Invega Sustenna

1 Whaat is Invega Sustenna?

Generic: Paliperidone

Invega Sustenna is used to treat schizophrenia and schizoaffective disorder. Paliperidone is an atypical antipsychotic.

It is available in extended-release tablets. Some doctors use Paliperidone for other psychiatric conditions like ADHD, sleep difficulties, and depression.

Paliperidone is the primary active metabolite of another drug Risperidone (Risperdal). The exact mechanisms on how these medications work are not fully understood.

Paliperidone comes with a boxed warning because it is known to cause serious side effects and risks in certain populations.

Paliperidone is a prescription medication.

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2 What to Know Before Using

Before using Invega Sustenna, you must know all about the risks and complications associated with it.

Tell your doctor if you experienced allergies or adverse effects to Paliperidone or Risperidone before taking the medication.

Do not use Paliperidone if you have allergies to it, or experienced allergies to Risperidone.

You must not use Paliperidone if you have severe kidney diseases or heartbeat irregularities like long QT syndrome and prolonged QT interval.

Long QT syndrome and prolonged QT interval are serious conditions in the heart’s electrical system, which can result to rapid and chaotic heart rhythms that cause fainting or death.

Tell your doctor if you have a history of:

Mention if you have problems with the kidneys, liver, bleeding or inflammation in the stomach or intestines before taking Paliperidone.

Tell your doctor if you have Reye’s syndrome, cystic fibrosis, issues with swallowing and aspiration (inhaling foreign matter into the lungs), alcohol abuse, neuroleptic malignant syndrome (NMS), and tardive dyskinesia (abnormal movements of the hands, tongue or face).

Tell your doctor if you have elevated blood sugar levels, diabetes, obesity or have a family history of diabetes.

You also have to tell if you have high prolactin levels, history or at risk of cancers of the breast, pancreas or esophagus, low potassium levels, low blood volume, experienced episodes of dizziness or fainting.

You must not consume alcohol or tobacco while using Paliperidone. Tell the doctor if you are consuming alcohol or using tobacco before taking Paliperidone.

Tell the doctor if you have or have a history of self-harm behaviors, suicidal thoughts and attempts.

Note that Paliperidone can interact with several medicines such as those used for:

Paliperidone can also interact with several narcotics, drugs for treating substance abuse, medications for nausea and vomiting.

Taking certain drugs with Paliperidone can increase the risk of prolonged QT interval.

These drugs include Amiodarone, Procainamide, Quinidine, Sotalol, Chlorpromazine, Thioridazine, Asenapine, Citalopram, Metoclopramide, Nilotinib, Gatifloxacin, Moxifloxacin, Tetrabenazine and many others.

Tell the doctor all the medications you take before taking Paliperidone.

If you are taking Paliperidone, do not take any medication, over-the-counter drugs or herbal supplements without your doctor’s supervision.

Note that Paliperidone also interacts with multivitamins and herbal supplements like herbal teas, coenzyme Q10, ginseng, Ginkgo and St. John’s wort.

Tell your doctor if you have used or never had been treated with Paliperidone or Risperidone.

3 Proper Usage

To use Invega Sustenna properly, you must follow all instructions given by your doctor.

Paliperidone comes with an extra information leaflet. Make sure to read this carefully before taking the drug. If you have questions about the medication, make sure to call your doctor.

Take Paliperidone tablets by mouth, usually once a day. The doctor will determine your dose. You may need to visit the doctor several times a week for dose adjustment and assess disease symptoms.

You can take Paliperidone with or without food. Swallow Paliperidone tablets whole with a glass of water. Do not chew, break or divide Paliperidone tablets, especially extended-release tablets.

Paliperidone tablets, notably extended-release brands, contain insoluble components that may show up in the stool and should not be a cause for concern.

Make sure to drink plenty of fluids while on Paliperidone treatment to avoid problems in the kidneys.

