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Paliperidone oral tablet is used to treat schizophrenia and schizoaffective disorder. Common side effects include movement problems, fast heartbeat, restlessness, and sleepiness. Paliperidone can affect your alertness or coordination. It can also affect your body’s ability to regulate temperature. Try to avoid getting overheated, stay hydrated, and wear light and breathable clothing while you are taking paliperidone.

Uses

What is paliperidone used for?

Paliperidone is commonly used to treat schizophrenia and schizoaffective disorder.

Learn more about Invega for Schizophrenia Treatment

Paliperidone may also be used for other conditions as determined by your health care provider.

See also: Erzofri, Hafyera, Invega Sustenna, and Invega Trinza

How does paliperidone work (mechanism of action)?

Paliperidone belongs to a group of medicines called second-generation (atypical) antipsychotics. It is thought to work by balancing brain chemicals called serotonin and dopamine. These chemicals are known to affect thoughts and mood.

How is paliperidone supplied (dosage forms)?

Brands and other names

  • Invega

Dosage forms and strengths

  • 1.5 mg extended-release oral tablets
  • 3 mg extended-release oral tablets
  • 6 mg extended-release oral tablets
  • 9 mg extended-release oral tablets

How should I store paliperidone?

Paliperidone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from moisture.

Side Effects

What are the most common side effects of paliperidone?

The most common side effects of paliperidone are listed below. These side effects may vary based on your age and the condition being treated. Tell your health care provider if you have any of these side effects that bother you.

  • Movement problems
  • Fast heartbeat
  • Restlessness (akathisia)
  • Drowsiness
  • Tremor
  • Anxiety
  • Weight gain
  • Upset stomach
  • Constipation
  • Infection in the nose or throat, sore throat, or common cold symptoms

There may be other side effects of paliperidone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of paliperidone?

While less common, the most serious side effects of paliperidone are described below, along with what to do if they happen.

Severe Allergic Reactions. Paliperidone may cause allergic reactions, which can be serious. Stop taking paliperidone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Rhythm Changes. Paliperidone may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Metabolism Changes. Paliperidone can cause high blood sugar levels or diabetes, high cholesterol levels, and weight gain. Keep all appointments with your health care provider to check your blood work and weight. Call your health care provider if you gain weight or develop the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Fruity-smelling breath

Uncontrolled Movements. Paliperidone can cause some people to have movements that they cannot control. This condition, called tardive dyskinesia (TD), can cause jerky movements of the face, tongue, or body. TD can be permanent. Call your health care provider right away if you have any of the following symptoms of TD.

  • Tongue sticking out
  • Lip smacking or puckering
  • Grimacing
  • Rapid eye blinking
  • Jerking or twisting motion of the arms, legs, or trunk

Low Blood Pressure Upon Standing (Orthostatic Hypotension) and Falls. Paliperidone may cause a sudden drop in blood pressure when standing up from a seated or lying position. This may increase your risk of falling. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your health care provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Blood Disorders. Paliperidone can cause blood disorders such as low white blood cell levels (leukopenia,  neutropenia, or agranulocytosis). Keep all appointments with your health care provider to check your blood work. Stop taking paliperidone and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Neuroleptic Malignant Syndrome (NMS). Antipsychotic medicines like paliperidone may cause a rare but serious condition called neuroleptic malignant syndrome. NMS can lead to death. Stop taking paliperidone and contact your health care provider right away if you have any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Confusion 
  • Changes in your breathing or heart rate
  • Increased sweating

High Prolactin Level (Hyperprolactinemia). Paliperidone may cause an increased level of the hormone prolactin in your blood. High levels of prolactin could lead to fertility or bone problems. Contact your health care provider if you have any of the following symptoms.

  • Vaginal dryness
  • Irregular or no periods
  • Production of breastmilk when not pregnant or nursing
  • Inability to get or keep an erection
  • Enlarged breast size (gynecomastia)
  • Decreased muscle and body hair

Painful, Prolonged Erection (Priapism). Paliperidone may cause an unwanted erection that is persistent, painful, and that may occur without sexual arousal. Permanent damage to the penis may occur if priapism is not treated quickly. Stop taking paliperidone and get emergency help right away if you have any of the following symptoms of priapism.

