| Schizophrenia
Invega Sustenna vs Fanapt
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Invega Sustenna vs Fanapt 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 signalsFanapt has a higher rate of injection site reactions vs Invega Sustenna based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fanapt but not Invega Sustenna, including UnitedHealthcare
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Category
Invega Sustenna
Fanapt
At A Glance
IM injection
Every 4 weeks
D2/5HT2A antagonist
Oral
Twice daily
D2/5-HT2 antagonist
Indications
- Schizophrenia
- Schizoaffective Disorder
- Schizophrenia
- Bipolar I disorder
Dosing
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.
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.
Contraindications
- Known hypersensitivity to paliperidone, risperidone, or any excipient in the INVEGA SUSTENNA formulation
- Known hypersensitivity reaction to iloperidone or any excipient in FANAPT
Adverse Reactions
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
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
Pharmacology
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.
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.
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Most Common Insurance
Anthem BCBS
Invega Sustenna
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (11/12)
Fanapt
- Covered on 5 commercial plans
- PA (8/12) · Step Therapy (8/12) · Qty limit (2/12)
UnitedHealthcare
Invega Sustenna
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Fanapt
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (3/8) · Qty limit (2/8)
Humana
Invega Sustenna
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Fanapt
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
No savings programs available for Fanapt.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.