Invega Sustenna (paliperidone palmitate)

Invega Sustenna generic

Invega Sustenna is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics usually cost less than brand-name drugs.

Invega Sustenna dosage

The Invega Sustenna dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Invega Sustenna to treat
• other medical conditions you may have, such as kidney problems

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Invega Sustenna comes as an extended-release* liquid suspension in a prefilled syringe. It’s given as an intramuscular injection into the deltoid or gluteal muscle. Invega Sustenna is administered by a doctor or another healthcare professional, typically at a doctor’s office or clinic.

Invega Sustenna is available in five strengths:

• 39 milligrams (mg) per 0.25 milliliter (mL)
• 78 mg/0.5 mL
• 117 mg/0.75 mL
• 156 mg/1 mL
• 234 mg/1.5 mL

* Extended release means the drug releases slowly in your body over a period of time.

Dosage for schizophrenia

A maintenance dose of Invega Sustenna is given once per month. The recommended dosage for schizophrenia is 117 mg per month but may range from 39 mg to 234 mg per month. The maximum dosage of Invega Sustenna is 234 mg per month.

At first, you’ll likely receive two starting doses of Invega Sustenna given 1 week apart. The first dose of 234 mg is typically given on day 1, with a second dose of 156 mg on day 8.

You’ll likely start the once-monthly dosage schedule about 5 weeks after your first dose. Your doctor may adjust your dosage depending on your body’s response to the medication.

Dosage for schizoaffective disorder

A maintenance dose of Invega Sustenna is given once per month. The recommended dosage for schizoaffective disorder ranges from 78 mg to 234 mg per month. The maximum dosage of Invega Sustenna is 234 mg per month.

At first, you’ll likely receive two starting doses of Invega Sustenna given 1 week apart. The first dose of 234 mg is typically given on day 1, with a second dose of 156 mg on day 8.

You’ll likely start the once-monthly dosage schedule about 5 weeks after your first dose. Your doctor may adjust your dosage depending on your body’s response to the medication.

About receiving Invega Sustenna

Below you’ll find information about key dosage issues.

• When to use: You’ll receive Invega Sustenna at a monthly appointment with a healthcare professional. Receiving the medication every 4 weeks helps keep a steady level of the drug in your body. This helps Invega Sustenna work effectively.
• If you miss a dose: If you miss a dose, call your doctor’s office right away. They can help you reschedule your appointment as soon as possible.
• Length of use: Invega Sustenna is meant to be used as a long-term treatment. If you and your doctor determine that Invega Sustenna is safe and effective for you, you’ll likely receive it long term.
• Length of time to work: Invega Sustenna is a long-acting injection that starts working within a month after it’s administered. Before starting Invega Sustenna, most people take an oral version of Invega (or oral risperidone, a similar medication), to help ensure the drug works safely and effectively for you. For many people, Invega Sustenna continues to work just as well as the oral medication did.

Invega Sustenna side effects

Invega Sustenna can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while receiving Invega Sustenna. These lists do not include all possible side effects.

For more information about the possible side effects of Invega Sustenna, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Invega Sustenna, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Invega Sustenna. To learn about other mild side effects, talk with your doctor or pharmacist, or view Invega Sustenna’s prescribing information.

Mild side effects of Invega Sustenna can include:

• injection site reactions, such as pain, swelling, redness, or discoloration
• sleepiness
• dizziness
• akathisia (feeling restless, tense, and a constant urge to move around)
• agitation

