Drug | Forms | Initial Dose (mg/day) | Maintenance Dose (mg/day) | Max Dose (mg/day) | Depot? | How Supplied | Example Cost Dose (pill count): price in USD |
FIRST-GENERATION ANTIPSYCHOTICS ("TYPICALS") | |||||||
Chlorpromazine (Thorazine®) | TABLET ACUTE IM | 75 | 200-600 | 2000 | NO | Tab: 10, 25, 50, 100, 200mg IM: 25mg/mL | 10mg (100): $20.79; 25mg (100): $27.03; 50mg (100): $38.24; 100mg (100): $43.52; 200mg (100): $56.77 |
Fluphenazine (Prolixin®) | TABLET ACUTE IM LIQUID | 2.5-10 | 1-5 | 40 | YES | Tab: 1, 2.5, 5, 10mg IM: 2.5mg/mL Liq: 2.5mg/5mL, 5mg/mL | 1mg (90): $17.99; 2.5mg (60): $15.99; 5mg (60): $18.99; 10mg (60): $24.99 Fluphenazine Decanoate: 25mg/mL (5mL): $82.99 |
Haloperidol (Haldol®) | TABLET ACUTE IM LIQUID | 1.5-15 | 1-30 | 30 | YES | Tab: 0.5, 1, 2, 5, 10, 20mg IM: 5mg/mL Liq: 2mg/mL | 0.5mg (90): $16.99; 1mg (90): $19.99; 2mg (90): $20.99; 5mg (90): $25.99; 10mg (60): $72.99; 20mg (60): $124.99
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Loxapine (Loxitane®) | CAPSULE | 20 | 60-100 | 250 | NO | Cap: 5, 10, 25, 50mg | 5mg (30): $28.99; 50mg (30): $39.99 |
Perphenazine (Trilafon®) | TABLET | 12-24 | 16-32 | 64 | NO | Tab: 2, 4, 8, 16mg | 2mg (60): $51.99; 4mg (60): $69.99; 8mg (60): $76.99; 16mg (60): $107.99 |
Pimozide (Orap™) | TABLET | 1-2 | 2-4 | 10 | NO | Tab: 1, 2mg | 1mg (60): $85.99; 2mg (60): $109.99 |
Thioridazine (Mellaril®) | TABLET | 150-300 | 200-800 | 800 | NO | Tab: 10, 25, 50, 100mg | 10mg (90): $23.99; 25mg (90): $28.99; 50mg (90): $35.99; 100mg (90): $34.99 |
Thiothixene (Navane®) | CAPSULE | 6-10 | 20-30 | 60 | NO | Cap: 1, 2, 5, 10mg | 1mg (90): $22.99; 2mg (90): $29.69; 5mg (90): $37.99 |
Trifluoperazine (Stelazine®) | TABLET | 4-10 | 15-20 | 40 | NO | Tab: 1, 2, 5, 10mg | 2mg (60): $36.99; 5mg (60): $35.99; 10mg (60): $55.99 |
SECOND-GENERATION ANTIPSYCHOTICS ("ATYPICALS") | |||||||
Aripiprazole (Abilify®) | TABLET ODT* ACUTE IM LIQUID | 10-15 | 10-15 | 30 | NO | Tab: 2, 5, 10, 15, 20, 30mg ODT*: 10, 15mg IM:7.5mg/mL Liq: 1mg/mL | 2mg (30): $570.01; 5mg (30): $558.02; 10mg (30): $584.00; 15mg (30): $560.01; 20mg (30): $793.98; 30mg (30): $815.98 ODT* --> 10mg (30): $631.30 |
Asenapine (Saphris®) | SUBLINGUAL | 10 | 10-20 | 20 | NO | SL: 5, 10mg | 5mg (6 boxes, 10 ea): $676.02 |
Clozapine (Clozaril®) | TABLET ODT* | 12.5-25 | 300-450 | 900 | NO | Tab: 25, 50, 100, 200mg ODT*: 12.5, 25, 100, 150, 200mg | 25mg (100): $242.17 |
Iloperidone (Fanapt®) | TABLET | 2 | 12-24 | 24 | NO | Tab: 1, 2, 4, 6, 8, 10, 12mg | 2mg (100): $174.00; 4mg (100): $174.00; 6mg (90) $208.00 |
Lurasidone (Latuda®) | TABLET | 40-80 | 40-80 | 160 | NO | Tab: 20, 40, 80, 120mg | 80mg (30 ea): $535.98 |
Olanzapine (Zyprexa®) | TABLET ODT* ACUTE IM | 5-10 | 10-20 | 20 | YES | Tab: 2.5, 5, 7.5, 10, 15, 20mg ODT*: 5, 10, 15, 20mg IM: 5mg/mL | 10mg (30): $379.98; 15mg (30): $490.03 ODT* --> 5mg (30): $470.01; 10mg (30): $659.97 Zyprexa® Relprevv™: 210mg (1 kit): $425; 300mg (1 kit): $599.00; 405mg (1 kit): $750.00 |
Paliperidone (Invega®) | TABLET | 6 | 3-12 | 12 | YES | ER Tab: 1.5, 3, 6, 9mg | 3mg (100): $1688.96; 6mg (100): $1879.48; 9mg (100): $2461.97 Invega® Sustenna®: 78mg/0.5mL (0.5mL): $617.02 |
Pimavanser in (Nuplazid®) | |||||||
Quetiapine (Seroquel®) | TABLET | 50 | 300-800 | 800 | NO | Tab: 25, 50, 100, 200, 300, 400mg XR Tab: 50, 150, 200, 300, 400mg | 25mg (60): $212.09; 50mg (100): $625.00; 100mg (60): $396.98; 200mg (60): $715.99; 300mg (60): $969.96; 400mg (30): $575.97 XR --> 50mg (60): $337.99; 150mg (60): $597.99; 200mg (60): $673.96; 300mg (60): $880.02; 400mg (60): $1022.95 |
Risperidone (Risperdal®) | TABLET ODT* LIQUID | 2 | 2-8 | 16 | YES | Tab: 0.25, 0.5, 1, 2, 3, 4mg ODT*: 0.25, 0.5, 1, 2, 3, 4mg Liq: 1mg/mL | 0.25mg (60): $145.97; 0.5mg (60): $179.99; 1mg (60): $195.99; 2mg (60): $289.96; 3mg (60): $300.01; 4mg (60): $399.98 ODT* --> 0.5mg (28): $171.98; 1mg (28): $195.00; 4mg (28): $542.99 Liquid -->1mg/mL (30mL): $125.98 Risperdal® Consta®: 12.5mg (2 kits): $316.71; 25mg (2 kits): $625.74; 37.5 (2 kits): $933.62; 50mg (2 kits): $1241.54 |
