Invega

The recommended starting adult dose is 6 mg taken once daily, preferably in the morning, with or without food. For some people, a lower dose of 3 mg may be enough. The dose may be adjusted by 3 mg every 5 days as recommended by your doctor, according to response and severity of side effects. The maximum daily dose is 12 mg. Lower maximum daily doses are recommended for people with decreased kidney function.

The tablets must be swallowed whole with water or other liquids and must not be chewed, divided, or crushed. The tablet shell is not absorbed and you may notice it in your stool (this is normal).

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Invega (Paliperidone) exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed dose. If you miss 2 or more doses, contact your doctor. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Invega (Paliperidone) at room temperature, protect it from moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause indigestion; it may cause drowsiness or dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause nausea or, rarely, vomiting; it may cause weight gain, mostly with prolonged use. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

3 mg
Each white, capsule-shaped extended-release tablet printed with "PAL 3" contains 3 mg of Invega (Paliperidone). Nonmedicinal ingredients: butylated hydroxytoluene, carnauba wax, cellulose acetate, ferric oxide red, ferric oxide yellow, hydroxyethyl cellulose, hypromellose, iron oxide black, lactose monohydrate, polyethylene oxides, polyethylene glycol, propylene glycol, povidone, sodium chloride, stearic acid, titanium dioxide, and triacetin.

6 mg
Each beige, capsule-shaped extended-release tablet printed with "PAL 6" contains 6 mg of Invega (Paliperidone). Nonmedicinal ingredients: butylated hydroxytoluene, carnauba wax, cellulose acetate, ferric oxide red, ferric oxide yellow, hydroxyethyl cellulose, hypromellose, iron oxide black, polyethylene oxides, polyethylene glycol, propylene glycol, povidone, sodium chloride, stearic acid, and titanium dioxide.

9 mg
Each pink, capsule-shaped extended-release tablet printed with "PAL 9" contains 9 mg of Invega (Paliperidone). Nonmedicinal ingredients: butylated hydroxytoluene, carnauba wax, cellulose acetate, ferric oxide red, ferric oxide yellow, hydroxyethyl cellulose, hypromellose, iron oxide black, polyethylene oxides, polyethylene glycol, propylene glycol, povidone, sodium chloride, stearic acid, and titanium dioxide.

Do not take Invega (Paliperidone) if you:

• are allergic to Invega (Paliperidone) or any ingredients of the medication
• are allergic to Risperidone

There may be an interaction between Invega (Paliperidone) and any of the following:

• alcohol
• Aldesleukin
• Aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• amantadine
• amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• Apalutamide
• azelastine
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, Phenobarbital)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, sotalol)
• brimonidine
• Buprenorphine
• Bupropion
• Buspirone
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• chloral hydrate
• Cyclosporine
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone)
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, Indapamide, triamterene)
• dofetilide
• Donepezil
• dopamine agonists (Parkinson's disease medications; e.g., Apomorphine, Bromocriptine, levodopa, Pramipexole, Ropinirole, Rotigotine)
• Dronedarone
• efavirenz
• Eliglustat
• Galantamine
• general anaesthetics (medications to put you to sleep for surgery)
• grapefruit juice
• Hepatitis C antivirals (e.g., glecaprevir, ledipasvir, ombitasvir, paritaprevir, velpatasvir)
• Hydralazine
• hydroxychloroquine
• kava kava
• Lapatinib
• lithium
• Loperamide
• lumacaftor and Ivacaftor
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• Methadone
• Methylphenidate
• Metoclopramide
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• muscle relaxants (e.g., Baclofen, Cyclobenzaprine, methocarbamol, orphenadrine)
• Nabilone
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• Obinutuzumab
• other antipsychotics (e.g., chlorpromazine, Clozapine, Haloperidol, Olanzapine, Pimozide, Quetiapine, risperidone)
• procainamide
• Propafenone
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin)
• rifampin
• ritonavir
• Rivastigmine
• St. John's wort
• seizure medications (e.g., Carbamazepine, Gabapentin, Levetiracetam, Perampanel, Phenytoin, Topiramate)
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin-norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• sodium oxybate
• suvorexant
• Tapentadol
• Tetrabenazine
• thalidomide
• tolcapone
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Tryptophan
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Invega (Paliperidone). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Invega (Paliperidone).

Abnormal heart rhythms: Invega (Paliperidone) can cause abnormal heart rhythms. Certain medications (e.g., quinidine, procainamide, Amiodarone, Sotalol, Chlorpromazine, thioridazine, moxifloxacin) can increase the risk of a type of abnormal heart rhythm called QT prolongation and should not be used in combination with Invega (Paliperidone). People who have a slow heart rate, low potassium or magnesium levels, or have congenital prolongation of the QT interval are more at risk for this type of abnormal heart rhythm and its complications. Talk to your doctor about the risks and benefits of using Invega (Paliperidone).

Blood Clots: Rarely, Invega (Paliperidone) increases the chance of blood clot formation, causing reduction of blood flow to organs or the extremities.

If you have a history of clotting, you may be at increased risk of experiencing blood clot-related problems such as Heart Attack, stroke, or clots in the deep veins of your leg. Discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.

Blood counts: Invega (Paliperidone) can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of infection (e.g., fever, chills, or sore throat) or unusual bleeding or bruising, contact your doctor immediately.