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects have been reported with the use of atypical antipsychotic drugs. (Invega Sustenna belongs to a group of drugs called atypical antipsychotics.) While not all of the following side effects were seen in Invega Sustenna’s clinical trials, they are still possible. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• neuroleptic malignant syndrome (a brain problem that rarely occurs as a reaction to antipsychotic medications), which may include symptoms such as:
  • high fever
  • stiff muscles
  • confusion
  • shortness of breath
  • loss of consciousness
• extrapyramidal disorders, which can range from mild to severe and may include symptoms such as:
  • involuntary movements
  • tremors
  • muscle stiffness or spasms
  • tardive dyskinesia (repeated, uncontrollable movements, such as unusual mouth or tongue movements)
• a serious heart rhythm problem called QT prolongation, also known as long QT syndrome, which may include symptoms such as:
  • heart palpitations
  • dizziness or feeling faint
  • loss of consciousness
• changes in metabolism, which may cause or worsen:
  • high blood sugar, which can lead to type 2 diabetes
  • high cholesterol or other lipid disorders
  • weight gain
• orthostatic hypotension (a drop in blood pressure that occurs as you stand or sit up), which may cause symptoms such as:
  • dizziness
  • fainting, which can lead to falling or getting injured
• increased levels of a hormone called prolactin, which may cause symptoms such as:
  • missed periods
  • nipple discharge
  • gynecomastia
  • erectile dysfunction
• blood disorders, such as low levels of white blood cells, which may cause symptoms such as:
  • fever
  • infection
• seizures
• trouble swallowing, which can increase the risk of aspiration (accidentally inhaling food or fluid into the lungs)
• priapism (a painful erection that lasts for hours)
• trouble with regulating body temperature, especially during exercise or when exposed to warmth, which may cause symptoms such as:
  • fever
  • sweating more or less than usual
• increased risk of stroke in certain older adults
• increased risk of death in certain older adults*

* Invega Sustenna has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see the “Invega Sustenna precautions” section.

ALLERGIC REACTION

For some people, Invega Sustenna injection can cause an allergic reaction.

But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep using the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Invega Sustenna, your doctor may recommend a different medication instead.

Invega Sustenna uses

The Food and Drug Administration (FDA) approves prescription drugs such as Invega Sustenna to treat certain conditions. Invega Sustenna may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Invega Sustenna for schizophrenia

Invega Sustenna is FDA approved to treat schizophrenia in adults.

Schizophrenia is a long-term mental health condition. Symptoms may include:

• hallucinations (seeing or hearing things that others do not)
• paranoia (feeling like others are trying to trick or harm you)
• delusions (strongly held beliefs in something that’s not real)
• trouble with focus and completing tasks
• limited emotional expression

Invega Sustenna for schizophrenia

Invega Sustenna is also FDA approved to treat schizoaffective disorder in adults. This condition involves symptoms of both schizophrenia and a mood disorder, such as bipolar disorder. With bipolar disorder, you have periods of depression and periods of mania (extreme levels of energy and activity).

For this purpose, Invega Sustenna may be prescribed by itself or with other drugs for mood disorders. Examples of other drugs that may be used with Invega Sustenna include antidepressants or mood stabilizers.

To learn more about these and other mental health conditions, visit Medical News Today’s mental health hub.

Invega Sustenna and children

Invega Sustenna isn’t FDA approved for use in children with schizophrenia or other mental health conditions. It’s only approved for use in people ages 18 years and older.

Invega Sustenna interactions

Invega Sustenna can interact with several other medications. It can also interact with certain supplements.

Before starting Invega Sustenna treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

For more information about Invega Sustenna and interactions, see this in-depth article.

Interactions with medications, foods, and supplements

Below is a list of medications, supplements, and foods that can interact with Invega Sustenna. This list does not contain all drugs that may interact with Invega Sustenna. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Alcohol interaction

It’s not safe to consume alcohol while receiving Invega Sustenna. If you have questions about the safety of drinking alcohol during Invega Sustenna treatment, talk with your doctor or pharmacist.

Invega Sustenna cost and coupons

As with all medications, the cost of Invega Sustenna can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks for price estimates of Invega Sustenna. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance: If you need financial support to pay for Invega Sustenna, or if you need help understanding your insurance coverage, help is available.

Programs called Janssen CarePath and Janssen Patient Assistance Program are available for Invega Sustenna. For more information and to find out if you’re eligible, call 855-452-6773 or visit the Janssen support website.

To learn more about saving money on prescriptions, check out this article.

Generic version:Invega Sustenna is not available in a generic form. A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics tend to cost less than brand-name drugs.

To learn more about saving money on prescriptions, check out this article.

Similar drugs

Other long-acting injectable drugs are available that can treat schizophrenia or schizoaffective disorder. Some may be a better fit for you than others. If you’re interested in finding an alternative to Invega Sustenna, talk with your doctor. They can tell you about other medications that may work well for you.