Ziprasidone (Geodon®) | CAPSULE ACUTE IM | 40 | 40-160 | 200 | NO | Tab: 20, 40, 60, 80mg IM: 20mg/mL | 20mg (60): $545.97; 40mg (60): $520.97; 60mg (60): $664.97; 80mg (60): $664.97 |
* ODT = orally disintegrating tablet - Data in above table from: Micromedix® 2.0 and Lexicomp Online™; Data in above table reviewed by Sujin Lee, Pharm.D. BCPP |
Drug | FDA Indications | Metabolism/Excretion/Half-Life (T1/2) |
FIRST-GENERATION ANTIPSYCHOTICS ("TYPICALS") | ||
Chlorpromazine (Thorazine®) | Schizophrenia Bipolar - Mania Nausea/Vomiting Acute Intermittent Porphyria Tetanus Intractable hiccups Pre-surgical apprehension Problem Behavior (pediatric) | METABOLISM: liver extensively, intestinal wall to variable extent; CYP2D6; active metabolites EXCRETION: renal (23%), bile, feces T1/2: 6 hours (parent), 10-40 hours (active metabolite) |
Fluphenazine (Prolixin®) | Schizophrenia | METABOLISM: liver extensively; CYP2D6; active metabolites |
Haloperidol (Haldol®) | Schizophrenia Tourette’s Hyperactive Behavior (pediatric) | METABOLISM: liver extensively, evidence of partial extrahepatic metabolism; CYP1A2, CYP2D6, CYP3A4; active metabolites T1/2: 21-24 hours; 21 days (decanoate) |
Loxapine (Loxitane®) | Schizophrenia | METABOLISM: liver extensively; CYP1A2, CYP2D6, CYP3A4; active metabolites |
Perphenazine (Trilafon®) | Schizophrenia Nausea/Vomiting | METABOLISM: liver extensively, some intestinal wall, possible enterohepatic cycling; CYP1A2, CYP2D6, CYP3A4 |
Pimozide (Orap™) | Tourette’s | METABOLISM: liver extensively; CYP1A2, CYP2D6, CYP3A4 |
Thioridazine (Mellaril®) | Schizophrenia | METABOLISM: liver extensively, GI tract; CYP2D6; active metabolites |
Thiothixene (Navane®) | Schizophrenia | METABOLISM: liver extensively; CYP1A2, CYP2D6 |
Trifluoperazine (Stelazine®) | Schizophrenia Anxiety | METABOLISM: liver extensively, some GI tract; CYP1A2; active metabolites EXCRETION: urine, bile, feces |
SECOND-GENERATION ANTIPSYCHOTICS ("ATYPICALS") | ||
Aripiprazole (Abilify®) | Schizophrenia Bipolar - Mania Depression (adjunct) Autism | METABOLISM: liver, extent unknown; CYP2D6, CYP3A4 (poor CYP2D6 metabolizers have 60% increased active drug); active metabolites |
Asenapine (Saphris®) | Schizophrenia Bipolar | METABOLISM: liver extensively; CYP1A2, CYP2D6, CYP3A4; active metabolites |
Clozapine (Clozaril®) | Schizophrenia Refractory Suicidality | METABOLISM: extensive extra-hepatic presystemic routes; CYP1A2, CYP2D6, CYP3A4; active metabolites |
Iloperidone (Fanapt®) | Schizophrenia | METABOLISM: liver extensively; CYP2D6, CYP3A4; active metabolites EXCRETION: renal (45-58%), feces (20-22%) |
Lurasidone (Latuda®) | Schizophrenia | METABOLISM: liver extensively; CYP3A4; active metabolites EXCRETION: feces (80%), renal (9%) |
Olanzapine (Zyprexa®) | Schizophrenia Mania Depression | METABOLISM: liver extensively; CYP1A2, CYP2D6, CYP3A4 |
Paliperidone (Invega®) | Schizophrenia | METABOLISM: liver minimal; minimal CYP450 |
Quetiapine (Seroquel®) | Schizophrenia Bipolar - Mania Bipolar - Depression Major Depression (Adjunct) | METABOLISM: liver extensively; CYP2D6, CYP3A4 EXCRETION: renal (70-73%), feces (20%) |
Risperidone (Risperdal®) | Schizophrenia Bipolar - Mania Bipolar - Maintenance | METABOLISM: liver extensively; CYP2D6; active metabolite |
(Geodon®) (Ziprasidone) | Schizophrenia Bipolar - Mania Bipolar - Maintenance | METABOLISM: liver extensively; CYP1A2, CYP3A4; active metabolites |
*Data in above table from: Micromedix® 2.0 and Lexicomp Online™; Data in above table reviewed by Sujin Lee, Pharm.D. BCPP |
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