Adult Dosing
Schizophrenia
- Start 2 mg/day PO divided daily-bid; then increase 1-2 mg/day at intervals >24 hrs to a target dose of 4-8 mg/day
- Dose range: 4-16 mg/day, however, doses >6 mg/day rarely more effective and may increase ADR risk
- Max: 16 mg/day
Bipolar mania
- Start 2-3 mg PO daily; then increase 1 mg/day at intervals >24 hrs
- Dose range: 1-6 mg/day
- Max: 6 mg/day
Dosage for geriatric/debilitated patients
- Start 0.5 mg PO bid; then increase by 0.5 mg bid at intervals >24 hrs up to 1.5 mg PO bid
- Can further increase by 0.5 mg bid q7 days
- Max: 6 mg/day
Note: Do not crush/cut/chew orodispersible tabs
Obsessive-compulsive disorder [Non-FDA Approved]
Pediatric Dosing
Schizophrenia
Adolescents (13-17 yrs)
- Start 0.5 mg PO daily; then increase 0.5-1 mg/day at intervals >24 hrs to a target dose of 3 mg/day (divided qd-bid)
- Dose range: 1-6 mg/day; however, doses >3 mg/day are rarely more effective and may increase ADR risk
- Max: 6 mg/day
Bipolar mania
Children and adolescents (10-17 yrs)
- Start 0.5 mg PO daily, then increase 0.5-1 mg/day at intervals >24 hrs to a target dose of 2.5 mg/day
- Dose range: 0.5-6 mg/day; however, doses >2.5 mg/day are rarely more effective and may increase ADR risk
- Max: 6 mg/day
Irritability associated with autistic disorder
Children and adolescents (5-16 yrs)
- <20 kgs: Start 0.25 mg/day x 4 days, then 0.5 mg/day x 14 days. Dosage can be further increased by 0.25 mg/day q2 wks PRN; Max: 1 mg/day
- >20 kgs: Start 0.5 mg/day x 4 days, then 1 mg/day x 14 days. Dosage can be further increased by 0.5 mg/day q2 wks PRN; Max: 2.5 mg/day if <45 kgs; 3 mg/day if >45 kgs
Note: Do not crush/cut/chew orodispersible tabs
[Outline]
See Supplemental Patient Information
- Elderly patients with dementia-related psychosis are at an increased risk of death when treated with antipsychotic drugs [US Black Box Warning]
- This drug is not approved for the treatment of patients with dementia-related psychosis [US Black Box Warning]
- Cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities may occur in elderly patients with dementia-related psychosis
- Potentially fatal symptom complex sometimes referred to as neuroleptic malignant syndrome (NMS) has occurred in association with administration of antipsychotic drugs. Manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability. Additional signs including elevated creatinine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure have occurred
- Immediately discontinue antipsychotic drugs and other drugs not essential for concomitant therapy, provide intensive symptomatic treatment, carefully monitor patients and provide treatment for concomitant serious medical problems for management of NMS
- Carefully consider potential reintroduction of drug therapy in patients recovered from NMS as recurrences of NMS may occur
- Risk of developing irreversible tardive dyskinesia increases as the duration of treatment and the total cumulative dose of antipsychotic drugs administered to the patient increases. Elderly women are more prone to syndrome of potentially irreversible, involuntary, dyskinetic movements. Syndrome may remit, partially or completely, if antipsychotic treatment is withdrawn
- Antipsychotic treatment may suppress (or partially suppress) the signs and symptoms of the syndrome and thereby may possibly mask the underlying process
- Prescribe this drug in a manner that is most likely to minimize the risk of tardive dyskinesia. Discontinue therapy on occurrence of signs and symptoms of tardive dyskinesia. Reserve chronic antipsychotic treatment for patients who suffer from a chronic illness that is known to respond to antipsychotic drugs, and for whom alternative, equally effective, but potentially less harmful therapy is not available or appropriate. Prescribe the smallest dose and the shortest course of therapy producing a satisfactory clinical response in patients who do require chronic therapy. Periodically reassessed need for continued treatment
- Consider discontinuation of therapy on development of signs and symptoms of tardive dyskinesia; however, some patients may require therapy despite the presence of the syndrome
- Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death have occurred in patients treated with atypical antipsychotics
- Regularly monitor patients treated with atypical antipsychotics for worsening of glucose control. Perform fasting blood glucose test at the beginning of treatment and periodically thereafter during treatment. Monitor patients treated with atypical antipsychotics for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness
- Hyperprolactinemia may occur in association with therapy with this drug; this may suppress hypothalamic GnRH, resulting in reduced pituitary gonadotropin secretion; inhibition of reproductive function by impairing gonadal steroidogenesis in both female and male patients may occur. Galactorrhea, amenorrhea, gynecomastia, and impotence may occur in patients receiving prolactin-elevating compounds. Long term hyperprolactinemia is associated with hypogonadism leading to decreased bone density in both female and male subjects
- Orthostatic hypotension associated with dizziness, tachycardia, and in some patients, syncope, especially during the initial dose-titration period may occur. Monitor orthostatic vital signs in patients for whom this is of concern. Consider dose reduction on occurrence of hypotension
