Adult Dosing
Schizophrenia
- Start 6 mg/day PO qam
- May increase by 3 mg/day PO at intervals >5 days; periodically reassess need for treatment
- Max: 12 mg/day
Schizoaffective disorder
- Start 6 mg/day PO qam
- May increase by 3 mg/day PO at intervals >4 days; for acute treatment as monotherapy or adjunct to mood stabilizers and/or antidepressants
- Max: 12 mg/day
Note: Discontinue therapy if ANC <1000 or if there is unexplained decrease in WBC.
Pediatric Dosing
Schizophrenia
Child 12-17 yrs
- Start 3 mg/day PO qam
- May increase by 3 mg/day PO at intervals >5 days; periodically reassess need for treatment
- Max: 12 mg/day
Note: Discontinue therapy if ANC <1000 or if there is unexplained decrease in WBC.
[Outline]
Renal Dose Adjustment (Based on CrCl)
- 50-79 mL/min: Max 6 mg/day
- 10-49 mL/min: Max 3 mg/day
Hepatic Dose Adjustment
- Mild-Moderate impairment (Child-Pugh Class A and B): No dose adjustment
- Severe impairment (Child-Pugh Class C): Dose adjustment not defined, caution advised
- Use not recommended for dementia-related psychosis [US Black Box Warning]
- Mortality risk is increased in elderly dementia patients on conventional or atypical antipsychotics; most deaths due to cardiovascular or infectious events [US Black Box Warning]
- The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristics of the patients is not clear [US Black Box Warning]
- Increased incidence of cerebrovascular adverse reactions, including stroke, transient ischemic attack (including fatalities) in elderly patients with dementia-related psychoses treated with atypical antipsychotics
- A potentially fatal symptom complex called Neuroleptic Malignant Syndrome (NMS) has been reported in association with antipsychotic drugs
- As therapy is associated with prolonged QT interval, avoid use with drugs that also increase QT interval and in patients with risk factors for prolonged QT interval
- Irreversible, involuntary, dyskinetic movements (Tardive Dyskinesia) may occur with the therapy. Discontinue therapy if such condition occurs
- Therapy is associated with metabolic changes that may increase cardiovascular/cerebrovascular risk, including hyperglycemia, dyslipidemia, and weight gain. Monitor for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, weakness and increased glucose in patients with diabetes or at risk for diabetes
- Undesirable alterations in lipids may occur in patients treated with paliperidone
- Clinical monitoring of weight is recommended as weight gain has been observed with the use of therapy
- Prolactin elevations may occur and persist during prolonged use of therapy
- Do not administer therapy in patients with preexisting severe gastrointestinal narrowing as obstructive symptoms have been reported in such patients with the use of therapy
- Because of alpha-blocking activity, paliperidone can induce orthostatic hypotension and syncope. Use cautiously in patients with known cardiovascular or cerebrovascular disease, and patients predisposed to hypotension
- Frequently perform CBC counts in patients with a history of a clinically significant low WBC or a drug-induced leukopenia/neutropenia during the first few months of therapy as leukopenia, neutropenia, and agranulocytosis have been reported with the use of therapy
- Suspend therapy at the first sign of a clinically significant decline in WBC in the absence of other causative factors
- As therapy has potential for cognitive and motor impairment, caution advised while operating machinery
- Use cautiously in patients with a history of seizures or with conditions that lower the seizure threshold
- Closely supervise high-risk patients for suicidal tendencies
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Dementia
- Cerebrovascular disease
- History of neuroleptic malignant syndrome
- History of MI or IHD
- Orthostatic hypotension
- History of seizure disorder
- Diabetes mellitus
- Presence of risk factors for diabetes mellitus
- Geriatric Patients
Pregnancy Category:C
Breastfeeding: Safety not established. Avoid use. Use only if potential benefits outweigh the risk.
Pricing data from www.DrugStore.com in U.S.A.
- Invega 9 MG TB24 [Bottle] (JANSSEN)
100 mg = $2461.97
200 mg = $4817.05 - Invega 6 MG TB24 [Bottle] (JANSSEN)
100 mg = $1879.48
200 mg = $3734.95 - Invega 3 MG TB24 [Bottle] (JANSSEN)
100 mg = $1688.96
200 mg = $3376.01
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.
