Cumulative Paliperidone Plasma Concentration from INVEGA® ER
Cumulative active moiety concentration of risperidone + 9-OH-risperidone (paliperidone) from RISPERDAL
Cumulative Paliperidone Plasma Concentration
Individual Dose Curves
Median Plasma Concentration for Oral INVEGA® ER 6-12 mg/day
Week 1 = Day 8
Graph Information^ Back to Top
INVEGA SUSTENNA® Standard Dosing
Consistent with the INVEGA SUSTENNA® Prescribing Information:
- Establish tolerability in patients who have never taken oral paliperidone or oral or injectable risperidone, prior to initiating treatment.
- Initiate with two doses a week apart both in the deltoid muscle. Administer INVEGA SUSTENNA® 234 mg followed by 156 mg one week later (Week 1).
- Administer in the deltoid muscle during initiation. The peak paliperidone plasma concentration is approximately 28% higher following an initiation dose in the deltoid vs. gluteal muscle.
- The initiation regimen (234 mg followed by 156 mg in the deltoid muscle one week later) rapidly attains steady-state paliperidone concentrations with no need for oral antipsychotic supplementation.
- Flexible dosing window: to avoid a missed dose, patients may be given the second initiation dose 4 days before or after the Week 1 time point.
- The INVEGA SUSTENNA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+SUSTENNA-pi.pdf] recommends a monthly maintenance dose for schizophrenia of 117 mg. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg).
- Monthly maintenance doses can be administered in either the deltoid or gluteal muscle.
- Similar to the INVEGA SUSTENNA® Clinical Studies described in the INVEGA SUSTENNA® Prescribing Information, monthly has been defined as every 4 weeks (28 days) in these modeling simulations.
- Adjustment of the maintenance dose may be made monthly. The full effect of the dose adjustment may not be evident for several months due to the prolonged-release characteristics.
- Flexible dosing window: To avoid a missed monthly dose, patients may be given a maintenance injection up to 7 days before or after the monthly timepoint.
- Administration: Each injection must be administered only by a healthcare professional. INVEGA SUSTENNA® is intended for intramuscular use only. Do not administer by any other route. Avoid inadvertent injection into a blood vessel.
- Please see Dosage Adjustments in the INVEGA SUSTENNA® Prescribing Information for use in renal impairment or in coadministration with strong CYP3A4/P-glycoprotein (P-gp) inducers.