Comparative Pharmacology
Head-to-head clinical analysis: ILOPERIDONE versus LYBALVI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ILOPERIDONE versus LYBALVI.
ILOPERIDONE vs LYBALVI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
LYBALVI is a combination of olanzapine and samidorphan. Olanzapine is an atypical antipsychotic with high affinity for serotonin 5-HT2A and 5-HT2C, dopamine D1-D4, histamine H1, and alpha1-adrenergic receptors. Samidorphan is an opioid receptor antagonist with high affinity for mu-opioid receptors, hypothesized to reduce olanzapine-associated weight gain by blocking opioid receptors in the central nervous system.
1-2 mg orally twice daily; target dose 6-12 mg/day; maximum 12 mg/day
Olanzapine 10 mg / samidorphan 10 mg orally once daily.
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 18 hours in extensive CYP2D6 metabolizers, 33 hours in poor metabolizers; clinical context: steady-state reached in ~5-7 days.
Terminal half-life ~20-30 hours; supports once-daily dosing.
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%.
Renal: ~50% as unchanged drug and metabolites; Fecal: ~40%; Biliary: minor.
Category A/B
Category C
Atypical Antipsychotic
Atypical Antipsychotic