- Leukopenia, neutropenia, and agranulocytosis have occurred in association with this therapy. Pre-existing low white blood cell count (WBC) and history of drug-induced leukopenia/neutropenia are possible risk factors for leukopenia/neutropenia. Monitor CBC frequently during the first few months of therapy in patients having history of a clinically significant low WBC or a drug-induced leukopenia/neutropenia. Consider discontinuation of therapy at the first sign of a clinically significant decline in WBC in the absence of other causative factors. Monitor patients with clinically significant neutropenia for fever or other symptoms or signs of infection and treat promptly on occurrence of such symptoms or signs. Discontinue this drug in patients having severe neutropenia (ANC <1000/mm3; follow their WBC count until recovery
- This drug interferes with cognitive and motor performance. Caution patients about activities requiring alertness
- Risk of occurrence of seizures in association with hyponatremia exists
- Esophageal dysmotility and aspiration may occur in association with antipsychotic drug
- Risk of development of Thrombotic Thrombocytopenic Purpura (TTP), priapism exists
- Hyperthermia and hypothermia may occur in association with this drug
- Antiemetic effect may occur which may mask signs and symptoms of overdosage with certain drugs or of manifestations such as intestinal obstruction, Reye’s syndrome, and brain tumor
- Closely supervise high-risk patients for suicidality. Prescribe this drug for the smallest quantity of tablets, consistent with good patient management, for reducing the risk of overdose
- Patients with Parkinson’s Disease or Dementia with Lewy Bodies exhibit increased sensitivity to antipsychotic medications
- Initiate a lower starting dose in patients with severe renal/hepatic impairment
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Cardiac disease
- Diabetes mellitus
- Risk of diabetes mellitus
- Cerebrovascular disease
- History of Seizure disorder
- Dementia
- Parkinson disease
- Risk of suicide
- History of neuroleptic malignant syndrome
- Patients at risk for aspiration pneumonia
- Dehydration
- Hypotension
- Hypovolemia
- History of drug induced leukopenia, neutropenia
- Leukopenia
- Pediatrics
- Adolescents
- Geriatrics
- PKU (phenylalanine-containing forms)
Supplemental Patient Information
- Advise patients of the risk of orthostatic hypotension, especially during the period of initial dose titration
- Caution patients about operating hazardous machinery, including automobiles, until they are reasonably certain that therapy with this drug does not affect them adversely
- Advise patients to notify their physician if they become pregnant or having intention to become pregnant during therapy
- Advise patients not to breastfeed an infant if they are taking this drug
- Advise patients to avoid alcohol while taking this drug
Pregnancy Category:C
Breastfeeding: Risperidone is excreted in breastmilk in low levels. Limited information indicates that maternal doses of up to 6 mg/day produce low levels in milk. Due to insufficient long term follow up data, other agents might be preferred. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 7 April 2011). Manufacturer advises that nursing women receiving therapy with risperidone should not breastfeed.
US Trade Name(s)
US Availability
risperidone (generic)
- TABS: 0.25, 0.5, 1, 2, 3, 4 mg
- ODT: 0.25, 0.5, 1, 2, 3, 4 mg
- SOLN: 1 mg/mL
Risperdal
- TABS: 0.25, 0.5, 1, 2, 3, 4 mg
- SOLN: 1 mg/mL
Risperdal M-tab
Canadian Trade Name(s)
Canadian Availability
risperidone (generic)
- TABS: 0.25, 0.5, 1, 2, 3, 4 mg
- ODT: 0.5, 1, 2 mg
- SOLN: 1 mg/mL
Risperdal
- TABS: 0.25, 0.5, 1, 2, 3, 4 mg
- SOLN: 1 mg/mL
Risperdal M-tab
UK Trade Name(s)
- Risperdal
- Risperdal Quicklet
UK Availability
risperidone (generic)
- TABS: 0.5, 1, 2, 3, 4, 6 mg
- ODT: 1, 2 mg
- SOLN: 1 mg/mL
Risperdal
- TABS: 0.5, 1, 2, 3, 4, 6 mg
- SOLN: 1 mg/mL
Risperdal Quicklet
Australian Trade Name(s)
- Ozidal
- Rispa
- Risperdal
- Risperdal Quicklet
- Rixadone
- Resdone
Australian Availability
risperidone (generic)
Ozidal, Rispa, Rixadone, Resdone
Risperdal
- TABS: 0.5, 1, 2, 3, 4 mg
- SOLN: 1 mg/mL
Risperdal Quicklet
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- RisperDAL M-TAB 4 MG TBDP [Box] (JANSSEN)
28 mg = $542.99
56 mg = $1069.98 - Risperdal M-TAB 1 MG TBDP [Box] (JANSSEN)
28 mg = $195
84 mg = $569.95 - RisperiDONE 0.5 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
60 mg = $179.99
180 mg = $499.9 - Risperdal 3 MG TABS [Bottle] (JANSSEN)
30 mg = $377.98
90 mg = $1049.01 - RisperiDONE 0.25 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
60 mg = $145.97
180 mg = $399.93 - Risperdal 0.25 MG TABS [Bottle] (JANSSEN)
30 mg = $160.99
90 mg = $463.96 - Risperdal 0.5 MG TABS [Bottle] (JANSSEN)
30 mg = $179.98
90 mg = $507.98 - Risperdal 4 MG TABS [Bottle] (JANSSEN)
30 mg = $472.97
90 mg = $1384.97 - RisperiDONE 2 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
60 mg = $289.96
180 mg = $829.89 - Risperdal 1 MG TABS [Bottle] (JANSSEN)
30 mg = $189.99
90 mg = $527.98 - Risperdal M-TAB 0.5 MG TBDP [Bottle] (JANSSEN)
28 mg = $171.98
84 mg = $492.97 - Risperdal 2 MG TABS [Bottle] (JANSSEN)
30 mg = $302.98
90 mg = $881.01 - Risperdal 1 MG/ML SOLN [Bottle] (JANSSEN)
60 ml = $405.97
180 ml = $1182.91
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
