Paliperidone (Intramuscular)

Generic name: Paliperidone
Drug class: Atypical antipsychotics

Usage of Paliperidone (Intramuscular)

Paliperidone injection is used to treat the symptoms of psychotic (mental) disorders, including schizophrenia. Invega Trinza® and Invega Hafyera™ are used if patients have been treated with Invega Sustenna® for at least 4 months. Invega Hafyera™ is also used if patients have been treated with Invega Trinza® for at least 3 months. Invega Sustenna® may also be used alone or in combination with other medicines to treat schizoaffective disorder. This medicine should not be used to treat behavioral problems in older adults who have dementia.

This medicine is to be given only by or under the direct supervision of your doctor.

Paliperidone (Intramuscular) side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Anxiety

bladder pain

bloody or cloudy urine

body aches or pain

chills

cough

deep or fast breathing with dizziness

difficult, burning, or painful urination

difficulty with breathing

difficulty with swallowing

dry mouth

ear congestion

fever

frequent urge to urinate

headache

inability to sit still

irregular heartbeat

irritability

loss of balance control

loss of voice

lower back or side pain

mask-like face

need to keep moving

nervousness

numbness of the feet, hands, and around the mouth

restlessness

runny or stuffy nose

shaking

shuffling walk

slowed movements

slurred speech

sneezing

sore throat

stiffness of the arms and legs

tic-like (jerky) movements of the head, face, mouth, and neck

trembling and shaking of the fingers and hands

trouble with sleeping

twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

unusual tiredness or weakness

Less common

Blurred vision

difficulty with speaking

dizziness

drooling

inability to move the eyes

increase in body movements

increased blinking or spasms of the eyelid

loss of balance control

muscle trembling, jerking, or stiffness

pounding in the ears

slow or fast heartbeat

sticking out of the tongue

uncontrolled movements, especially of the face, neck, and back

uncontrolled twisting movements of the neck, trunk, arms, or legs

unusual facial expressions

Incidence not known

Change in mental status

chest tightness

decrease in the amount and frequency of urination

difficulty speaking

hives, itching, skin rash

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

loss of bladder control

pale color of the skin

pinpoint red spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

seizures

severe constipation

severe vomiting

stomach pain

swollen tongue

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

Less common

Back pain

constipation

diarrhea

difficulty with moving

dry mouth

increased weight

lack or loss of strength

muscle pains, cramps, or stiffness

nausea

nightmares

pain and swelling in the joints

pain in the arms or legs

tearing of the skin

toothache

upper abdominal or stomach pain

vomiting

Incidence not known

Sleepwalking

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking Paliperidone (Intramuscular)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever HAD any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Paliperidone injection in the pediatric population. Use of Invega Trinza® or Invega Hafyera™ is not recommended. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of paliperidone injection in the elderly. However, elderly patients are more likely to have age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving paliperidone injection.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil

