Paliperidone(pal ah peer’ ah dohn)
InvegaDNC, Invega Sustenna
PREGNANCY CATEGORY C
Drug Classes
Atypical antipsychotic
Benzisoxazole
Therapeutic Actions
Mechanism of action not completely understood; is the major active metabolite of risperidone. Blocks dopamine and serotonin receptors in the brain and depresses the RAS. Antihistaminic and alpha-adrenergic blocking activity may contribute to some therapeutic and adverse effects.
Indications
Treatment of schizophrenia; acute and long-term maintenance treatment of schizophrenia; as monotherapy or as adjunct to mood stabilizers or antidepressants in patients 12 yr and older
Acute treatment of schizoaffective disorder as monotherapy or with antidepressant or mood stabilizers (oral only)
NEW INDICATION: Unlabeled use: Psychoses or agitation related to Alzheimer’s disease
Contraindications and Cautions
Contraindicated with hypersensitivity to any component of the drug or to risperidone, lactation, and in elderly patients with dementia-related psychosis.
Available Forms
ER tabletsDNC—1.5, 3, 6, 9 mg; injection—39/0.25 mL, 78 mg/0.25 mL, 117 mg/0.75 mL, 156 mg/mL, 234 mg/1.5 mL
Dosages
Adults
Schizophrenia and schizoaffective disorder: 6 mg/day PO in the morning; may be adjusted to a maximum 12 mg/day PO if warranted and tolerated by the patient. Increases of 3 mg/day at intervals of at least 4 days are suggested.
Schizophrenia: Parenteral—234 mg IM, followed by 156 mg IM in 1 wk, both injections in the deltoid. 117 mg IM 1 wk later in gluteal or deltoid site. Maintenance dose—39–234 mg IM once per month in deltoid or gluteal site.
Pediatric patients 12–17 yr
Treatment of schizophrenia: Weighing 51 kg and more: Initially, 3 mg/day PO; range, 3–12 mg/day.
Weighing less than 51 kg: Initially, 3 mg/day PO; range, 3–6 mg/day.
Patients with renal impairment
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