INVEGA SUSTENNA® Common Dosing and Administration Topics

Initiation Dosing

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
  1. 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).
  2. 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:
  1. Administer a deltoid injection as soon as possible.
  2. Administer a second deltoid injection 1 week later.
  3. Thereafter, resume regular monthly dosing in either the deltoid or gluteal muscle.
More than 7 weeks since first injection Restart dosing with recommended initiation:
  1. Administer a 234 mg deltoid injection on Day 1.
  2. Administer a 156 mg deltoid injection 1 week later.
  3. 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

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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