Standard Dosing

Dose Information

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INVEGA SUSTENNA® Standard Dosing

Consistent with the INVEGA SUSTENNA® Prescribing Information:

Initiation Dosing:

  • 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.

Maintenance Dosing:

  • The INVEGA SUSTENNA® Prescribing Information [] 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.

INVEGA SUSTENNA® Prescribing Information []

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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