INVEGA SUSTENNA® Common Dosing and Administration Topics

Switching from Other Antipsychotics

From Oral RISPERDAL® to INVEGA SUSTENNA® - General Overview

Consistent with the INVEGA SUSTENNA® Prescribing Information:

  • There are no systematically collected data to specifically address switching patients with 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. Patients stabilized on RISPERDAL® tablets can attain similar steady-state exposure with INVEGA SUSTENNA® as depicted in Table. The INVEGA SUSTENNA® Prescribing Information does not specifically address conversion of RISPERDAL® tablets to INVEGA SUSTENNA®. This information is based on pharmacokinetic (PK) modeling performed to compare steady-state exposure during maintenance treatment between risperidone tablets and INVEGA SUSTENNA® (after both the 234 mg/156 mg deltoid starting doses).*

Table: Doses of RISPERDAL® and INVEGA SUSTENNA® Needed To Attain Similar Steady-State Palliperidone Exposure During Maintenance Treatment*

Formulation RISPERDAL® Tablet INVEGA SUSTENNA® Injection
Dosing Frequency Total Daily Dose Every 4 weeks
Dose (mg) 6 234
4 156
3 117
2 78
1 39

*Russu A, Sliwa JK, Ravestijn P, et al. Maintenance dose conversion between oral risperidone and paliperidone palmitate 1 month: Practical guidance based on pharmacokinetic simulations. Int J Clin Pract. 2018;e13089.

For illustrative displays of this dosing scenario, please click the link(s) below.

Switching from Oral RISPERDAL® for Schizophrenia

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:


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


  • 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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