Be aware that missing dose of Paliperidone may cause undesirable symptoms. If you missed or going to miss a dose of Paliperidone, call your doctor right away.

If you overdosed on Paliperidone, call your doctor or local poison control centers and head to the nearest hospital immediately.

4 Precautions to Take

Before using Invega Sustenna, there are some precautions you must take.

Note that Paliperidone needs some time to work, much like other drugs for mental disorders. Always take the medication as prescribed and do not take more or less than the prescribed dose.

Call your doctor first if you want to stop or change the dose of the medication.

If you will receive care from another clinic or having dental work done, make sure they know you are taking Paliperidone.

Paliperidone may cause dizziness, drowsiness or light-headedness, which can cause problems when you drive or operate heavy machinery. Make sure you understand the effects of Paliperidone to your body before doing critical or dangerous tasks.

Do not drink alcohol while taking Paliperidone. Call your doctor before taking medications that cause drowsiness such as sleeping pills, narcotics and muscle relaxants.

When having treatment with Paliperidone, remember that drinking alcohol, staying in hot environments, vigorous exercise or having a fever can cause dizziness, lightheadedness, and fainting. Do not become overheated while being active. Sit or lie down if you feel lightheaded or feel you are about to faint.

Paliperidone may increase blood sugar levels so you may need to have frequent blood sugar tests. Watch out for symptoms of high blood sugar such as confusion, drowsiness, thirst, unusual weakness, urinating more than usual and having a fruit-like breath odor. Call your doctor if you experience these symptoms.

If you have diabetes, you need to check your blood sugar levels more frequently. Make sure the doctor knows you are taking Paliperidone, and always seek their permission before changing doses of medications.

Paliperidone may cause neuroleptic malignant syndrome (NMS), which can be fatal. Watch out for symptoms such as fever, stiff muscles, confusion, changes in thinking, fast or irregular heartbeat and sweating. Call your doctor right away if any of those symptoms occur.

Paliperidone may cause involuntary muscle movements, resulting in things like jerking of the arms, legs, tongue, face, and mouth, repeatedly sticking out the tongue, puffing cheeks, puckering the mouth or chewing movements while on Paliperidone.

These are called extrapyramidal symptoms and tends to occur more in elderly. Call your doctor if you experienced these symptoms.

Paliperidone may lower your immune system and make you at risk for infections. Wash hands frequently, avoid large groups of people and keep distance to individuals with colds, flu or infections. Call your doctor right away if you have a sore throat, fever, chills and a rash.

Paliperidone can cause your prolactin levels to rise. Prolactin is a hormone and high levels in the bloodstream can cause symptoms like enlarged breasts in men (gynecomastia), missed menses, reduced interest in sex, and nipple discharge. If you experienced these symptoms while using Paliperidone, call the doctor immediately.

In males, Paliperidone may cause painful and prolonged erections (priapism). This is dangerous and must be treated right away. Call your doctor and head to the nearest hospital if you have an erection lasting more than an hour or two.

Paliperidone may cause increased risk of strokes in elderly patients. Paliperidone is not approved to treat dementia or mental problems caused by dementia. Talk to your doctor about this risk before taking Paliperidone.

You need to have frequent lab tests when taking Paliperidone to monitor for side effects and assess your condition. Always stick to scheduled appointments.Paliperidone may cause weight gain.

Do not breastfeed or get pregnant when taking Paliperidone. Note that Paliperidone is expressed in breast milk and can harm the breastfeeding baby. If you get pregnant during treatment, call your doctor right away.

Note that Paliperidone needs some time to work, much like other drugs for mental disorders. Always take the medication as prescribed and do not take more or less than the prescribed dose. Call your doctor first if you want to stop or change the dose of the medication.

If you will receive care from another clinic or having dental work done, make sure they know you are taking Paliperidone.

Paliperidone may cause dizziness, drowsiness or light-headedness, which can cause problems when you drive or operate heavy machinery. Make sure you understand the effects of Paliperidone to your body before doing critical or dangerous tasks.

