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Invega Disease Interactions

There are 16 disease interactions with Invega (paliperidone).

Major

Atypical antipsychotic agents (applies to Invega) dementia

Major Potential Hazard, High plausibility.

Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo. These agents are not approved for the treatment of patients with dementia-related psychosis.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Nuplazid (pimavanserin)." Accelis Pharma (2016):
  14. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 14 references
Major

Atypical antipsychotic agents (applies to Invega) QT Prolongation

Major Potential Hazard, Moderate plausibility. Applicable conditions: Diarrhea, Hypokalemia, Arrhythmias, Magnesium Imbalance, Abnormal Electrocardiogram

Some atypical antipsychotic agents can prolong the QTc interval of the electrocardiogram in a dose-dependent manner. Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of these agents on the QT interval and should be corrected prior to institution of therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with these agents. Atypical antipsychotic agents should be avoided in patients with a history of cardiac arrhythmias or other conditions that may increase the risk of torsade de pointes and/or sudden death, including bradycardia; hypokalemia or hypomagnesemia; and congenital long QT syndrome.

References

  1. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  2. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
Major

Neuroleptics (applies to Invega) NMS

Major Potential Hazard, High plausibility. Applicable conditions: Neuroleptic Malignant Syndrome

The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

References

  1. Hermesh H, Sirota P, Eviatar J "Recurrent neuroleptic malignant syndrome due to haloperidol and amantadine." Biol Psychiatry 25 (1989): 962-5
  2. Ryken TC, Merrell AN "Haloperidol-induced neuroleptic malignant syndrome in a 67-year-old woman with parkinsonism." West J Med 151 (1989): 326-8
  3. Levitt AJ, Midha R, Craven JL "Neuroleptic malignant syndrome with intravenous haloperidol." Can J Psychiatry 35 (1990): 789
  4. Aisen PS, Lawlor BA "Neuroleptic malignant syndrome induced by low-dose haloperidol." Am J Psychiatry 149 (1992): 844
  5. Caroff SN "The neuroleptic malignant syndrome." J Clin Psychiatry 41 (1980): 79-83
  6. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  7. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  8. Miller DD, Sharafuddin MJ, Kathol RG "A case of clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 99-101
  9. DasGupta K, Young A "Clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 105-7
  10. Anderson ES, Powers PS "Neuroleptic malignant syndrome associated with clozapine use." J Clin Psychiatry 52 (1991): 102-4
  11. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  12. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  13. Nemecek D "Atropism may precipitate neuroleptic malignant syndrome during treatment with clozapine." Am J Psychiatry 150 (1993): 1561
  14. Ewert AL, Kloek J, Wells B, Phelps S "Neuroleptic malignant syndrome associated with loxapine" J Clin Psychiatry 44 (1983): 37-8
  15. Chong LS, Abbott PM "Neuroleptic malignant syndrome secondary to loxapine." Br J Psychiatry 159 (1991): 572-3
  16. Padgett R, Lipman E "Use of neuroleptics after an episode of neuroleptic malignant syndrome" Can J Psychiatry 34 (1989): 323-5
  17. Webster P, Wijeratne C "Risperidone-induced neuroleptic malignant syndrome." Lancet 344 (1994): 1228-9
  18. Campellone JV, Mccluskey LF, Greenspan D "Fatal outcome from neuroleptic malignant syndrome associated with clozapine." Neuropsychiatry Neuropsychol Behav Neurol 8 (1995): 70-3
  19. Raitasuo V, Vataja R, Elomaa E "Risperidone-induced neuroleptic malignant syndrome in young patient." Lancet 344 (1994): 1705
  20. Dave M "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1233-4
  21. Singer S, Richards C, Boland RJ "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1234
  22. Najara JE, Enikeev ID "Risperidone and neuroleptic malignant syndrome: a case report." J Clin Psychiatry 56 (1995): 534-5
  23. Tarsy D "Risperidone and neuroleptic malignant syndrome." JAMA 275 (1996): 446
  24. Kern JL, Cernek PK "Delayed risperidone-induced malignant syndrome." Ann Pharmacother 30 (1996): 300
  25. Sharma R, Trappler B, Ng YK, Leeman CP "Risperidone-induced neutroleptic malignant syndrome." Ann Pharmacother 30 (1996): 775-8
  26. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  27. Gleason PP, Conigliaro RL "Neuroleptic malignant syndrome with risperidone." Pharmacotherapy 17 (1997): 617-21
  28. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  29. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  30. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  31. Moltz DA, Coeytaux RR "Case report: Possible neuroleptic malignant syndrome associated with olanzapine." J Clin Psychopharmacol 18 (1998): 485-6
  32. Burkhard PR, Vingerhoets FJG "Olanzapine induced neuroleptic malignant syndrome." Arch Gen Psychiat 56 (1999): 101-2
  33. Johnson V, Bruxner G "Neuroleptic malignant syndrome associated with olanzapine." Aust N Z J Psychiat 32 (1998): 884-6
  34. Margolese HC, Chouinard G "Olanzapine-induced neuroleptic malignant syndrome with mental retardation." Am J Psychiat 156 (1999): 1115-6
  35. Levenson JL "Neuroleptic malignant syndrome after the initiation of olanzapine." J Clin Psychopharmacol 19 (1999): 477-8
  36. Nyfort-Hansen K, Alderman CP "Possible neuroleptic malignant syndrome associated with olanzapine." Ann Pharmacother 34 (2000): 667
  37. SierraBiddle D, Herran A, DiezAja S, GonzalezMata JM, Vidal E, DiezManrique F, VazquezBarquero JL "Neuroleptic malignant syndrome and olanzapine." J Clin Psychopharmacol 20 (2000): 704-5
  38. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  39. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):
  40. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  41. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  42. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  43. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  44. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  45. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  46. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
View all 46 references
Moderate

