A medicine for schizophrenia
Iloperidone
A second-generation antipsychotic used to treat schizophrenia, with the dose built up slowly to avoid dizziness.
What is Iloperidone?
Iloperidone is a second-generation antipsychotic used to treat schizophrenia, a serious mental-health condition. It helps reduce symptoms such as hearing voices, unusual beliefs and disordered thinking. The dose has to be built up slowly because it can cause a marked drop in blood pressure on standing, leading to dizziness or fainting. It can also affect the heart's electrical rhythm (the QT interval) and cause drowsiness. Like all antipsychotics, it carries a warning about a raised risk of death when used for dementia-related psychosis in older people, where it is not appropriate.
Education and reference only. This is a plain-language guide to Iloperidone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Iloperidone is a second-generation (atypical) antipsychotic, a type of medicine used to treat schizophrenia. Schizophrenia can cause symptoms such as hearing or seeing things that are not there, fixed false beliefs, muddled thinking and withdrawal from others. Iloperidone helps bring these symptoms under control and reduce the chance of relapse. It is taken by mouth as a tablet, started low and increased gradually. It is prescribed and monitored by a doctor, often with mental-health specialist involvement, as part of a wider treatment and support plan.
How it works
Iloperidone acts on chemical messengers in the brain, particularly dopamine and serotonin, which are involved in how thoughts, perceptions and mood are processed. By rebalancing the activity of these messengers, it helps quieten symptoms such as hallucinations and disordered thinking. Its action on certain other receptors is also why it can lower blood pressure, especially on standing, which is why the dose is increased slowly to let the body adjust. It works steadily over time, so it is taken regularly rather than only when symptoms are bad.
Company & origin
Originated / developed by: Specialist manufacturers.
A second-generation antipsychotic used to treat schizophrenia, started at a low dose and built up slowly.
What it treats
Conditions Iloperidone is used for
Practical use
How to take Iloperidone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, building the dose up slowly exactly as your prescriber directs.
- Stand up slowly, especially when starting or increasing the dose, as it can cause dizziness or fainting.
- Take care with driving or operating machinery until you know how drowsy it makes you.
- Tell your prescriber about any heart-rhythm problems or other medicines that affect the heart rhythm.
- Do not stop it suddenly; discuss any changes with your prescriber, as stopping abruptly can cause problems.
Weighing it up
Advantages & disadvantages of Iloperidone
Advantages
- Helps control the symptoms of schizophrenia, such as hallucinations and disordered thinking.
- A second-generation antipsychotic that may suit people who have not done well on other options.
- Taken by mouth as part of a wider treatment and support plan.
Disadvantages
- Can cause a marked drop in blood pressure on standing, so the dose must be built up slowly.
- Can affect the heart's rhythm (the QT interval) and commonly causes drowsiness.
- Carries the antipsychotic class warning of raised death risk in older people with dementia-related psychosis.
Practical use
Good to know
The most important practical point with iloperidone is that the dose must be built up slowly. It can cause a marked drop in blood pressure when you stand up, leading to dizziness, light-headedness or even fainting, so starting low and increasing gradually gives your body time to adjust; standing up slowly helps too. It can also affect the heart's electrical rhythm (the QT interval), so your prescriber may check this and will be careful with other medicines that do the same. Drowsiness is common, especially early on, so take care with driving or machinery until you know how it affects you. Like all antipsychotics, it carries a warning about a raised risk of death when used to treat psychosis in older people with dementia, and it is not licensed for that use. Do not stop it suddenly; talk to your prescriber about any changes.
Who should not take it / use with caution
- People who have had a serious allergic reaction to iloperidone should not take it.
- It is not appropriate for treating psychosis in older people with dementia, where antipsychotics raise the risk of death.
- It is used with caution in people with certain heart-rhythm problems or those on medicines that affect the QT interval.
Monitoring
- Reviewing symptoms and how well treatment is working over time.
- Checking blood pressure, especially while the dose is being built up, and heart rhythm where appropriate.
- Watching weight, blood sugar and cholesterol, as these can change with antipsychotics.
Side effects
- Dizziness or light-headedness, especially on standing, and drowsiness, particularly early in treatment.
- A fast heartbeat, dry mouth, blocked nose or weight gain in some people.
- Less commonly, changes in the heart's rhythm (the QT interval), and, rarely, more serious reactions that need urgent medical attention.
Key interactions
- Medicines that also affect the heart's QT interval should be reviewed, as the risk can add up.
- Some medicines change how iloperidone is broken down, which can raise or lower its levels, so give a full medicines list.
- Alcohol and other sedating medicines can add to drowsiness, so seek advice before combining them.
Available as: Tablets taken by mouth.
Answers
Iloperidone: frequently asked questions
What is iloperidone used for?
It is a second-generation antipsychotic used to treat schizophrenia, helping to control symptoms such as hearing voices, unusual beliefs and disordered thinking.
Why is the dose built up slowly?
It can cause a marked drop in blood pressure on standing, leading to dizziness or fainting, so starting low and increasing gradually gives your body time to adjust.
Does it affect the heart?
It can affect the heart's electrical rhythm (the QT interval), so your prescriber may check this and will be careful with other medicines that do the same.
Can older people with dementia take it?
No. Like all antipsychotics, it carries a warning of a raised risk of death when used for dementia-related psychosis in older people, and it is not licensed for that use.
Can I stop taking it when I feel better?
Do not stop it suddenly. Talk to your prescriber first, as stopping abruptly can cause problems and symptoms may return.
The wider class
About Second-generation antipsychotic
Iloperidone belongs to the second-generation antipsychotic class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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