5th injection 15 Weeks Since 4th INVEGA TRINZA® Injection

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Legend
- Initiation Doses
- Maintenance Doses
- Cumulative INVEGA SUSTENNA® Plasma Concentration
- Cumulative INVEGA TRINZA® Plasma Concentration
- Cumulative Oral INVEGA® ER Plasma Concentration
- Daily Oral INVEGA® Doses
- Cumulative RISPERDAL CONSTA® Plasma Concentration
- Median Plasma Concentration for Oral INVEGA® ER 6-12 mg/day
- Initiation Doses
- Maintenance Doses
- Cumulative Paliperidone Palmitate Concentration
- Daily Oral INVEGA® ER Dose
- Cumulative RISPERDAL CONSTA® Plasma Concentration
- Week 1 = Day 8
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Typical Paliperidone Plasma Concentration (ng/mL)

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Dose Information
The dosage strength (234 mg) and dosage location (deltoid muscle) of the first INVEGA SUSTENNA® initiation dose is fixed per the INVEGA SUSTENNA® Prescribing Information. Dosage Timing: The first INVEGA SUSTENNA® initiation dose occurs on Day 1 (on the x-axis).
The dosage strength (156 mg) and dosage location (deltoid muscle) of the second INVEGA SUSTENNA® initiation dose is fixed per the INVEGA SUSTENNA® Prescribing Information. Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±4 days to help avoid a missed second initiation dose, for illustrative purposes, the timing of the second INVEGA SUSTENNA® dose cannot be adjusted.
Dosage Strength: The recommended maintenance dosage strength for the treatment of schizophrenia is 117 mg per the INVEGA SUSTENNA® Prescribing Information. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg). Dosage Location: The INVEGA SUSTENNA® monthly maintenance doses can be administered in either the deltoid or gluteal muscle per the INVEGA SUSTENNA® Prescribing Information. For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses. Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±7 days to help avoid a missed monthly dose, for illustrative purposes, the timing of the INVEGA SUSTENNA® maintenance doses cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA SUSTENNA® maintenance dosage strength may be adjusted by one dose increment up or down from the previous dose administered. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses. Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±7 days to help avoid a missed monthly dose, for illustrative purposes, the timing of the INVEGA SUSTENNA® maintenance doses cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA SUSTENNA® maintenance dosage strength may be adjusted by one dose increment up or down from the previous dose administered. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses. Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±7 days to help avoid a missed monthly dose, for illustrative purposes, the timing of the INVEGA SUSTENNA® maintenance doses cannot be adjusted.
Dosage Strength: The last two doses of INVEGA SUSTENNA® must be the same dosage strength in order to establish a consistent maintenance dose before starting INVEGA TRINZA®, as recommended per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses. Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±7 days to help avoid a missed monthly dose, for illustrative purposes, the timing of the INVEGA SUSTENNA® maintenance doses cannot be adjusted.
Dosage Strength: The first INVEGA TRINZA® dose is determined by the consistent INVEGA SUSTENNA® maintenance dose, using the equivalent 3.5-fold higher INVEGA TRINZA® dosage strength per the INVEGA TRINZA® Prescribing Information. Adjustment to the final INVEGA SUSTENNA® maintenance doses will adjust all INVEGA TRINZA® dosage strengths. Dosage Location: The INVEGA TRINZA® dose can be administered in either the deltoid or gluteal muscle per the INVEGA TRINZA® Prescribing Information. Dosage Timing: For illustrative purposes only, the timing of the first INVEGA TRINZA® dose cannot be adjusted. However, the INVEGA TRINZA® Prescribing Information does allow the first INVEGA TRINZA® dose to be administered ±7 days of the next scheduled INVEGA SUSTENNA® dose.
Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses. Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses. Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses. Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses. Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.
Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information. Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses. Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.

Dose Information

The dosage strength (234 mg) and dosage location (deltoid muscle) of the first INVEGA SUSTENNA® initiation dose is fixed per the INVEGA SUSTENNA® Prescribing Information.

