Paliperidone

Tranquilizer, Sedative/Hypnotic · Atypical antipsychotic

Indications

Schizophrenia. Psychotic or manic symptoms of schizoaffective disorder.

Dosage

ORAL: Adults: Initially 6 mg once daily in the morning taken consistently in fasting or fed state. Adjust dose according to response; Schizophrenia: Recommended range 3-12 mg once daily. Schizoaffective disorder: Recommended range 6-12 mg once daily. Children: Not recommended. INJECTION: IM: Initially 150 mg on treatment day 1 and 100 mg 1 week later. Both administered IM in the deltoid muscle. Subsequent monthly dose: 75 mg; may be increased or decreased in 25-150 range. Administer IM in either the deltoid or gluteal muscle.

Administration

It is intended for IM use only. Inject slowly deep into the muscle. Care should be taken to avoid inadvertent injection into blood vessels. Administration should be in a single injection. Do not administer IV or SC. Stability: Store at room temperature, 25°C (77°F); excursions are permitted between 15°C and 30°C (59° and 86°F).

Adverse Effects

Insomnia, headache, akathisia, dizziness, dystonia, extrapyramidal disorder, Parkinsonism, somnolence, tachycardia, bradycardia, orthostatic hypotension, GI upset, dry mouth, toothache, asthaenia, fatigue, weight change, increased appetite, agitation, depression, anxiety, UTI, URTI, cough, nasal congestion, blurred vision, musculoskeletal pain, pain in extremity, rash, pyrexia, inj. Site reaction, hyperprolactinaemia, increased blood glucose, triglycerides and transaminases. Reports of priapism.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Renal impairment (CrCl <10 mL/min). Precautions: Renal impairment (CrCl <80 mL/min) or severe hepatic impairment. Cardiovascular or cerebrovascular disease, family history of QT prolongation, diabetes, history of seizures, Parkinson's disease, dementia with heavy bodies, blood dyscrasias, risk factors for hypotension. Monitor for hyperglycaemia and weight gain, risk of neuroleptic malignant syndrome, discontinue if occurs. Risk of tardive dyskinesia, consider discontinuation if occurs. Elevation of core body temp, risk of thromboembolism. Prolactin dependent tumours. Elderly. Severe GI narrowing, dysphagia, altered GI transit.

Interactions

Risperidone, drugs that prolong QT interval or reduce seizure threshold, levodopa, other dopamine agonists, centrally acting agents, valproate, carbamazepine, St. John's Wort, rifampicin.

Advice to Patient

Take either always with meals or always without meals. Do not chew, crush, or break tablets, swallow whole with liquid. Change position slowly from sitting or lying to standing. Avoid activities that may increase body temperature, such as exercising strenuously, being exposed to extreme heat, or becoming dehydrated.

Pharmacokinetics

Bioavailability: Absolute: 28%. Half-life elimination: Oral: 23 hrs. IM: 25-49 days. Time to peak, plasma: Oral: 24 hrs. IM: 13 days. Excretion: Urine (59%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.