paliperidone palmitate at a glance
Medicine class
Second-generation antipsychotic
Form
Prolonged-release intramuscular suspension in a pre-filled syringe
Administration
Given by a healthcare professional into a shoulder or buttock muscle
What is paliperidone palmitate used for?
The selected product is licensed for:
Maintenance treatment of schizophrenia in adults stabilised with paliperidone or risperidone.
Use in selected adults with a previous response to oral paliperidone or risperidone, mild-to-moderate psychotic symptoms and a need for long-acting injectable treatment, without prior oral stabilisation.
How does paliperidone palmitate work?
The injection slowly releases paliperidone after placement in muscle. Paliperidone blocks dopamine D2 and serotonin 5-HT2 receptors; its antipsychotic effect is thought mainly to result from reducing excessive dopamine signalling involved in schizophrenia symptoms.
paliperidone palmitate preparations and strengths
Injection
Route: Parenteral
Strengths: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 175 mg, 263 mg, 350 mg, 525 mg, 700 mg, 1000 mg
How to take paliperidone palmitate
It is administered only by a healthcare professional. Food does not affect administration because it is an intramuscular injection.
It is injected slowly and deeply into the deltoid or gluteal muscle, not into a vein or by another route.
The injection is a single administration, not divided injections.
Left and right injection sites should be alternated.
paliperidone palmitate side effects
Common or expected effects
- Injection-site discomfort or reaction
- Headache, dizziness, anxiety or sleep disturbance
- Sleepiness, sedation or tiredness
- Restlessness, tremor, stiffness or other movement symptoms
- Weight gain or raised blood glucose
- Raised prolactin, which may affect periods, breasts or sexual function
- Nausea, vomiting, constipation, diarrhoea or abdominal discomfort
- Fast heartbeat
Get urgent medical advice
- High temperature, marked muscle rigidity, confusion or reduced consciousness
- New persistent involuntary movements, particularly of the face or tongue
- Severe allergic reaction or blistering skin reaction
- Seizure or loss of consciousness
- Blood-clot symptoms, such as sudden breathlessness or a painful swollen leg
- Severe infection symptoms, particularly with a low white-cell count
- A prolonged painful erection
paliperidone palmitate in pregnancy
Pregnancy data are limited. The selected product should be used only when the clinical need justifies it. Exposure near delivery can cause temporary movement, breathing, feeding or withdrawal-like symptoms in the newborn. Do not stop treatment because of pregnancy without speaking to the prescriber or perinatal mental-health team.
paliperidone palmitate while breastfeeding
Paliperidone passes into breast milk, and the selected product's SmPC advises against use while breastfeeding. Discuss feeding plans early with the prescriber and a specialist breastfeeding-medicines or perinatal team rather than stopping treatment suddenly.
paliperidone palmitate interactions
Tell the prescriber about all prescribed, over-the-counter and recreational substances. Important examples include:
Medicines that prolong the QT interval
May add to the risk of abnormal heart rhythm.
Alcohol, opioids, sleeping medicines and other sedatives
May increase sleepiness and impairment.
Levodopa and other dopamine agonists
Paliperidone may reduce their effects, while these medicines may oppose its antipsychotic action.
Common questions about paliperidone palmitate
Answers are fully visible for fast scanning and source review.
Is this the same as paliperidone tablets?
It delivers the same active antipsychotic, paliperidone, but is a slowly dissolving injectable prodrug. The formulations have different pharmacokinetics and cannot be substituted without a planned clinical switch.
Can it cause weight gain or diabetes?
Yes. Weight gain, raised glucose and worsening diabetes can occur, so weight and metabolic health should be reviewed during treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.