paliperidone at a glance
Medicine class
Second-generation antipsychotic
Main uses
Schizophrenia; prolonged-release tablets are also licensed for schizoaffective disorder in adults
Tablets
Swallow whole and take consistently either with breakfast or without food
Long-acting injection
Given into a muscle by a healthcare professional
What is paliperidone used for?
The selected products are licensed for:
Prolonged-release tablets: schizophrenia in adults and adolescents aged 15 years and older.
Prolonged-release tablets: schizoaffective disorder in adults.
Prolonged-release injection: maintenance treatment of schizophrenia in adults stabilised with paliperidone or risperidone.
In selected adults who previously responded to oral paliperidone or risperidone, the injection may be considered without prior oral stabilisation when symptoms are mild to moderate and a long-acting injectable treatment is needed.
How does paliperidone work?
Paliperidone blocks dopamine D2 and serotonin 5-HT2 receptors. This can reduce psychotic symptoms. Its activity at alpha-adrenergic and histamine receptors also helps explain effects such as postural dizziness and sleepiness.
paliperidone preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 3 mg, 6 mg, 9 mg
Injection
Route: Parenteral
Strengths: 75 mg, 100 mg, 150 mg
How to take paliperidone
Follow the instructions for the formulation prescribed. Do not stop treatment without discussing this with the treating team, as symptoms may return.
Swallow prolonged-release tablets whole with liquid; do not chew, divide or crush them.
Take tablets consistently in relation to food: always fasting or always with breakfast.
The empty tablet shell may occasionally be visible in the stool; this is expected.
The prolonged-release injection is given deeply into an upper-arm or buttock muscle by a healthcare professional. Attend scheduled appointments and contact the clinic promptly if one cannot be kept.
paliperidone side effects
Common or expected effects
- Difficulty sleeping, sleepiness or headache
- Restlessness, tremor, stiffness, slowed movement or other movement effects
- Dizziness
- Weight change, raised blood glucose or appetite changes
- Raised prolactin, which may cause menstrual changes, breast symptoms or sexual dysfunction
- Nausea, vomiting, constipation, diarrhoea or abdominal discomfort
- Fast heartbeat
- Injection-site pain, itching or swelling with the injectable formulation
Get urgent medical advice
- High temperature, marked muscle stiffness, sweating or reduced consciousness
- Severe allergic reaction, including facial or tongue swelling and breathing difficulty
- Blood clot symptoms, such as a painful swollen leg or sudden chest pain and breathlessness
- Persistent involuntary movements, particularly of the tongue, mouth or face
- Painful prolonged erection
- Severe infection symptoms where a low white-cell count is suspected
- Severe hyperglycaemia, including marked thirst, frequent urination, weakness or reduced consciousness
- New palpitations, fainting or suspected abnormal heart rhythm
paliperidone in pregnancy
Human pregnancy data are limited, so paliperidone should be used only when the expected clinical benefit justifies treatment. Do not stop suddenly after discovering a pregnancy; contact the prescriber or specialist mental-health team. Exposure near delivery may cause newborn movement, alertness, breathing or feeding problems, so neonatal monitoring may be needed.
paliperidone while breastfeeding
The selected product information advises against breastfeeding because paliperidone enters breast milk and effects on the infant are considered likely. Decisions should involve mental-health and maternity teams; specialist breastfeeding advice is particularly important for long-acting injections, premature or unwell infants, or treatment involving several medicines.
paliperidone interactions
Tell the prescriber and pharmacist about all medicines, supplements and alcohol use. Important examples include:
Medicines that prolong the QT interval
Antiarrhythmics, some antihistamines, antimalarials and antipsychotics may add to the risk of abnormal heart rhythm.
Alcohol, opioids, sleeping tablets and other sedating medicines
Combined effects may increase sleepiness, impaired alertness or falls.
Common questions about paliperidone
Answers are fully visible for fast scanning and source review.
What is paliperidone used for?
It treats schizophrenia. Prolonged-release tablets are also licensed for schizoaffective disorder in adults, while the long-acting injection is used for maintenance treatment of schizophrenia in suitable adults.
Can paliperidone tablets be crushed or split?
No. Crushing, chewing or dividing a prolonged-release tablet can disrupt its controlled-release system.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.