section name header

Pronunciation

pa-li-PER-i-done

Classifications

Therapeutic Classification: antipsychotics

Pharmacologic Classification: benzisoxazoles

Indications

IM: IM: IM: IM:

BEERS REMS


Action

  • May act by antagonizing dopamine and serotonin in the CNS. Paliperidone is the active metabolite of risperidone.
Therapeutic effects:
  • Decreased manifestations of schizophrenia.
  • Decreased manifestations of schizoaffective disorder.

Pharmacokinetics

Absorption: 28% absorbed following oral administration, food absorption; slowly absorbed after IM administration (concentrations higher and more rapidly achieved with administration into deltoid muscle).

Distribution: Unknown.

Metabolism/Excretion: 59% excreted unchanged in urine; 32% excreted in urine as metabolites.

Half-Life: PO: 23 hr; IM (Erzofri): 27 days; IM (Sustenna): 25–49 days; IM (Trinza): 84–139 days; IM (Hafyera): 148–159 days.

Time/Action Profile

(plasma concentrations)

ROUTEONSETPEAKDURATION
POunknown24 hr24 hr
IM—Erzofriunknown16–28 days1 mo
IM—Sustennaunknown13 days1 mo
IM—Trinzaunknown30–33 days3 mo
IM—Hafyeraunknown29–32 days6 mo



Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: palpitations, tachycardia (dose related), bradycardia, orthostatic hypotension, QT interval prolongation

EENT: blurred vision

Endo: galactorrhea, gynecomastia, hyperglycemia

GI: abdominal pain, dry mouth, dyspepsia, nausea, swollen tongue

GU: fertility (females), amenorrhea, impotence, priapism

Hemat: AGRANULOCYTOSIS, leukopenia, neutropenia

Metab: dyslipidemia, weight gain

MS: back pain, dystonia (dose related)

Neuro: drowsiness, extrapyramidal disorders (dose related), headache, insomnia, akathisia, anxiety, confusion, dizziness, dysarthria, fatigue, NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, syncope, tardive dyskinesia, tremor (dose related), weakness

Resp: dyspnea, cough

Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Schizophrenia

Renal Impairment

Renal Impairment

Schizoaffective Disorder

Renal Impairment

Renal Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Erzofri, Invega, Invega Hafyera, Invega Sustenna, Invega Trinza

Code

NDC Code