INVEGA TRINZA® Common Dosing and Administration Topics
Transition to INVEGA TRINZA®
Transition from RISPERDAL CONSTA®
Consistent with the INVEGA TRINZA® Prescribing Information:
Patients may transition from every 2-week RISPERDAL CONSTA® at steady state (with an initial 3 weeks of oral supplementation) to monthly INVEGA SUSTENNA® (with adequate treatment for at least 4 months) to every 3-month INVEGA TRINZA®.
Since paliperidone is the active metabolite of risperidone, the cumulative plasma level curve will reflect the plasma level contributions from the RISPERDAL CONSTA® treatment in this scenario. See the respective Prescribing Information for complete information.
When transitioning a patient from RISPERDAL CONSTA® to INVEGA SUSTENNA® to INVEGA TRINZA®, it is important to note:
Oral Supplementation with RISPERDAL CONSTA®: Oral RISPERDAL® (or another antipsychotic medication) should be given with the first injection of RISPERDAL CONSTA® and continued for 3 weeks (and then discontinued) to ensure that adequate therapeutic plasma concentrations are maintained prior to the main release phase of risperidone from the injection site.
RISPERDAL CONSTA® Dosing: The recommended RISPERDAL CONSTA® dose is 25 mg IM every 2 weeks. Some patients not responding to the 25 mg dose may benefit from a higher dose of 37.5 mg or 50 mg. The maximum dose should not exceed 50 mg every 2 weeks. Upward dose adjustments of RISPERDAL CONSTA® should not be made more frequently than every 4 weeks. Steady-state plasma concentrations are reached after 4 injections and are maintained for 4 to 6 weeks after the last RISPERDAL CONSTA® injection. Administer by deep intramuscular (IM) deltoid or gluteal injection.
INVEGA SUSTENNA® Dosing: When transitioning patients currently at steady-state on a long-acting injectable antipsychotic, initiate INVEGA SUSTENNA® therapy in place of the next scheduled injection. Patients who were being treated with 25 mg, 37.5 mg, or 50 mg of RISPERDAL CONSTA® were transitioned to 78 mg, 117 mg, or 156 mg, respectively of INVEGA SUSTENNA®. INVEGA SUSTENNA® should then be continued at monthly intervals. Based on previous clinical history of tolerability and/or efficacy, some patients may benefit from lower or higher maintenance doses within the available strengths. Monthly maintenance doses can be administered in either the deltoid or gluteal muscle. The last two doses of INVEGA SUSTENNA® must be the same dosage strength before starting INVEGA TRINZA®.
INVEGA TRINZA® Dosing: Patients adequately treated for at least four months with 78 mg, 117 mg, 156 mg, or 234 mg of INVEGA SUSTENNA® were transitioned to 273 mg, 410 mg, 546 mg, or 819 mg, respectively of INVEGA TRINZA® at the next INVEGA SUSTENNA® injection (± 1 week). INVEGA TRINZA® should then be administered every 3 months, slowly deep into the gluteal or deltoid muscle. INVEGA TRINZA® dose adjustments can be made every 3 months in increments within the range of 273 mg to 819 mg based on individual patient tolerability and/or efficacy.