Cumulative Paliperidone Plasma Concentration from INVEGA® ER
Cumulative active moiety concentration of risperidone + 9-OH-risperidone (paliperidone) from RISPERDAL
Cumulative Paliperidone Plasma Concentration
Individual Dose Curves
Median Plasma Concentration for Oral INVEGA® ER 6-12 mg/day
Week 1 = Day 8
Graph Information^ Back to Top
INVEGA SUSTENNA® Standard Dosing
Consistent with the INVEGA SUSTENNA® Prescribing Information:
- Establish tolerability in patients who have never taken oral paliperidone or oral or injectable risperidone, prior to initiating treatment.
- Initiate with two doses a week apart both in the deltoid muscle. Administer INVEGA SUSTENNA® 234 mg followed by 156 mg one week later (Week 1).
- Administer in the deltoid muscle during initiation. The peak paliperidone plasma concentration is approximately 28% higher following an initiation dose in the deltoid vs. gluteal muscle.
- The initiation regimen (234 mg followed by 156 mg one week later, both in the deltoid muscle) rapidly attains steady-state paliperidone concentrations with no need for oral antipsychotic supplementation.
- Flexible dosing window: to avoid a missed dose, patients may be given the second initiation dose 4 days before or after the Week 1 time point.
- The INVEGA SUSTENNA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+SUSTENNA-pi.pdf] recommends adjustments of the monthly maintenance dose for schizoaffective disorder based on tolerability and/or efficacy using available strengths. The 39 mg strength was not studied in the long-term schizoaffective disorder study.
- For subjects randomized to INVEGA SUSTENNA® in the long-term schizoaffective disorder study, the distribution of monthly maintenance doses was 78 mg (4.9%), 117 mg (9.8%), 156 mg (47.0%), and 234 mg (38.4%).
- Monthly maintenance doses can be administered in either the deltoid or gluteal muscle.
- Adjustment of the maintenance dose may be made monthly. The full effect of the dose adjustment may not be evident for several months due to the prolonged-release characteristics.
- Flexible dosing window: To avoid a missed monthly dose, patients may be given a maintenance injection up to 7 days before or after the monthly time point.
- Administration: Each injection must be administered only by a healthcare professional. INVEGA SUSTENNA® is intended for intramuscular use only. Do not administer by any other route. Avoid inadvertent injection into a blood vessel.
- Please see Dosage Adjustments in the INVEGA SUSTENNA® Prescribing Information for use in renal impairment or in coadministration with strong CYP3A4/P-glycoprotein (P-gp) inducers.