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FDA Approves Vanda’s Bysanti for Bipolar I Mania and Schizophrenia

Vanda secured clearance using bridged iloperidone evidence to speed the review.

Overview

  • Milsaperidone, the active metabolite of iloperidone, was cleared using bioequivalence data across the therapeutic range.
  • The label mirrors iloperidone’s safety profile, including a boxed warning about increased mortality in older adults with dementia-related psychosis.
  • Vanda plans a U.S. launch in the third quarter of 2026, with tablets offered in multiple strengths and dosed twice daily.
  • Vanda’s shares rose as much as 44% in after-hours trading following the approval.
  • The therapy holds new chemical entity status with patent coverage reported through 2044, and adjunctive major depressive disorder trials are underway with results expected by late 2026.