Antipsychotic agents (applies to Invega) aspiration

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Dysphagia

Esophageal dysmotility and aspiration have been associated with the use of antipsychotic drugs. These drugs should be administered cautiously in patients at risk for aspiration pneumonia.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 13 references
Moderate

Antipsychotic/neuroleptic agents (applies to Invega) seizure

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures, Head Injury, Alcoholism

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 13 references
Moderate

Atypical antipsychotic agents (applies to Invega) hematologic abnormalities

Moderate Potential Hazard, High plausibility. Applicable conditions: Neutropenia

Cases of leukopenia, neutropenia, and agranulocytosis have been reported with the use of atypical antipsychotic agents. Patients with preexisting low white blood cell count may be at increased risk. Therapy with these agents should be administered cautiously in patients with a history of, or predisposition to, decreased white blood cell or neutrophil counts. Clinical monitoring of hematopoietic function is recommended. At the first sign of a clinically significant decline in white blood cells, discontinuation of atypical antipsychotic therapy should be considered in the absence of other causative factors, and the patient closely monitored for fever or other signs and symptoms of infection.

References

  1. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  2. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  3. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  4. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  5. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  6. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  7. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  8. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  9. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  10. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  11. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  12. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 12 references
Moderate

Atypical antipsychotic agents (applies to Invega) hyperglycemia/diabetes

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus, Obesity

Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported with the use of atypical antipsychotic agents. Patients with diabetes should be monitored for worsening control of blood glucose when treated with these agents. It is recommended that patients with risk factors for diabetes mellitus starting treatment with atypical antipsychotics should undergo fasting blood glucose testing at the beginning of treatment, and periodically thereafter. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when treatment with these agents was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the atypical antipsychotic drug.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 13 references
Moderate

Atypical antipsychotic agents (applies to Invega) hypotension

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Syncope, Dehydration, Ischemic Heart Disease, Diarrhea, Vomiting, Arrhythmias, Congestive Heart Failure, History - Myocardial Infarction, Cerebrovascular Insufficiency

The use of atypical antipsychotic agents has been associated with orthostatic hypotension and syncope. Therapy with atypical antipsychotics should be administered cautiously in patients with hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with atypical antipsychotics. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 13 references
Moderate

Atypical antipsychotic agents (applies to Invega) lipid alterations

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Hyperlipidemia

Atypical antipsychotic drugs have been associated with undesirable alterations in lipid levels. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. Before or soon after initiation of antipsychotic medications, a fasting lipid profile should be obtained at baseline and monitored periodically during treatment.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
View all 13 references
Moderate

Atypical antipsychotic agents (applies to Invega) priapism

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Peyronie's Disease, Sickle Cell Anemia, Thalassemia, Multiple Myeloma, Leukemia, Cavernosal/Penile Tissue Abnormalities

Atypical antipsychotic agents with alpha-adrenergic blocking effects may cause priapism. The condition is characterized by prolonged, often painful erections lasting longer than 4 hours. If not treated promptly, priapism can cause irreversible damage to the erectile tissue. Therapy with these agents should be administered cautiously in patients with a history of priapism, conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia, thalassemia), or anatomical deformations of the penis (e.g., angulation, cavernosal fibrosis, Peyronie's disease). Patients who experience an erection lasting longer than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention.

