Transition from RISPERDAL CONSTA® to INVEGA SUSTENNA® to INVEGA TRINZA®

  • Legend
    • initiation-dosing-symbol

      Initiation Doses

    • maintenace-dose-symbol

      Maintenance Doses

    • legend-pp1m-plasma-concentration

      Cumulative INVEGA SUSTENNA® Plasma Concentration

    • legend-pp3m-plasma-concentration

      Cumulative INVEGA TRINZA® Plasma Concentration

    • legend-er-plasma-concentration

      Cumulative Oral INVEGA® ER Plasma Concentration

    • legend-er-doses

      Daily Oral INVEGA® Doses

    • legend-rl-dose-symbol

      Cumulative RISPERDAL CONSTA® Plasma Concentration

    • median-plasma-concentration-symbol

      Median Plasma Concentration for Oral INVEGA® ER 6-12 mg/day

    • initiation-dosing-symbol

      Initiation Doses

    • maintenace-dose-symbol

      Maintenance Doses

    • legend-old-browser-paliperidone-palmitate-concentration

      Cumulative Paliperidone Palmitate Concentration

    • legend-er-doses

      Daily Oral INVEGA® ER Dose

    • legend-rl-dose-symbol-greyscale

      Cumulative RISPERDAL CONSTA® Plasma Concentration

    • Week 1 = Day 8

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Typical Paliperidone Plasma Concentration (ng/mL)
Typical Paliperidone Plasma Concentration (ng/mL)
Dose Information

Graph Information

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Transition to INVEGA TRINZA® from RISPERDAL CONSTA® (RISPERDAL CONSTA® to INVEGA SUSTENNA® to INVEGA TRINZA®)

Consistent with the INVEGA TRINZA® Prescribing Information:

  • Clinically stable patients entering the INVEGA TRINZA® long-term maintenance study who were being treated with 25 mg, 37.5 mg, or 50 mg of RISPERDAL CONSTA® (risperidone long-acting injection) were transitioned to 78 mg, 117 mg, or 156 mg, respectively, of INVEGA SUSTENNA® administered in the deltoid muscle in place of the next scheduled injection.
  • INVEGA TRINZA® is to be used only after INVEGA SUSTENNA® has been established as adequate treatment for at least four months. Adjust the INVEGA SUSTENNA® dose (78 mg, 117 mg, 156 mg, or 234 mg) according to efficacy/tolerability needs of the patient. Conversion from the INVEGA SUSTENNA® 39 mg dose was not studied.
  • In order to establish a consistent maintenance dose, it is recommended that the last two doses of INVEGA SUSTENNA® be the same dosage strength before starting INVEGA TRINZA®.
  • Initiate INVEGA TRINZA® when the next INVEGA SUSTENNA® dose is scheduled with an INVEGA TRINZA® dose based on the previous INVEGA SUSTENNA® dose, using the equivalent 3.5-fold higher dose as shown in table below.

INVEGA TRINZA® Doses for Adult Patients Adequately Treated with INVEGA SUSTENNA®

If the Last Dose of INVEGA SUSTENNA® is:

Initiate INVEGA TRINZA® at the Following Dose:

78 mg

273 mg

117 mg

410 mg

156 mg

546 mg

234 mg

819 mg

Conversion from the INVEGA SUSTENNA® 39 mg dose was not studied.

  • INVEGA TRINZA® should be administered every 3 months.
  • If needed, an INVEGA TRINZA® dose adjustment can be made every 3 months in increments within the range of 273 mg to 819 mg based on individual patient tolerability and/or efficacy. Due to the long-acting nature of INVEGA TRINZA®, the patient’s response to an adjusted dose may not be apparent for several months.
  • In a long-term placebo-controlled, randomized-withdrawal trial, the percentages of patients with schizophrenia entering the double-blind phase on each of the INVEGA TRINZA® dose levels were 4% for 273 mg, 9% for 410 mg, 49% for 546 mg, and 38% for 819 mg.
  • Since paliperidone is the active metabolite of risperidone, the cumulative plasma level curve will reflect the plasma level contributions from RISPERDAL CONSTA®, INVEGA SUSTENNA®, and INVEGA TRINZA® treatment in this scenario.
  • Administration: For intramuscular injection only by a healthcare professional. Care should be taken to avoid inadvertent injection into a blood vessel.

INVEGA TRINZA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+TRINZA-pi.pdf]
INVEGA SUSTENNA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA+SUSTENNA-pi.pdf]
RISPERDAL CONSTA® Prescribing Information [http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/RISPERDAL+CONSTA-pi.pdf]

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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