deltoid on Day 8; monthly maintenance 39-156 mg; maximum monthly dose 156 mg.
Contraindications
- Known hypersensitivity reaction to iloperidone or any excipient in FANAPT
- Known hypersensitivity to paliperidone, risperidone, or any excipient in the INVEGA SUSTENNA formulation
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%) Injection site reactions, somnolence/sedation, dizziness, akathisia, extrapyramidal disorder
Serious Increased mortality in elderly patients with dementia-related psychosis, cerebrovascular adverse reactions, neuroleptic malignant syndrome, QT prolongation, tardive dyskinesia, metabolic changes, orthostatic hypotension and syncope, leukopenia/neutropenia/agranulocytosis, hyperprolactinemia, seizures
Postmarketing Angioedema, anaphylactic reaction, catatonia, ileus, somnambulism, swollen tongue, thrombotic thrombocytopenic purpura, urinary incontinence, urinary retention
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.
Paliperidone palmitate is hydrolyzed to paliperidone, the major active metabolite of risperidone; its therapeutic effect in schizophrenia may be mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism, with additional antagonist activity at histamine H1 and alpha-1/alpha-2 adrenergic receptors.
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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)
Invega Sustenna
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (11/12)
UnitedHealthcare
Fanapt
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (2/8)
Invega Sustenna
- 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)
Invega Sustenna
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Fanapt.
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
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.