Two medicines, side by side
Iloperidone vs paliperidone
Iloperidone and paliperidone are both labeled for schizophrenia. Drugs@FDA records approvals of iloperidone since 2009 and of paliperidone since 2006. Pharmacies paid $60.01 per Fanapt 12 mg tablet and $0.972 per paliperidone ER 3 mg tablet (NADAC, October 7, 2026); the strengths differ and one is a brand and one a generic, so the two prices are not like for like. How each works, in its label's words: Iloperidone, “The mechanism of action of iloperidone in schizophrenia and bipolar I disorder is unknown.”; Paliperidone, “Paliperidone is the major active metabolite of risperidone.”
Check it at the source: the iloperidone FDA label on DailyMed (effective May 6, 2026); the paliperidone FDA label on DailyMed (effective January 31, 2025).
Highlights of the iloperidone record
Iloperidone (Fanapt) · label of May 6, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. FANAPT is not approved for the treatment of patients with dementia-related psychosis [see Warnings and Precautions (5.1) ]. WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsFANAPT ® is indicated for: Treatment of schizophrenia in adults [see Clinical Studies (14.1) ]. Acute treatment of manic or mixed episodes associated with bipolar I disorder in adults [see Clinical Studies (14.2) ]. FANAPT is an atypical antipsychotic indicated for: Treatment of schizophrenia in adults. ( 1 , 14.1 ) Acute treatment of manic or mixed episodes associated with bipolar I disorder in adults.
On the market
- Earliest approval on file
- May 6, 2009
- Generic labelers
- 1 labeler
- Pharmacy cost
- $60.01 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the paliperidone record
Paliperidone (Invega) · label of January 31, 2025
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. INVEGA is not approved for the treatment of patients with dementia-related psychosis. [see Warnings and Precautions (5.1) ] WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsINVEGA is an atypical antipsychotic agent indicated for Treatment of schizophrenia ( 1.1 ) Adults: Efficacy was established in three 6-week trials and one maintenance trial. ( 14.1 ) Adolescents (ages 12–17): Efficacy was established in one 6-week trial. ( 14.1 ) Treatment of schizoaffective disorder as monotherapy and as an adjunct to mood stabilizers and/or antidepressants. […]
On the market
- Earliest approval on file
- December 19, 2006
- Generic labelers
- 18 labelers
- Pharmacy cost
- $0.972 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Iloperidone label of May 6, 2026, Paliperidone label of January 31, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do iloperidone and paliperidone differ on the record?
How each works, in its label's words: Iloperidone, “The mechanism of action of iloperidone in schizophrenia and bipolar I disorder is unknown.”; Paliperidone, “Paliperidone is the major active metabolite of risperidone.”
Both are in FDA's class atypical antipsychotics.
Both labels carry a boxed warning; the records quote them.
Generics: iloperidone since 2016; paliperidone since 2015 (Drugs@FDA).
| Iloperidone | Paliperidone | |
|---|---|---|
| Labeled for | Schizophrenia, Bipolar disorder | Schizophrenia |
| Pharmacologic class | Atypical Antipsychotic | Atypical Antipsychotic |
| How it works (label) | The mechanism of action of iloperidone in schizophrenia and bipolar I disorder is unknown. However, the efficacy of iloperidone could be mediated through a combination of dopamine type 2 (D 2 ) and serotonin type 2 (5-HT 2 ) antagonism. | Paliperidone is the major active metabolite of risperidone. The mechanism of action of paliperidone in schizophrenia is unclear. |
| Half-life (label) | n/a | The terminal elimination half-life of paliperidone is approximately 23 hours. |
| Earliest approval on file (Drugs@FDA) | May 6, 2009 | December 19, 2006 |
| First generic approved | November 28, 2016 | August 3, 2015 |
| Generic labelers (NDC) | 1 labeler | 18 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $60.01 per tablet (Fanapt 12 mg tablet) | $0.972 per tablet (Paliperidone ER 3 mg tablet) |
| 12-month price change | +4% | -23% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 1,470 | 52,997 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to iloperidone
- every medicine labeled for the same conditions