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risperidone (Intramuscular route)

Pronunciation

ris-PER-i-done

Intramuscular route(Powder for Suspension, Extended Release)

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. RisperiDONE is not approved for use in patients with dementia-related psychosis .

Commonly used brand name(s)

In the U.S.

  • Risperdal Consta

Available Dosage Forms:

  • Powder for Suspension, Extended Release

Therapeutic Class: Antipsychotic

Chemical Class: Benzisoxazole

Uses For risperidone

Risperidone injection is used to treat the symptoms of psychotic (mental) disorders, such as schizophrenia. It may be used alone or together with other medicines (eg, lithium or valproate) to treat patients with bipolar disorder. risperidone should not be used to treat behavioral problems in older adults who have dementia.

risperidone is available only with your doctor's prescription.

Before Using risperidone

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For risperidone, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to risperidone or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of risperidone injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Elderly patients may be especially sensitive to the effects of risperidone. This may increase the chance of having side effects during treatment. risperidone should not be used for behavioral problems in older adults with dementia.

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of risperidone injection in the elderly. However, elderly patients are more likely to have age-related heart problems, which may require caution and an adjustment in the dose for patients receiving risperidone injection.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving risperidone, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using risperidone with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Amisulpride
  • Bepridil
  • Bromopride
  • Cisapride
  • Dronedarone
  • Levomethadyl
  • Mesoridazine
  • Metoclopramide
  • Pimozide
  • Piperaquine
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using risperidone with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Ajmaline
  • Amiodarone
  • Amitriptyline
  • Anagrelide
  • Aprindine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azimilide
  • Bretylium
  • Buprenorphine
  • Bupropion
  • Buserelin
  • Butorphanol
  • Chloral Hydrate
  • Chloroquine
  • Chlorpromazine
  • Citalopram
  • Clarithromycin
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Deutetrabenazine
  • Dibenzepin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Donepezil
  • Doxepin
  • Droperidol
  • Efavirenz
  • Encainide
  • Enflurane
  • Erythromycin
  • Escitalopram
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Foscarnet
  • Gemifloxacin
  • Ginkgo Biloba
  • Gonadorelin
  • Goserelin
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydroquinidine
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibutilide
  • Imipramine
  • Itraconazole
  • Ivabradine
  • Ketoconazole
  • Leuprolide
  • Levofloxacin
  • Linezolid
  • Lithium
  • Lorcainide
  • Mefloquine
  • Metronidazole
  • Milnacipran
  • Moxifloxacin
  • Nafarelin
  • Nortriptyline
  • Octreotide
  • Ondansetron
  • Panobinostat
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Pentazocine
  • Pimavanserin
  • Pitolisant
  • Posaconazole
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Remifentanil
  • Ribociclib
  • Sematilide
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Simvastatin
  • Sotalol
  • Spiramycin
  • Sufentanil
  • Sulfamethoxazole
  • Sulpiride
  • Sultopride
  • Tacrolimus
  • Tedisamil
  • Telithromycin
  • Tetrabenazine
  • Trifluoperazine
  • Trimethoprim
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vemurafenib
  • Vinflunine
  • Zotepine
  • Zuclopenthixol

Using risperidone with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Carbamazepine
  • Cimetidine
  • Fosphenytoin
  • Lamotrigine
  • Midodrine
  • Phenobarbital
  • Phenytoin
  • Ranitidine
  • Ritonavir
  • Valproic Acid

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of risperidone. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergic reaction to paliperidone (Invega®), history of—Should not be used in patients with this condition.
  • Alzheimer's disease or
  • Dehydration or
  • Heart attack, recent or history of or
  • Heart or blood vessel disease or
  • Heart failure, history of or
  • Heart rhythm problem, or a history of or
  • Hypotension (low blood pressure) or
  • Hypovolemia (low amount of blood) or
  • Stroke, history of or
  • Trouble with swallowing—May cause side effects to become worse.
  • Blood or bone marrow problems or
  • Bone problems (eg, osteodystrophy) or
  • Breast cancer, prolactin-dependent or
  • Diabetes or
  • Hyperglycemia (high blood sugar) or
  • Hyperprolactinemia (high prolactin in the blood) or
  • Neuroleptic malignant syndrome (NMS), history of or
  • Parkinson's disease or
  • Priapism (painful or prolonged erection of the penis) or
  • Seizures, history of—Use with caution. May make these conditions worse.
  • Bowel blockage or
  • Brain tumor or
  • Reye's syndrome—risperidone may mask symptoms in patients with these conditions.
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of risperidone

A nurse or other trained health professional will give you risperidone. risperidone is given as a shot into one of your muscles.

