Invega Sustenna

Adult Dosing .

Dosage forms:  INJ (pre-filled syringe): 39 mg per 0.25 mL, 78 mg per 0.5 mL, 117 mg per 0.75 mL, 156 mg per mL, 234 mg per 1.5 mL

schizophrenia

[paliperidone or risperidone-naive pts]

Dose: 39-234 mg IM qmo; Start: 234 mg IM x1 after establishing tolerability w/ oral paliperidone or risperidone, then 156 mg IM x1 after 1wk, then 117 mg IM qmo; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 3 mg/day PO]

Dose: 39-78 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 6 mg/day PO]

Dose: 117 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 9 mg/day PO]

Dose: 156 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 12 mg/day PO]

Dose: 234 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from other long-acting injectable antipsychotic]

Dose: 39-234 mg IM qmo; Start: at next scheduled dose after establishing tolerability w/ oral paliperidone or risperidone; Max: 234 mg/dose; Info: may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

schizoaffective disorder

[paliperidone or risperidone-naive pts]

Dose: 78-234 mg IM qmo; Start: 234 mg IM x1 after establishing tolerability w/ oral paliperidone or risperidone, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 3 mg/day PO]

Dose: 78 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 6 mg/day PO]

Dose: 117 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 9 mg/day PO]

Dose: 156 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from paliperidone 12 mg/day PO]

Dose: 234 mg IM qmo; Start: 234 mg IM x1, then 156 mg IM x1 after 1wk; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

[conversion from other long-acting injectable antipsychotic]

Dose: 78-234 mg IM qmo; Start: at next scheduled dose after establishing tolerability w/ oral paliperidone or risperidone; Max: 234 mg/dose; Info: for monotherapy or adjunct to mood stabilizers or antidepressants; may adjust dose qmo; see pkg insert for missed dose recommendations; periodically reassess need for tx; D/C if ANC <1000; consider D/C if unexplained decr. in WBC

renal dosing

[see below]

CrCl 50-79: start 156 mg IM x1, then 117 mg IM x1 after 1wk, then 78 mg IM qmo, max 156 mg/dose; CrCl <50: avoid use

HD/PD: not defined

hepatic dosing

[see below]

Child-Pugh Class A or B: no adjustment; Child-Pugh Class C: not defined

Peds Dosing .

Peds dosing is currently unavailable or not applicable for this drug.