Switching from Long-Acting Injectable Antipsychotics

  • Legend
    • legend-oier-dose-symbol

      Cumulative Paliperidone Plasma Concentration from INVEGA® ER

    • legend-or-dose-symbol

      Cumulative active moiety concentration of risperidone + 9-OH-risperidone (paliperidone) from RISPERDAL

    • initiation-dosing-symbol

      Initiation Dosing

    • maintenace-dose-symbol

      Maintenance Doses

    • cumulative-paliperidone-plasma-concentration-symbol

      Cumulative Paliperidone Plasma Concentration

    • individual-dose-curves-symbol

      Individual Dose Curves

    • median-plasma-concentration-symbol

      Median Plasma Concentration for Oral INVEGA® ER 6-12 mg/day

    • Week 1 = Day 8

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Typical Paliperidone Plasma Concentration (ng/mL)
Typical Paliperidone Plasma Concentration (ng/mL)
Dose Information

Graph Information

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Switching from Long-acting Injectable Antipsychotics

Consistent with the INVEGA SUSTENNA® Prescribing Information:

  • There are no systematically collected data to specifically address switching patients with schizophrenia or schizoaffective disorder from other antipsychotics to INVEGA SUSTENNA®, or concerning concomitant administration with other antipsychotics.
  • For patients who have never taken oral paliperidone or oral or injectable risperidone, tolerability should be established with oral paliperidone or oral risperidone prior to initiating treatment with INVEGA SUSTENNA®.
  • When switching patients currently at steady-state on a long-acting injectable antipsychotic, initiate INVEGA SUSTENNA® therapy in place of the next scheduled injection. INVEGA SUSTENNA® should then be continued at monthly intervals.
  • The recommended initiation dosing regimen (234 mg followed by 156 mg in the deltoid muscle one week later) is not required.
  • The INVEGA SUSTENNA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+SUSTENNA-pi.pdf] recommends adjustment 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.
  • 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.

INVEGA SUSTENNA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+SUSTENNA-pi.pdf]

Educational Dose Illustrator for:
INVEGA SUSTENNA® (paliperidone palmitate)
INVEGA TRINZA® (paliperidone palmitate)

The Educational Dose Illustrator can be used to visualize how dosing affects paliperidone plasma concentrations following administration of:

INVEGA SUSTENNA® for:

  • the treatment of schizophrenia in adults
  • the treatment of schizoaffective disorder in adults as monotherapy and as an adjunct to mood stabilizers or antidepressants

INVEGA TRINZA® for:

  • the treatment of schizophrenia in patients after they have been adequately treated with INVEGA SUSTENNA® for at least four months.

This resource simulates the paliperidone plasma concentrations over time resulting from different dosing scenarios that are set forth in the respective Prescribing Information for INVEGA SUSTENNA® and INVEGA TRINZA®. The Educational Dose Illustrator is intended to be used as a resource to foster a better understanding of, and educate healthcare professionals about, the dosing recommendations provided in the respective Prescribing Information for INVEGA SUSTENNA® and INVEGA TRINZA®. It is intended for educational purposes only.

Because the simulated patient paliperidone plasma levels shown in the dosing scenarios are based upon aggregated pharmacokinetic information from clinical studies, the simulations may not be representative of individual patient response.

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