Bromopride

Cisapride

Dronedarone

Levoketoconazole

Mesoridazine

Metoclopramide

Pimozide

Piperaquine

Saquinavir

Sparfloxacin

Terfenadine

Thioridazine

Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acecainide

Adagrasib

Ajmaline

Alfuzosin

Amiodarone

Amisulpride

Amitriptyline

Amoxapine

Anagrelide

Apomorphine

Aripiprazole

Aripiprazole Lauroxil

Arsenic Trioxide

Artemether

Asenapine

Atazanavir

Azimilide

Azithromycin

Bedaquiline

Bretylium

Buprenorphine

Buserelin

Carbamazepine

Ceritinib

Chloroquine

Chlorpromazine

Ciprofloxacin

Citalopram

Clarithromycin

Clofazimine

Clomipramine

Clothiapine

Clozapine

Crizotinib

Cyclobenzaprine

Dabrafenib

Dasatinib

Degarelix

Delamanid

Desipramine

Deslorelin

Deutetrabenazine

Dexmedetomidine

Disopyramide

Dofetilide

Dolasetron

Domperidone

Donepezil

Droperidol

Efavirenz

Encorafenib

Entrectinib

Enzalutamide

Erythromycin

Escitalopram

Etrasimod

Fexinidazole

Fingolimod

Flecainide

Fluconazole

Fluoxetine

Formoterol

Foscarnet

Fosphenytoin

Fostemsavir

Gatifloxacin

Gemifloxacin

Gepirone

Glasdegib

Gonadorelin

Goserelin

Granisetron

Halofantrine

Haloperidol

Histrelin

HydroQuinidine

Hydroxychloroquine

Hydroxyzine

ibutilide

Iloperidone

Imipramine

Inotuzumab Ozogamicin

Ivabradine

Ivosidenib

Ketoconazole

Lapatinib

Lefamulin

Lenvatinib

Leuprolide

Levofloxacin

Lofexidine

Lopinavir

LuMacaftor

Lumefantrine

Macimorelin

Mefloquine

Methadone

Metronidazole

Mifepristone

Mirtazapine

Mitotane

Mobocertinib

Moxifloxacin

Nafarelin

Nilotinib

Norfloxacin

Nortriptyline

Octreotide

Ofloxacin

Olanzapine

Ondansetron

Osilodrostat

Osimertinib

Oxaliplatin

Oxymorphone

Ozanimod

Pacritinib

Panobinostat

Paroxetine

Pasireotide

Pazopanib

Phenobarbital

Phenytoin

Pimavanserin

Pitolisant

Ponesimod

Posaconazole

Primidone

Procainamide

Prochlorperazine

Promethazine

Propafenone

Protriptyline

Quinidine

Relugolix

Remifentanil

Ribociclib

Rifampin

Selpercatinib

Sematilide

Sertraline

Sevoflurane

Simeprevir

Siponimod

Sodium Phosphate

Sodium Phosphate, Dibasic

Sodium Phosphate, Monobasic

SolifeNACin

Sorafenib

Sotalol

St John's Wort

Sulpiride

Sunitinib

Tacrolimus

Tedisamil

Telavancin

Telithromycin

Tetrabenazine

Tipranavir

Toremifene

Trazodone

Triclabendazole

Trifluoperazine

Trimipramine

Triptorelin

Vandetanib

Vardenafil

Vemurafenib

Vilanterol

Vinflunine

Voclosporin

Voriconazole

Zuclopenthixol

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Relate drugs

How to use Paliperidone (Intramuscular)

A nurse or other trained health professional will give you this medicine in a medical facility. It is given as a shot into one of your muscles, usually in the arms or buttocks.

This medicine should come with a patient information leaflet. Read and follow these instructions carefully. Ask your doctor if you have any questions.

When you receive the first dose of Invega Sustenna®, you will need to get a second dose 1 week later. After that, you will only need to get a dose once a month. You will receive Invega Trinza® once every 3 months and Invega Hafyera™ once every 6 months.

Warnings

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

This medicine may raise your risk of having a stroke. This is more likely in people who already have heart or blood vessel disease. Check with your doctor right away if you are having confusion, difficulty in speaking, slow speech, inability to speak or move the arms, legs, or facial muscles, double vision, or headache.

Check with your doctor right away if you have difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, seizures, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

This medicine can cause changes in heart rhythm, including QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Call your doctor right away if you have any symptoms of heart rhythm problems, such as dizziness, feeling faint, or a fast, pounding, or irregular heartbeat.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have blurred vision, dry mouth, flushed, dry skin, increased hunger, increased thirst or urination, nausea, sweating, trouble breathing, unexplained weight loss, unusual tiredness or weakness, or vomiting. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

This medicine may increase the amount of cholesterol and fats in your blood. If this condition occurs, your doctor may give you some medicines that can lower the amount of cholesterol and fats in the blood.

This medicine may increase prolactin blood levels if used for a long time. Check with your doctor if you have breast swelling or soreness, unusual breast milk production, absent, missed, or irregular menstrual periods, stopping of menstrual bleeding, loss in sexual ability, desire, drive, or performance, decreased interest in sexual intercourse, or an inability to have or keep an erection.

Dizziness, lightheadedness, or fainting may occur, especially when you suddenly get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Paliperidone injection can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor right away if you think you are getting an infection, or if you have a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

This medicine may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause difficulty swallowing that can cause food or liquid to get into your lungs and a prolonged or painful erection, which can last for more than 4 hours. Talk to your doctor if you have any concerns about this.

This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke. Also, use extra care not to become too cold while you are receiving risperidone injection. If you become too cold, you may feel drowsy, confused, or clumsy.

This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are receiving this medicine. Talk to your doctor about ways to prevent weight gain.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with risperidone may worsen the side effects of this medicine, including dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

If you plan to have children, talk with your doctor before using this medicine. Some women using this medicine have become infertile (unable to have children).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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