For intramuscular injection only. For deltoid injection, use 1
½-inch 22G needle for patients
90 kg or 1-inch
23G needle for patients < 90 kg. For gluteal injection, use 1 ½-inch 22G needle
regardless of patient weight. For patients naïve to oral
paliperidone or oral or injectable risperidone, establish tolerability with oral
paliperidone or oral risperidone prior to initiating treatment with INVEGA®
SUSTENNA®. Initiate dosing with 234 mg on treatment day 1 and
156 mg one week later, both administered in the deltoid muscle.
Recommended monthly maintenance dose is 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). Administer monthly maintenance
in either the deltoid or gluteal muscle. Missed Doses: To manage either a missed second
initiation dose or a missed monthly maintenance dose, refer to the Full
Dosing must be individualized according to the patient's renal function
Extended release tablets:
For patients with mild renal impairment (creatinine clearance 50 mL/min to < 80
mL/min), the recommended initial dose of INVEGA® is 3 mg once daily. The
dose may then be increased to a maximum of 6 mg once daily based on
clinical response and tolerability.
For patients with moderate to severe renal impairment (creatinine
mL/min to < 50 mL/min), the recommended initial dose of INVEGA® is 1.5
mg once daily, which may be increased to a maximum of 3 mg once daily
after clinical reassessment.
As INVEGA® has not been studied in patients with creatinine clearance
below 10 mL/min, use is not recommended in such patients.
Moderate to severe renal impairment (creatinine clearance < 50 mL/min):
INVEGA® SUSTENNA® is not recommended.
Mild renal impairment (creatinine clearance
50 mL/min to < 80 mL/min): Administer 156 mg on treatment day 1 and 117
mg one week later, both administered in the deltoid muscle. Follow with
monthly injections of 78 mg in either the deltoid or gluteal muscle.
Tablets: As INVEGA® has not been studied in patients with creatinine
clearance below 10 mL/min, use is not recommended in such patients.
Injection: Moderate to severe
renal impairment (creatinine clearance < 50 mL/min): INVEGA® SUSTENNA®
is not recommended.
National Institutes of Health, U.S. National Library of Medicine,
DailyMed Database. Provides access to the latest drug monographs submitted to the
Food and Drug Administration (FDA). Please review the latest applicable package insert for
additional information and possible updates. A local search
option of this data can be found here.
The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
judgment. Neither GlobalRPh Inc. nor any other party involved in the
preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER
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