Switching from Oral INVEGA® ER

  • 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 Oral INVEGA® ER

Consistent with the INVEGA® Prescribing Information:

  • The recommended dose of oral INVEGA® ER for the treatment of schizophrenia in adults is 6 mg administered once daily. Initial dose titration is not required. Some patients may benefit from higher doses, up to 12 mg/day, and for some patients, a lower dose of 3 mg/day may be sufficient. Dose increases above 6 mg/day should be made only after clinical reassessment and generally should occur at intervals of more than 5 days. When dose increases are indicated, increments of 3 mg/day are recommended. The maximum recommended dose is 12 mg/day.

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.
  • Previous oral antipsychotics can be gradually discontinued at the time of initiation of treatment with INVEGA SUSTENNA®.
  • Recommended initiation of INVEGA SUSTENNA® is with a dose of 234 mg followed by 156 mg one week later, both administered in the deltoid 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.
  • Patients previously stabilized on different doses of oral INVEGA® ER can attain similar paliperidone steady-state exposure during maintenance treatment with INVEGA SUSTENNA® monthly doses as depicted in the Table.
Table: Doses of INVEGA® and INVEGA SUSTENNA® Needed To Attain Similar Steady-State Palliperidone Exposure During Maintenance Treatment.
Formulation INVEGA® Exteneded-Release Tablet INVEGA SUSTENNA® Injection
Dosing Frequency Once Daily Once every 4 weeks
Dose (mg) 12 234
9 156
6 117
3 39-78
  • 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]

Oral INVEGA® ER Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA-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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