Paliperidone

Paliperidone is a prescription medicine used in the treatment of schizophrenia (a mental disorder that can result in hallucinations or delusions and also adversely affects a person’s ability to think and behave) and mania. Paliperidone may be taken with or without food. However, it is advised to take it at the same time each day as this helps to maintain a consistent level of medicine in the body. Take this in the dose and duration as advised by your doctor and if you have missed a dose, take it as soon as you remember. It is important that this medication is not stopped suddenly without talking to your doctor as it may worsen your symptoms. However, discontinue this medicine immediately if you experience Neuroleptic malignant syndrome (NMS), characterized by fever, muscle rigidity, and altered consciousness. Some common side effects of this medicine includes nystagmus (involuntary eye movement) and tremor. It also causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. You should be cautious if you are using this medicine as it may increase the risk of developing diabetes, so it is better to monitor glucose regularly. Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or suicidal thoughts while taking this medicine. Paliperidone is an atypical antipsychotic. It works by affecting the levels of chemical messengers (dopamine and serotonin) to improve mood, thoughts and behavior.

• Schizophrenia • Mania

Major metabolite of risperidone; improves negative symptoms of psychoses and reduces incidence of EPS Has high affinity for serotonin type 2 (5-HT2) receptors; binds to dopamine D2 receptors with 20 times lower affinity than that for 5-HT2 receptors; antagonizes alpha1-adrenergic, alpha2-adrenergic, and histaminergic receptors; has moderate affinity for serotonin type 1 (5-HT1C, 5-HT1D, 5-HT1A) receptors; has weak affinity for dopamine D1 receptors; has no affinity for muscarinic, beta1-adrenergic, and beta2-adrenergic receptors

Adult Dose: Oral Schizophrenia Adult: Initially, 6 mg once daily in the morning. May be titrated upward or downward in increments of 3 mg/day at intervals >5 days; not to exceed 12 mg/day Schizoaffective Disorder Indicated for schizoaffective disorder as monotherapy and as an adjunct to mood stabilizers or antidepressants 6 mg PO qDay in am (range 3-12 mg); titration may not be necessary; if exceeding 6 mg/day, increases of 3 mg/day recommended at intervals of 4 days of more; not to exceed 12 mg/day Child Dose: Schizophrenia 12 years (12 years (>51 kg): 3 mg/day PO initially; may be increased if necessary in increments of 3 mg/day at intervals ?5 days; not to exceed 12 mg/day Schizoaffective Disorder <18 years: Safety and efficacy not established Renal Dose: Renal impairment CrCl 50-79 mL/min: 3 mg/day initially; not to exceed 6 mg/day CrCl 10-49 mL/min: 1.5 mg/day initially; not to exceed 3 mg/day CrCl <10 mL/min: Not recommended

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Paliperidone may be taken with or without food, but it is better to take it at a fixed time.

Common: • Abnormal involuntary movements • Dizziness • Nystagmus (involuntary eye movement) • Sleepiness • Tremor

[UNSAFE] Paliperidone may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur. Take it in the morning, preferably at the same time every day. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Use caution while driving or doing anything that requires concentration as Paliperidone can cause dizziness and sleepiness. It may cause an increase in weight, blood sugar, cholesterol, and triglycerides (fat). Eat healthy, exercise, and monitor your levels regularly. Monitor your blood sugar regularly as Paliperidone can affect blood sugar levels. Do not stop taking Paliperidone without talking to your doctor first as it may cause a worsening of symptoms.

Hypersensitivity to paliperidone or risperidone.

Increased risk of QT prolongation w/ class IA (e.g. quinidine, disopyramide) and class III (e.g. amiodarone, sotalol) antiarrhythmics. Additive effects w/ drugs that cause orthostatic hypotension (e.g. other antipsychotics, tricyclics). May antagonise actions of levodopa and other dopaminergics. Additive effect w/ drugs known to lower seizure threshold (e.g. phenothiazines or butyrophenones, clozapine, tricyclics or SSRIs, tramadol, mefloquine). May reduce plasma levels w/ carbamazepine. Enhanced central effects w/ other CNS depressants. May increase plasma levels w/ valproate. May affect the absorption w/ metoclopramide.

[UNSAFE] Paliperidone may cause excessive drowsiness with alcohol.

[CONSULT YOUR DOCTOR] Paliperidone may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

[CONSULT YOUR DOCTOR] Paliperidone is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

[CAUTION] Paliperidone should be used with caution in patients with kidney disease. Dose adjustment of Paliperidone may be needed. Please consult your doctor. Use of Paliperidone is not recommended in patients with end-stage kidney disease. [CAUTION] Paliperidone should be used with caution in patients with severe liver disease. Dose adjustment of Paliperidone may be needed. Please consult your doctor. Limited information is available on the use of Paliperidone in these patients. No dose adjustment is recommended in patients with mild to moderate liver disease.

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