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Invega Sustenna (injection)

Generic Name: paliperidone (injection) (PAL ee PER i DONE)
Brand Name: Invega Sustenna, Invega Trinza

Medically reviewed by on Aug 9, 2017 – Written by Cerner Multum

What is Invega Sustenna?

Invega Sustenna is an antipsychotic medicine. It works by changing the effects of chemicals in the brain.

Invega Sustenna is used to treat schizophrenia in adults. This medicine is also used alone or with other medicines to treat schizoaffective disorder in adults.

Invega Sustenna may also be used for purposes not listed in this medication guide.

Important Information

Invega Sustenna is not approved for use in psychotic conditions related to dementia. This medicine may increase the risk of death in older adults with dementia-related conditions.

Before taking this medicine

You should not use Invega Sustenna if you are allergic to Invega Sustenna or to risperidone (Risperdal).

Invega Sustenna is not approved for use in psychotic conditions related to dementia. This medicine may increase the risk of death in older adults with dementia-related conditions.

Invega Sustenna can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include uncontrollable muscle movements of your lips, tongue, eyes, face, arms, or legs. The longer you use this medicine, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women and older adults.

To make sure Invega Sustenna is safe for you, tell your doctor if you have ever had:

  • heart disease, heart attack, heart rhythm disorder, long QT syndrome;

  • high or low blood pressure, or fainting spells;

  • low white blood cell (WBC) counts;

  • uncontrolled muscle movements in your face;

  • liver or kidney disease;

  • seizures or epilepsy;

  • breast cancer;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

  • diabetes (Invega Sustenna may raise your blood sugar); or

  • a serious neurologic disorder caused by taking an antipsychotic medicine.

Before you receive your first injection, tell your doctor if you have never taken oral (by mouth) Invega Sustenna or risperidone.

Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Using antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop using your medicine during pregnancy. If you become pregnant while using Invega Sustenna, do not stop using it without your doctor's advice.

Paliperidone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Invega Sustenna is not approved for use by anyone younger than 18 years old.

How is Invega Sustenna given?

Invega Sustenna is injected into a muscle. A healthcare provider will give you this injection.

Invega Sustenna is usually given only once per month, but the first two doses are given 1 week apart. Invega Trinza is usually given once every 3 months, after you have used Invega Sustenna for at least 4 months in a row.

Follow your doctor's dosing instructions very carefully. Get your Invega Sustennas regularly to get the most benefit.

Your doctor will need to check your progress while you are using Invega Sustenna.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Invega Sustenna.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include a headache with chest pain, fast or pounding heartbeats, and severe dizziness.

What should I avoid while using Invega Sustenna?

While you are using Invega Sustenna, you may be more sensitive to temperature extremes such as very hot or cold conditions. Avoid getting too cold, or becoming overheated or dehydrated. Drink plenty of fluids, especially in hot weather and during exercise. It is easier to become dangerously overheated and dehydrated while you are using this medicine.

Avoid drinking alcohol. Dangerous side effects could occur.

Invega Sustenna may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Dizziness or severe drowsiness can cause falls, fractures, or other injuries.

Invega Sustenna side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Tell your doctor right away if you have any of these signs of a serious movement disorder:

  • tremors or shaking in your arms or legs;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); or

  • any new or unusual muscle movements you cannot control.

Call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • trouble swallowing;

  • a seizure (convulsions);

  • breast swelling (in women or men), nipple discharge;

  • changes in menstrual periods;

  • impotence, or penis erection that is painful or lasts 4 hours or longer;

  • weight gain;

  • low white blood cell counts--sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, swollen gums, pain when swallowing, skin sores, cough, trouble breathing;

  • high blood sugar--increased thirst, increased urination, hunger, fruity breath odor; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, fast or pounding heartbeats, fainting.

Common side effects may include:

  • dizziness, drowsiness;

  • restless feeling;

  • tremors or shaking;

  • uncontrolled muscle movements, trouble with walking or balance;

  • weight gain; or

  • pain or tenderness where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Invega Sustenna?

Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Ask your doctor before using any new medications during the month(s) between your doses of paliperidone.

Many drugs can interact with Invega Sustenna. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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