References

  1. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  2. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  3. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  4. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  5. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
View all 5 references
Moderate

Atypical antipsychotic agents (applies to Invega) weight gain

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Obesity

Weight gain has been observed with atypical antipsychotic use. While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile. When treating pediatric patients with atypical antipsychotic agents, weight gain should be monitored and assessed against that expected for normal growth. Monitor weight at baseline and frequently thereafter.

References

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
View all 12 references
Moderate

Atypical antipsychotics (applies to Invega) depression

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Bipolar Disorder

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset.

References

  1. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  2. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  3. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  4. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  5. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  6. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
View all 6 references
Moderate

Neuroleptics (applies to Invega) hyperprolactinemia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Breast Cancer

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

References

  1. Meco G, Falaschi P, Casacchia M, et al. "Neuroendocrine effects of haloperidol decanoate in patients with chronic schizophrenia." Adv Biochem Psychopharmacol 40 (1985): 89-93
  2. Ash PR, Bouma D "Exaggerated hyperprolactinemia in response to thiothixene ." Arch Neurol 38 (1981): 534-5
  3. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  4. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  5. Huang ML, Van Peer A, Woestenborghs R, De Coster R, Heykants J, Jansen AA, Zylicz Z, Visscher HW, Jonkman JH "Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects." Clin Pharmacol Ther 54 (1993): 257-68
  6. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  7. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  8. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham (2001):
  9. Dickson RA, Dalby JT, Williams R, Edwards AL "Risperidone-induced prolactin elevations in premenopausal women with schizophrenia." Am J Psychiatry 152 (1995): 1102-3
  10. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  11. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  12. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  13. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  14. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):
  16. Bai YM, Ciu HJ, Guo ZZ "Risperidone-induced hyperprolactinemia in an elderly woman." Am J Psychiatry 159 (2002): 2112
View all 16 references
Moderate

Neuroleptics (applies to Invega) tardive dyskinesia

Moderate Potential Hazard, High plausibility.

Tardive dyskinesia (TD) has occurred in patients treated with antipsychotic drugs; the syndrome consists of potentially irreversible, involuntary, dyskinetic movements. The risk appears highest in older patients (particularly older women) but it is not possible to predict which patients are likely to develop TD; whether antipsychotic drugs differ in their potential to cause TD is unknown. The risk of TD and the likelihood that it will become irreversible increase with the duration of therapy and the total cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low dosages; it may also occur after discontinuation of therapy. TD may remit (partially or completely) upon discontinuation of antipsychotic therapy, although antipsychotic therapy itself may suppress (or partially suppress) signs/symptoms of TD, possibly masking the underlying process; the effect of symptomatic suppression on the long-term course of TD is unknown. In patients with preexisting drug-induced TD, initiating or increasing the dosage of antipsychotic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. In patients requiring chronic therapy, the lowest dose and shortest duration of therapy producing a satisfactory clinical response are recommended; the need for continued therapy should be reassessed periodically. If signs/symptoms of TD occur during antipsychotic therapy, discontinuation of the offending agent should be considered; however, some patients may require treatment despite the presence of TD.

References

  1. "Product Information. Abilify (ARIPiprazole)." Otsuka American Pharmaceuticals Inc (2020):
  2. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2021):
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Moderate

Paliperidone (applies to Invega) antiemetic effect

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Reye's Syndrome, Intestinal Obstruction, Brain/Intracranial Tumor

An antiemetic effect was observed in preclinical studies with paliperidone. This effect, if it occurs in humans, may mask the signs and symptoms of overdosage with certain drugs or of conditions such as intestinal obstruction, Reye's syndrome, and brain tumor. Cautions should be exercised when given paliperidone to these patients.

References

  1. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
Moderate

Paliperidone (applies to Invega) gastrointestinal obstruction

Moderate Potential Hazard, Moderate plausibility.

There have been rare reports of obstructive symptoms in patients with known strictures in association with the ingestion of drugs in non-deformable controlled-release formulations. Because paliperidone extended-release tablets are non-deformable and do not appreciably change in shape in the gastrointestinal tract, paliperidone extended-release tablets should ordinarily not be administered to patients with preexisting severe gastrointestinal narrowing, pathologic or iatrogenic.

References

  1. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):

Invega drug interactions

There are 606 drug interactions with Invega (paliperidone).

Invega alcohol/food interactions

There are 4 alcohol/food interactions with Invega (paliperidone).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.