Dosage Timing: The first INVEGA SUSTENNA® initiation dose occurs on Day 1 (on the x-axis).

The dosage strength (156 mg) and dosage location (deltoid muscle) of the second INVEGA SUSTENNA® initiation dose is fixed per the INVEGA SUSTENNA® Prescribing Information.

Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±4 days to help avoid a missed second initiation dose, for illustrative purposes, the timing of the second INVEGA SUSTENNA® dose cannot be adjusted.

Dosage Strength: The recommended maintenance dosage strength for the treatment of schizophrenia is 117 mg per the INVEGA SUSTENNA® Prescribing Information. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg).

Dosage Location: The INVEGA SUSTENNA® monthly maintenance doses can be administered in either the deltoid or gluteal muscle per the INVEGA SUSTENNA® Prescribing Information. For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses.

Dosage Timing: While the INVEGA SUSTENNA® Prescribing Information does permit a dosing window of ±7 days to help avoid a missed monthly dose, for illustrative purposes, the timing of the INVEGA SUSTENNA® maintenance doses cannot be adjusted.

Dosage Strength: For illustrative purposes only, the INVEGA SUSTENNA® maintenance dosage strength may be adjusted by one dose increment up or down from the previous dose administered.

Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA SUSTENNA® maintenance dose, the site of injection will remain constant for all remaining INVEGA SUSTENNA® maintenance doses.

Dosage Strength: For illustrative purposes only, the INVEGA SUSTENNA® maintenance dosage strength may be adjusted by one dose increment up or down from the previous dose administered.

Dosage Strength: The last two doses of INVEGA SUSTENNA® must be the same dosage strength in order to establish a consistent maintenance dose before starting INVEGA TRINZA®, as recommended per the INVEGA TRINZA® Prescribing Information.

Dosage Strength: The first INVEGA TRINZA® dose is determined by the consistent INVEGA SUSTENNA® maintenance dose, using the equivalent 3.5-fold higher INVEGA TRINZA® dosage strength per the INVEGA TRINZA® Prescribing Information. Adjustment to the final INVEGA SUSTENNA® maintenance doses will adjust all INVEGA TRINZA® dosage strengths.

Dosage Location: The INVEGA TRINZA® dose can be administered in either the deltoid or gluteal muscle per the INVEGA TRINZA® Prescribing Information.

Dosage Timing: For illustrative purposes only, the timing of the first INVEGA TRINZA® dose cannot be adjusted. However, the INVEGA TRINZA® Prescribing Information does allow the first INVEGA TRINZA® dose to be administered ±7 days of the next scheduled INVEGA SUSTENNA® dose.

Dosage Strength: For illustrative purposes only, the INVEGA TRINZA® maintenance dosage strength will remain constant for all INVEGA TRINZA® maintenance doses. INVEGA TRINZA® dosage 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 per the INVEGA TRINZA® Prescribing Information.

Dosage Location: For illustrative purposes only, once you select the deltoid or gluteal muscle for an INVEGA TRINZA® maintenance dose, the site of injection will remain constant for all remaining INVEGA TRINZA® maintenance doses.

Dosage Timing: While the INVEGA TRINZA® Prescribing Information does permit a dosing window of ±2 weeks to help avoid a missed dose, for illustrative purposes, the timing of the INVEGA TRINZA® maintenance dose cannot be adjusted.

Graph Information

INVEGA TRINZA® Managing a Missed Dose (3½ to Less than 4 Months since the last injection)

Consistent with the INVEGA TRINZA® Prescribing Information:

INVEGA TRINZA® is to be used only after INVEGA SUSTENNA® has been established as adequate treatment for at least four months.
INVEGA TRINZA® should be administered every 3 months.
Missing doses of INVEGA TRINZA® should be avoided.
Administration: For intramuscular injection only by a healthcare professional. Care should be taken to avoid inadvertent injection into a blood vessel.

INVEGA TRINZA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+TRINZA-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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Prescribing Information for:

Educational Dose Illustrator

Prescribing Information for:

Educational Dose Illustrator