Management of Missed Second Initiation Dose

Consistent with the INVEGA SUSTENNA® Prescribing Information:

• If the target date for the second INVEGA SUSTENNA® injection (one week ± 4 days) is missed, the recommended reinitiation depends on the length of time which has elapsed since the patient's first injection.
• In case of a missed second initiation dose follow the dosing instructions provided in the Table.

Table: Management of a Missed Maintenance Dose.

Timing of Missed Maintenance Dose	Dosing
Less than 4 weeks since first injection	Administer the second initiation dose of 156 mg in the deltoid muscle as soon as possible It is recommended to administer a third injection of 117 mg in either in the deltoid or gluteal muscle 5 weeks after the first injection (regardless of the timing of the second injection). Thereafter, resume regular monthly dosing in either the deltoid or gluteal muscle.
4 to 7 weeks since first injection	Resume dosing with two injections of 156 mg in the following manner: Administer a deltoid injection as soon as possible. Administer a second deltoid injection 1 week later. Thereafter, resume regular monthly dosing in either the deltoid or gluteal muscle.
More than 7 weeks since first injection	Restart dosing with recommended initiation: Administer a 234 mg deltoid injection on Day 1. Administer a 156 mg deltoid injection 1 week later. Thereafter, resume regular monthly dosing in either the deltoid or gluteal muscle.

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

Missed 2nd Initiation Dose: <4 weeks from 1st injection for Schizophrenia

Missed 2nd Initiation Dose: 4-7 weeks from 1st injection for Schizophrenia

Missed 2nd Initiation Dose: > 7 weeks from 1st injection for Schizophrenia