Iloperidone and Paliperidone interaction

Iloperidone and Paliperidone: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Iloperidone (FANAPT) label · effective 2026-05-06

Major

Avoid the use of FANAPT in combination with any other drugs that prolong the QT interval [see Warnings and Precautions (5.3) ] .

Drug interactionsby drug classView label on DailyMed
Moderate

…prolong QTc including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval (e.g., pentamidine, levomethadyl acetate, methadone).

Warnings and precautionsby drug classView label on DailyMed
Minor

Seizures Like other antipsychotic drugs, FANAPT may cause seizures.

Warnings and precautionsby drug classView label on DailyMed
Minor

In the short-term trials, FANAPT was associated with modest levels of prolactin elevation compared to greater prolactin elevations observed with some other antipsychotic agents.

Warnings and precautionsby drug classView label on DailyMed
Minor

Potential for Cognitive and Motor Impairment FANAPT, like other antipsychotics, may cause somnolence and has the potential to impair judgment, thinking or motor skills.

Warnings and precautionsby drug classView label on DailyMed

From the Paliperidone (Erzofri extended-release) label · effective 2026-03-09

Moderate

…combination with other drugs that are known to prolong QTc including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g., chlorpromazine, thioridazine), antibiotics (e.g., gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval.

Warnings and precautionsby drug classView label on DailyMed
Moderate

ERZOFRI and other antipsychotic drugs should be used cautiously in patients at risk for aspiration.

Warnings and precautionsby drug classView label on DailyMed
Minor

Paliperidone has a prolactin-elevating effect similar to that seen with risperidone, a drug that is associated with higher levels of prolactin than other antipsychotic drugs.

Warnings and precautionsby drug classView label on DailyMed
Minor

Like other antipsychotic drugs, ERZOFRI should be used cautiously in patients with a history of seizures or other conditions that potentially lower the seizure threshold.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.