INVEGA SUSTENNA Rx
Generic Name and Formulations:
Paliperidone (as palmitate) 39mg, 78mg, 117mg, 156mg, 234mg; ext-rel susp for IM inj.
Janssen Pharmaceuticals, Inc.
Indications for INVEGA SUSTENNA:
Treatment of schizophrenia. Treatment of schizoaffective disorder as monotherapy or as an adjunct to mood stabilizers or antidepressants.
Establish tolerability with oral paliperidone or oral risperidone prior to initiating. Give by deep deltoid IM inj, initially 234mg on Day 1, then 156mg one week later. Maintenance: Give by deep deltoid or gluteal IM inj once monthly. Schizophrenia: 117mg; may increase or decrease in the range of 39–234mg. Schizoaffective: usual range of 78–234mg. Both max: 234mg/month. Renal impairment: CrCl ≥50–<80mL/min: initially 156mg on Day 1, then 117mg one week later, then 78mg monthly; CrCl<50mL/min: not recommended. Missed doses or switching from other antipsychotics: see full labeling.
<18yrs: not established.
Elderly with dementia-related psychosis (not approved use): increased risk of death. Avoid in congenital long QT syndrome, cardiac arrhythmias. Discontinue if neuroleptic malignant syndrome (NMS) occurs; consider discontinuing if tardive dyskinesia occurs. Diabetes risk factors (obtain baseline fasting blood sugar). Cardio- or cerebrovascular disease; risks may be increased due to metabolic changes (eg, hyperglycemia, dyslipidemia, weight gain); monitor. Pre-existing low WBCs or history of leukopenia/neutropenia; monitor CBCs during 1st few months of treatment; discontinue if WBCs decline. Monitor for signs/symptoms of infection; discontinue if severe neutropenia (ANC <1000mm3) occurs. Predisposition to hypotension; monitor. Perform fall risk assessments when initiating and recurrently on long-term therapy. Parkinson's disease. Dementia with Lewy bodies. History of seizures. Patients at risk for aspiration pneumonia. Renal impairment. Severe hepatic impairment. Exposure to extreme temperatures. Suicidal patients. Reevaluate periodically. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: not recommended.
Avoid drugs that prolong QT interval (eg, Class 1A and Class III antiarrhythmics, chlorpromazine, thioridazine, gatifloxacin, moxifloxacin). Avoid concomitant strong CYP3A4 and/or P-gp inducers (eg, carbamazepine, rifampin, St. John's Wort); if coadmin necessary, consider oral paliperidone ext-rel tabs. Caution with other CNS drugs, alcohol, drugs that may cause orthostatic hypotension (monitor). May antagonize levodopa, other dopamine agonists. Additive effects with concomitant risperidone or oral paliperidone for long-term use; caution.
Inj site reactions, somnolence/sedation, dizziness, akathisia, extrapyramidal disorder; may cause NMS, tardive dyskinesia, QT prolongation, metabolic changes, orthostatic hypotension, syncope, hyperprolactinemia, priapism.
Kit—1 (prefilled syringe + needles)
Sign Up for Free e-newsletters
- Managing Chemo Brain in Pediatric Survivors of Childhood Cancer
- Aggressive Therapy Provides No Additional Advantage in Metastatic Prostate Cancer
- Excretion of Volatile Organic Compounds Higher in AYAs Using Vaping Products
- FDA, ASHP Actions to Prevent or Manage Chemotherapy Drug Shortages
- Breast Cancer Screening Recommendations Not Completely Reflective of Race, Age
- Various Aspects of Palliative Care Focus Associated With Different Outcomes In Cancer
- Cost vs Benefits: The Controversy Over Proton Beam Radiotherapy
- Patient Expectations at Odds With Actual Outcomes for Radiotherapy in Breast Cancer
- Patients Desire More Online Tools and Access
- Metformin Plus Ruxolitinib: A Potential Therapeutic Alternative for Myeloproliferative Neoplasms
- Sexual Quality of Life Decreased During, After Chemotherapy for Digestive Cancers
- CHEMO-SUPPORT: A Nursing Intervention to Relieve Chemotherapy Symptom Burden
- Approach and Management of Checkpoint Inhibitor-related Immune Hepatitis
- Revised AJCC8 Demonstrates Superior Tumor Classification for HNCSCC
- Oral Androgen Receptor Inhibitor Granted FDA Approval for Nonmetastatic CRPC
Regimen and Drug Listings
GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION
|Head and Neck Cancer||Regimens||Drugs|