Comparative Pharmacology
Head-to-head clinical analysis: ARISTADA versus ILOPERIDONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARISTADA versus ILOPERIDONE.
ARISTADA vs ILOPERIDONE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Aripiprazole lauroxil is a prodrug of aripiprazole, a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and an antagonist at 5-HT2A receptors. The mechanism of action in schizophrenia and bipolar I disorder is thought to be mediated through these receptor interactions.
Iloperidone is an atypical antipsychotic with high affinity for serotonin 5-HT2A and dopamine D2 receptors; also moderate affinity for D3, D4, 5-HT6, 5-HT7, and α1-adrenergic receptors; low affinity for H1, 5-HT1A, and α2-adrenergic receptors; no affinity for M1 muscarinic receptors.
Initial dose: 675 mg intramuscularly every 4 weeks for the first 2 doses, then maintenance dose of 882 mg intramuscularly every 4 weeks. Alternatively, 1064 mg intramuscularly every 6 weeks after appropriate initiation.
1-2 mg orally twice daily; target dose 6-12 mg/day; maximum 12 mg/day
None Documented
None Documented
Clinical Note
moderateIloperidone + Levofloxacin
"Iloperidone may increase the QTc-prolonging activities of Levofloxacin."
Clinical Note
moderateIloperidone + Norfloxacin
"Iloperidone may increase the QTc-prolonging activities of Norfloxacin."
Clinical Note
moderateIloperidone + Gemifloxacin
"Iloperidone may increase the QTc-prolonging activities of Gemifloxacin."
Clinical Note
moderateIloperidone + Haloperidol
"The metabolism of Haloperidol can be decreased when combined with Iloperidone."
Terminal elimination half-life of aripiprazole lauroxil (the prodrug in ARISTADA) is approximately 54 days (range 29-74 days) after IM injection, allowing monthly dosing.
Terminal elimination half-life 18 hours in extensive CYP2D6 metabolizers, 33 hours in poor metabolizers; clinical context: steady-state reached in ~5-7 days.
Primarily renally excreted (approximately 60% as metabolites, <1% unchanged). Fecal elimination accounts for about 20%.
Primarily hepatic metabolism via CYP3A4 and CYP2D6; approximately 7% excreted unchanged in urine and 18% in feces; total renal elimination of metabolites ~25%, fecal ~60%.
Category C
Category A/B
Atypical Antipsychotic
Atypical Antipsychotic