Invega Trinza

Paliperidone palmitate

A 3-mth inj for the treatment of schizophrenia in patients after they have been adequately treated w/ Invega Sustenna for at least 4 mth.

IM Use only after Invega Sustenna (1-mth paliperidone palmitate inj) has been established as adequate treatment for at least 4 mth. To establish consistent maintenance dose, the last 2 doses of Invega Sustenna should be the same dosage strength before starting Invega Trinza. Initiate Invega Trinza when the next 1-mth paliperidone palmitate dose is scheduled w/ an Invega Trinza dose based on the previous 1-mth inj dose, using the equivalent 3.5-fold higher dose (eg, if last dose of Invega Sustenna is 50 mg, initiate Invega Trinza at 175 mg dose; if last dose of Invega Sustenna is 75 mg, initiate Invega Trinza at 263 mg dose; if last dose of Invega Sustenna is 100 mg, initiate Invega Trinza at 350 mg dose; if last dose of Invega Sustenna is 150 mg, initiate Invega Trinza at 525 mg dose). Invega Trinza may be administered up to 7 days before or after the mthly time point of the next scheduled paliperidone palmitate 1-mth dose. Following initial Invega Trinza dose, administer Invega Trinza every 3 mth. Adjust dose every 3 mth, if necessary, in increments w/in the range of 175-525 mg.

Hypersensitivity to paliperidone or risperidone.

Increased mortality in elderly patients w/ dementia-related psychosis. Cerebrovascular adverse events in elderly patients w/ dementia-related psychosis. Discontinue treatment if neuroleptic malignant syndrome or tardive dyskinesia occurs. Avoid in combination w/ drugs that prolong QTc, patients w/ congenital QT syndrome or history of cardiac arrhythmias. Monitor for metabolic changes (hyperglycemia, DM & wt gain). Hyperprolactinemia. Monitor orthostatic vital signs in patients vulnerable to hypotension. Reports of somnolence, postural hypotension, motor & sensory instability. Leukopenia, neutropenia & agranulocytosis. Use cautiously in patients w/ history of seizures or w/ conditions that lower seizure threshold; in patients at risk for aspiration pneumonia. Patients w/ Parkinson's disease or dementia w/ Lewy bodies can experience increased sensitivity to Invega Trinza. Priapism. Conditions that contribute to core body temp elevation or dehydration. Intraoperative floppy iris syndrome. Avoid inj into a blood vessel. Moderate to severe renal impairment (CrCl <50 mL/min). Use caution when performing activities requiring mental alertness. Pregnancy & lactation. Childn <18 yr. Elderly.

Inj site reaction, wt increased, headache, upper resp tract infection, akathisia & parkinsonism.

Additive effect w/ drugs that may cause orthostatic hypotension. Decreased exposure w/ strong inducers of CYP3A4 & P-gp (eg, carbamazepine, rifampin, or St John's wort). Antagonized effect of levodopa & other dopamine agonist.

Antipsychotics

N05AX13 - paliperidone ; Belongs to the class of other antipsychotics.

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