Do not drink alcohol while taking Paliperidone. Call your doctor before taking medications that cause drowsiness such as sleeping pills, narcotics and muscle relaxants.

When having treatment with Paliperidone, remember that drinking alcohol, staying in hot environments, vigorous exercise or having a fever can cause dizziness, lightheadedness, and fainting. Do not become overheated while being active. Sit or lie down if you feel lightheaded or feel you are about to faint.

Paliperidone may increase blood sugar levels so you may need to have frequent blood sugar tests. Watch out for symptoms of high blood sugar such as confusion, drowsiness, thirst, unusual weakness, urinating more than usual and having a fruit-like breath odor. Call your doctor if you experience these symptoms.

If you have diabetes, you need to check your blood sugar levels more frequently. Make sure the doctor knows you are taking Paliperidone, and always seek their permission before changing doses of medications.

Paliperidone may cause neuroleptic malignant syndrome (NMS), which can be fatal. Watch out for symptoms such as fever, stiff muscles, confusion, changes in thinking, fast or irregular heartbeat and sweating. Call your doctor right away if any of those symptoms occur.

Paliperidone may cause involuntary muscle movements, resulting in things like jerking of the arms, legs, tongue, face, and mouth, repeatedly sticking out the tongue, puffing cheeks, puckering the mouth or chewing movements while on Paliperidone.

These are called extrapyramidal symptoms and tends to occur more in elderly. Call your doctor if you experienced these symptoms.

Paliperidone may lower your immune system and make you at risk for infections. Wash hands frequently, avoid large groups of people and keep distance to individuals with colds, flu or infections. Call your doctor right away if you have a sore throat, fever, chills and a rash.

Paliperidone can cause your prolactin levels to rise. Prolactin is a hormone and high levels in the bloodstream can cause symptoms like enlarged breasts in men (gynecomastia), missed menses, reduced interest in sex, and nipple discharge. If you experienced these symptoms while using Paliperidone, call the doctor immediately

In males, Paliperidone may cause painful and prolonged erections (priapism). This is dangerous and must be treated right away. Call your doctor and head to the nearest hospital if you have an erection lasting more than an hour or two.

Paliperidone may cause increased risk of strokes in elderly patients. Paliperidone is not approved to treat dementia or mental problems caused by dementia. Talk to your doctor about this risk before taking Paliperidone.

You need to have frequent lab tests when taking Paliperidone to monitor for side effects and assess your condition. Always stick to scheduled appointments.  Paliperidone may cause weight gain.

Do not breastfeed or get pregnant when taking Paliperidone. Note that Paliperidone is expressed inbreast milkk and can harm the breastfeeding baby. If you get pregnant during treatment, call your doctor right away.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Invega Sustenna.

Call your doctor if you experienced the following while taking Paliperidone:

  • Severe allergic reactions like swelling of the face, tongue and lips, tightness in the chest, unusual hoarseness, hives, itching and a rash
  • Abnormal thoughts or thinking
  • Self-harm or suicidal thoughts
  • Decreased urination
  • Confusion
  • Lightheadedness or fainting
  • Fever
  • Chills
  • A persistent sore throat
  • Increased salivation or drooling
  • Increased sweating
  • Muscle cramps
  • Pain
  • Weakness or stiffness of the muscles
  • New or worsening mood changes, like having agitation or anxiety
  • One-sided weakness
  • Seizures
  • Severe or persistent constipation
  • Stomach pain
  • Severe or persistent dizziness
  • Drowsiness
  • Headache
  • Shortness of breath
  • Slurred speech
  • Swelling of the hands, feet or ankles
  • Tremors
  • Trouble concentrating, speaking or swallowing
  • Inability to control urination
  • Trouble sitting still
  • Trouble standing or walking
  • Uncontrolled or involuntary movements of the arms or legs
  • Twitching of the face or tongue
  • Unusual bleeding or bruising
  • Unusual eye movements
  • Vision problems

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