Nasal congestion with iloperidone therapy in a case series

Iloperidone or 40-[3-[4-(6-Fluoro-1,2-benzisoxazol-3-yl)piperidino] propoxy]-30-methoxyacetophenone is an atypical psychotropic agent belonging to piperidinyl-benzisoxazole derivative, having marked antagonistic actions on adrenergic, serotonergic, and dopaminergic receptors. It is an excellent emerging drug in anxiety and schizophrenia, and particularly useful in acute stages due to involvement of single nucleotide polymorphism in action. Iloperidone is metabolized primarily by 3 biotransformation pathways: carbonyl reduction, hydroxylation (mediated by CYP2D6) and O-demethylation (mediated by CYP3A4). There are 2 predominant iloperidone metabolites, P95 and P88, having a higher plasma concentration compared with the parent compound. The half lives of these metabolites, drug concentration in plasma and toxicities vary in fast and slow metabolizers of CYP2D6.