| Schizophrenia
Fanapt vs Vraylar
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Fanapt vs Vraylar 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 signalsVraylar has a higher rate of injection site reactions vs Fanapt based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vraylar but not Fanapt, including UnitedHealthcare
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Category
Fanapt
Vraylar
At A Glance
Oral
Twice daily
D2/5-HT2 antagonist
Oral
Daily
Atypical antipsychotic
Indications
- Schizophrenia
- Bipolar I disorder
- Schizophrenia
- Manic Disorder
- Depression, Bipolar
- Major Depressive 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 Adults: start 1.5 mg once daily; recommended 1.5-6 mg once daily (max 6 mg). Pediatric patients (13-17 years): start 0.5 mg once daily; recommended 1.5-4.5 mg once daily (max 4.5 mg).
Manic Disorder Adults: start 1.5 mg once daily, increase to 3 mg on Day 2; recommended 3-6 mg once daily (max 6 mg). Pediatric patients (10-17 years): start 0.5 mg once daily; recommended 3 mg or 4.5 mg once daily (max 4.5 mg).
Depression, Bipolar Adults: start 1.5 mg once daily; may increase to 3 mg on Day 15 (max 3 mg once daily).
Major Depressive Disorder Adults (adjunctive to antidepressants): start 1.5 mg once daily; may increase to 3 mg on Day 15 (max 3 mg once daily).
Contraindications
- Known hypersensitivity reaction to iloperidone or any excipient in FANAPT
- History of hypersensitivity reaction to cariprazine, including rash, pruritus, urticaria, and reactions suggestive of angioedema (e.g., swollen tongue, lip swelling, face edema, pharyngeal edema, swelling face)
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%) Extrapyramidal symptoms, akathisia, nausea, restlessness, insomnia, somnolence, dyspepsia, vomiting
Serious Neuroleptic malignant syndrome, tardive dyskinesia, increased mortality in elderly patients with dementia-related psychosis, suicidal thoughts and behaviors, cerebrovascular adverse reactions, metabolic changes, leukopenia/neutropenia/agranulocytosis, orthostatic hypotension, seizures
Postmarketing Stevens-Johnson syndrome
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.
Cariprazine is an atypical antipsychotic that acts as a partial agonist at central dopamine D2/D3 and serotonin 5-HT1A receptors and as an antagonist at serotonin 5-HT2A receptors; its two major active metabolites, desmethylcariprazine (DCAR) and didesmethylcariprazine (DDCAR), have in vitro receptor binding profiles similar to the parent drug.
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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)
Vraylar
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (3/12)
UnitedHealthcare
Fanapt
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (2/8)
Vraylar
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Fanapt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Vraylar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Fanapt.
$75/fillfill
Vraylar Savings Card - Non-covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.