section name header

Pronunciation

riss-PER-i-done

Classifications

Therapeutic Classification: antipsychotics, mood stabilizers

Pharmacologic Classification: benzisoxazoles

Indications

IM: IM:

BEERS REMS


Action

  • May act by antagonizing dopamine and serotonin in the CNS.
Therapeutic effects:
  • Decreased symptoms of psychoses, bipolar mania, or autism.

Pharmacokinetics

Absorption: 70% after administration of tablets, solution, or orally disintegrating tablets. Following IM administration, small initial release of drug, followed by 3-wk lag; the rest of release starts at 3 wk and lasts 4–6 wk. Following SUBQ administration, initial release of drug occurs at 4–6 hr, with the rest of release occurring at 10–14 days after administration.

Distribution: Unknown.

Metabolism/Excretion: Primarily metabolized by the liver by the CYP2D6 isoenzyme to 9-hydroxyrisperidone (has similar pharmacological properties as risperidone). Risperidone and its active metabolite are renally eliminated.

Half-Life: Extensive metabolizers: 3 hr for risperidone, 21 hr for 9-hydroxyrisperidone. Poor metabolizers: 20 hr for risperidone and 30 hr for 9-hydroxyrisperidone; SUBQ: 9–11 days.

Time/Action Profile

(clinical effects)

ROUTEONSETPEAKDURATION
PO1–2 wkunknownup to 6 wk
IM3 wk4–6 wkup to 6 wk
SUBQ2 wk6–8 wkunknown



After discontinuation.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: arrhythmias, orthostatic hypotension, syncope, tachycardia

Derm: itching/skin rash, pigmentation, dry skin, photosensitivity, seborrhea, STEVENS-JOHNSON SYNDROME, sweating, TOXIC EPIDERMAL NECROLYSIS

EENT: pharyngitis, rhinitis, visual disturbances

Endo: galactorrhea, hyperglycemia

F and E: polydipsia

GI: constipation, diarrhea, dry mouth, nausea, salivation, abdominal pain, anorexia, dyspepsia, dysphagia, vomiting

GU: libido, dysmenorrhea/menorrhagia, fertility (females), amenorrhea, difficulty urinating, gynecomastia, impotence, polyuria, priapism

Hemat: AGRANULOCYTOSIS, leukopenia, neutropenia

Metab: weight gain, dyslipidemia, weight loss

MS: arthralgia, back pain

Neuro: dreams, sleep duration, aggressive behavior, dizziness, extrapyramidal reactions, headache, insomnia, sedation, fatigue, impaired temperature regulation, nervousness, NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, tardive dyskinesia

Resp: cough, dyspnea

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Schizophrenia

Acute Manic or Mixed Episodes Associated With Bipolar I Disorder

Maintenance Treatment of Bipolar I Disorder

Irritability Associated With Autistic Disorder

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Perseris, RisperDAL, RisperDAL Consta, RisperDAL M-TAB, Rykindo, Uzedy

Code

NDC Code