Body temperature: Invega (Paliperidone), like other antipsychotic medications, can disrupt the body's ability to control body temperature. People who exercise vigorously, who are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., Benztropine, Oxybutynin) are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool down while taking Invega (Paliperidone).

Cataract surgery: During eye surgery for Cataracts, people who take or have taken Invega (Paliperidone) are at risk for developing a condition called Intraoperative Floppy Iris Syndrome (IFIS). This condition can lead to eye damage. If you are planning to have an operation on your eye, inform your doctor if you are taking or have taken Invega (Paliperidone).

Cholesterol: Invega (Paliperidone) can cause increased blood cholesterol levels. If you are at risk of developing High Cholesterol or you have high cholesterol levels before starting Invega (Paliperidone), discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.

Diabetes and blood sugar: Invega (Paliperidone) may cause an increase in blood sugar levels and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using Invega (Paliperidone).

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.

If you experience weakness, increased thirst, increased urination, and increased appetite while taking Invega (Paliperidone), contact your doctor.

Drowsiness/reduced alertness: Invega (Paliperidone) may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Invega (Paliperidone) affects you.

Gastrointestinal problems: Invega (Paliperidone) should not be taken by people with conditions associated with narrowing of the gastrointestinal tract (e.g., esophagus disorders, inflammatory bowel disease, "short gut" syndrome, Cystic Fibrosis), or by people who have difficulty swallowing.

Heart conditions: If you have a heart condition, such as Angina, heart failure, irregular heartbeat, or you have had a heart attack, discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.

Hypersensitivity syndrome: A severe allergic reaction called hypersensitivity syndrome has occurred for some people taking medications similar to Invega (Paliperidone). Stop taking the medication and get immediate medical attention if you have symptoms of a severe allergic reaction, including fever, severe rash, swollen glands, yellowing of the skin or eyes, or flu-like symptoms with skin rash or blistering.

Lactose intolerance: Certain strengths (3 mg tablets) of Invega (Paliperidone) tablets are prepared with lactose. If you have hereditary lactose or galactose intolerance problems you should not take this strength of the medication.

Kidney function: Kidney Disease or reduced kidney function may cause Invega (Paliperidone) to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.
Low Blood Pressure: Invega (Paliperidone) may cause low blood pressure when rising from a sitting or lying down position. If you feel dizzy, lightheaded, or feel your pulse racing, call your doctor. While you are taking Invega (Paliperidone), get up slowly after you have been sitting or lying down for a prolonged period.

Neuroleptic malignant syndrome (NMS): Invega (Paliperidone), like other antipsychotic medications, can cause a potentially fatal syndrome known as NMS. If you experience the symptoms of NMS, such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, and fainting, get immediate medical attention.

Parkinson's Disease: People with Parkinson's disease or Dementia with Lewy bodies (DLB) may be at an increased risk of NMS (see warning about NMS), as well as other side effects associated with Invega (Paliperidone). Talk to your doctor about the risks and benefits of using Invega (Paliperidone).

Risperidone: People who are taking risperidone should not take Invega (Paliperidone) at the same time. These medications are related, and taking them together may cause an increased risk of side effects.

Seizures: Invega (Paliperidone) may increase the risk of seizures, especially in people who have had seizures in the past. People who are at risk of seizures who take Invega (Paliperidone) should be closely monitored by their doctor. If you have had seizures, discuss with your doctor how Invega (Paliperidone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Invega (Paliperidone), and whether any special monitoring is needed.

Suicidal or agitated behaviour: People taking Invega (Paliperidone) may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting Invega (Paliperidone). If you experience these side effects or notice them in a family member who is taking Invega (Paliperidone), contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Invega (Paliperidone).

Tardive dyskinesia (TD): TD, a syndrome consisting of potentially irreversible, involuntary, repetitive movements of the face and tongue muscles, may develop in people who take certain antipsychotic medications including Invega (Paliperidone). Although TD appears most commonly in seniors, especially women, it is impossible to predict who will develop TD. The risk of developing TD increases with higher doses and long-term treatment. If you experience muscle twitching or abnormal movements of the face or tongue, contact your doctor as soon as possible.

Pregnancy: Invega (Paliperidone) should not be used during pregnancy unless the benefits outweigh the risks. Using Invega (Paliperidone) during the last three months of pregnancy can harm the developing baby and cause withdrawal symptoms after birth. If you become pregnant while taking Invega (Paliperidone), contact your doctor immediately.

Breast-feeding: Invega (Paliperidone) passes into breast milk. If you are a breast-feeding mother and are taking Invega (Paliperidone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Invega (Paliperidone) have not been established for children under 18 years of age. Clinical studies using Invega (Paliperidone) to treat adolescents with schizophrenia have shown an increased likelihood of movement disorders occurring in this group.

Seniors: Medications similar to Invega (Paliperidone) can increase the risk of death as a result of a stroke, mini-stroke, and severe infection, when used to treat seniors with dementia. Invega (Paliperidone) should not be used to treat seniors with dementia.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It is not advisable to stop using this product suddenly, particularly if you have been on it for several weeks. If you are considering stopping the medication, talk to your pharmacist first. This medication should be swallowed whole. It should not be split, crushed or chewed. You may notice the presence of a whole tablet in your stools. This is only the outer shell; the medication inside has been absorbed. This medication may be taken with or without food. This product may intensify the effect of alcohol. Limit alcohol consumption to an occasional intake.