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]