  • Erection lasting for more than four hours
  • Erection that is unrelated to sexual stimulation
  • Painful or tender penis

Body Temperature Regulation. Paliperidone can affect your ability to regulate your body temperature. This could make you become very hot, especially in hot weather or after exercising a lot. You should drink water and avoid overheating and dehydration. Call your health care provider right away if you are severely ill and have the following symptoms.

  • Excessive or no sweating
  • Dry mouth
  • Feeling very hot
  • Feeling thirsty
  • Not able to pee

Trouble Swallowing. Paliperidone can cause trouble swallowing (dysphagia), which can increase your risk of choking while eating or drinking. Eat small amounts of food, and chew your food well. Get emergency help if you are choking or have food stuck in your esophagus that is not passing.

Seizures. Some people who have taken paliperidone have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking paliperidone and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Decreased Alertness or Coordination. Paliperidone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how paliperidone affects you.

Warnings & Precautions

Who should not use paliperidone?

Allergies to Ingredients. People who are allergic to any of the following should not take paliperidone.

  • Invega
  • Paliperidone
  • Risperidone
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific paliperidone products they stock.

What should I know about paliperidone before using it?

Do not take paliperidone unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share paliperidone with other people, even if they have the same condition as you. It may harm them.

Keep paliperidone out of the reach of children.

Do not chew, cut, or crush paliperidone. Swallow the tablet whole.

You may notice a tablet shell in your stool (poop). This is normal and does not mean the medicine did not work. The medicine is released in the body while the outer shell may stay intact.

Because paliperidone can make it hard for you to regulate your body temperature, try to avoid becoming too hot or dehydrated. Drink plenty of water, limit your exposure to the heat and sun, do not overexercise, and wear light and breathable clothing.

If you can become pregnant, taking paliperidone may make this more difficult. These effects likely go away after you stop taking paliperidone. Talk to your health care provider if you have any concerns.

People who are 65 or older can be at greater risk for some side effects from paliperidone. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using paliperidone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if paliperidone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Psychosis Related to Dementia. There is a higher risk of death, stroke, or ministroke in older adults who take paliperidone or another antipsychotic and have memory loss or psychosis related to dementia. Paliperidone is not approved to treat dementia-related psychosis.

Other Medicines and Supplements. Paliperidone may interact with other medicines and supplements. Before taking paliperidone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Paliperidone taken later in pregnancy may lead to an increased risk of certain problems in your newborn. Tell your health care provider if you are or plan to become pregnant while taking paliperidone. Your health care provider will advise you if you should take paliperidone while you are pregnant or trying to get pregnant. If you become pregnant while taking paliperidone, you can register with the National Pregnancy Registry for Atypical Antipsychotics by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry. This registry collects safety information about the use of psychiatric medicines during pregnancy.

Breastfeeding. Paliperidone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should take paliperidone while breastfeeding.

Interactions

Does paliperidone interact with foods or drinks?

There are no known interactions between paliperidone and foods or drinks.

You should avoid drinking alcohol while using paliperidone. The risk of dizziness and sleepiness may be increased if you drink alcohol while using paliperidone.

Does paliperidone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking paliperidone.

  • Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem
  • Carbamazepine (Carbatrol, Tegretol, and others) or divalproex sodium, which is a medicine commonly used to treat seizures or other conditions
  • A medicine for high blood pressure
  • A dopamine agonist, such as apomorphine (Apokyn), pramipexole (Mirapex ER), ropinirole, or rotigotine (Neupro), which is a medicine that may be used for Parkinson’s disease or restless legs syndrome (RLS)
  • Levodopa, which is a medicine commonly used for Parkinson’s disease
  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Risperidone (Risperdal and others), which is a medicine for certain mental health conditions

Many other medicines may alter the blood levels of paliperidone. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with paliperidone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much paliperidone?

If you or someone else has used too much paliperidone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of paliperidone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

 

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