Precautions While Using risperidone

It is very important that your doctor check your progress at regular visits to make sure risperidone is working properly. Blood tests may be needed to check for unwanted effects.

Check with your doctor right away if you have any of the following symptoms while using risperidone: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

risperidone may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while using risperidone: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

risperidone may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Risperidone injection can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

risperidone may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures or other injuries. Make sure you know how you react to risperidone before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well.

risperidone may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke. Also, use extra care not to become too cold while you are receiving risperidone injection. If you become too cold, you may feel drowsy, confused, or clumsy.

risperidone may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. If you or your caregiver notice any of these side effects, tell your doctor right away.

risperidone may increase your weight. Your doctor may need to check your weight on a regular basis while you are using risperidone.

Check with your doctor before using risperidone with alcohol or other medicines that affect the central nervous system (CNS). The use of alcohol or other medicines that affect the CNS with risperidone may worsen the side effects of risperidone, such as dizziness, poor concentration, drowsiness, unusual dreams, and trouble with sleeping. Some examples of medicines that affect the CNS are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicines, medicine for depression, medicine for anxiety, prescription pain medicine or narcotics, medicine for attention deficit and hyperactivity disorder, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics.

risperidone may increase prolactin blood levels if used for a long time. Check with your doctor if you have breast swelling or soreness, unusual breast milk production, absent, missed, or irregular menstrual periods, stopping of menstrual bleeding, loss in sexual ability, desire, drive, or performance, decreased interest in sexual intercourse, or an inability to have or keep an erection.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

risperidone Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common
  • Aggressive behavior
  • agitation
  • anxiety
  • changes in vision, including blurred vision
  • difficulty concentrating
  • difficulty speaking or swallowing
  • inability to move the eyes
  • increase in amount of urine
  • loss of balance control
  • mask-like face
  • memory problems
  • muscle spasms of the face, neck, and back
  • problems with urination
  • restlessness or need to keep moving (severe)
  • shuffling walk
  • skin rash or itching
  • stiffness or weakness of the arms or legs
  • tic-like or twitching movements
  • trembling and shaking of the fingers and hands
  • trouble sleeping
  • twisting body movements
Less common
  • Back pain
  • chest pain
  • speech or vision problems
  • sudden weakness or numbness in the face, arms, or legs
Rare
  • Confusion
  • dizziness
  • drowsiness
  • extreme thirst
  • fast, shallow breathing
  • fast, weak heartbeat
  • headache
  • increased thirst
  • lip smacking or puckering
  • loss of appetite
  • muscle cramps
  • pale, clammy skin
  • poor coordination
  • prolonged, painful, inappropriate erection of the penis
  • puffing of the cheeks
  • rapid or worm-like movements of the tongue
  • shivering
  • talking, feeling, and acting with excitement and activity that cannot be controlled
  • uncontrolled chewing movements
  • uncontrolled twisting movements of neck, trunk, arms, or legs
  • unusual bleeding or bruising
  • unusual facial expressions or body positions

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Constipation
  • cough
  • diarrhea
  • dry mouth
  • headache
  • heartburn
  • increased dream activity
  • increased length of sleep
  • nausea
  • sleepiness or unusual drowsiness
  • sore throat
  • stuffy or runny nose
  • unusual tiredness or weakness
  • weight gain
Less common
  • Absent, missed, or irregular menstrual periods
  • bleeding, blistering, burning, discoloration of the skin, infection, inflammation, itching, lumps, numbness, pain, rash, redness, soreness, stinging, swelling, tenderness, tingling, or warmth at the injection site
  • body aches or pain
  • breast swelling or soreness
  • chills
  • dandruff
  • darkening of skin color
  • decreased interest in sexual intercourse
  • dry skin
  • ear congestion
  • fever
  • inability to have or keep an erection
  • increase in body movements
  • increased watering of the mouth
  • joint pain
  • loss in sexual ability, desire, drive, or performance
  • loss of voice
  • oily skin
  • pain or tenderness around the eyes and cheekbones
  • sneezing
  • stomach pain
  • stopping of menstrual bleeding
  • tightness in the chest
  • toothache
  • unusual breast milk production
  • vomiting
  • weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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