The following drugs are similar to Invega Sustenna:

• paliperidone palmitate (Invega Trinza, Invega Hafyera, Erzofri)
• risperidone (Risperdal Consta, Uzedy, Perseris, Rykindo)
• aripiprazole (Abilify Maintena, Abilify Asimtufii)
• aripiprazole lauroxil (Aristada)
• olanzapine (Zyprexa Relprevv)

Things to consider when receiving Invega Sustenna

If you can become pregnant, consider the following information about pregnancy, fertility, birth control, and breastfeeding.

Invega Sustenna and pregnancy

It’s not known whether Invega Sustenna should be used during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before using this medication.

If you become pregnant during or after treatment with Invega Sustenna, tell your doctor right away. They may advise you to enroll in the National Pregnancy Registry for Atypical Antipsychotics. This registry collects information about the safety of using these medications while pregnant. To learn more, talk with your doctor or call 866-961-2388.

Invega Sustenna and fertility

Invega Sustenna may affect female fertility (ability to become pregnant). This is a reversible effect, meaning that if your doctor stops your Invega Sustenna treatment, your fertility will likely go back to what it was before you started the drug.

Invega Sustenna isn’t known to affect male fertility (ability to get a partner pregnant).

If you have questions or concerns about your fertility, talk with your doctor before starting Invega Sustenna.

Note: Sex and gender exist on spectrums. Use of the term “female” and “male” in this article refers to sex assigned at birth.

Invega Sustenna and birth control

It’s not known if Invega Sustenna is safe to receive during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re receiving Invega Sustenna treatment.

Invega Sustenna and breastfeeding

It’s not known whether Invega Sustenna should be used while breastfeeding. It’s possible that exposure to this drug in breast milk may cause side effects in a child who’s breastfed. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication. They may recommend other feeding methods during treatment with Invega Sustenna.

Common questions about Invega Sustenna

Here are answers to some frequently asked questions about Invega Sustenna.

How long do Invega Sustenna side effects last?

This depends on the specific side effect of Invega Sustenna. For example, injection site reactions are common but temporary. These include pain, swelling, redness, or discoloration at the muscle where Invega Sustenna is injected.

On the other hand, some examples of rare side effects with potentially long-lasting consequences are neuroleptic malignant syndrome and stroke. These side effects of Invega Sustenna could result in brain damage or other problems that may be long term.

If your doctor stops your Invega Sustenna treatment, keep in mind that the drug will stay in your system for a while after your last dose. This is because Invega Sustenna has a long half-life of 25 to 49 days. (A drug’s half-life is the length of time it takes for half of a dose to be cleared from your body.) So, a low level of the drug may still be in your blood up to 6 months later.

If you have questions about how long side effects from Invega Sustenna may last, or how to manage them, talk with your doctor.

Is it possible to switch from risperidone to Invega Sustenna?

Yes, if your doctor recommends it. Like Invega Sustenna, risperidone is an atypical antipsychotic drug that can be used to treat schizophrenia and other mental health conditions.

Risperidone comes in several forms, such as an oral tablet and a long-acting injection. Once inside your body, risperidone gets converted into paliperidone (the active ingredient in Invega).

Invega Sustenna is a long-acting injection that’s given once a month. Before starting Invega Sustenna, most people take an oral version of a similar medication that’s short-acting. This is usually either paliperidone oral tablet (Invega) or risperidone oral tablet (Risperdal).

Starting with one of these short-acting medications helps ensure the drug works safely and effectively for you before your doctor switches you to a long-acting treatment. For many people, Invega Sustenna continues to work just as well as the oral medication did.

In some cases, your doctor may recommend switching from one long-acting injection to another. This may include switching from a risperidone injection to Invega Sustenna (or vice versa). Since they’re similar medications and can cause many of the same side effects, it’s not recommended to use them together.

If you have questions about whether risperidone or Invega Sustenna may be right for you, talk with your doctor or pharmacist. If they recommend switching from one to the other, they’ll explain the dosage schedule and timing.

How does Invega Sustenna work?

To treat schizophrenia and schizoaffective disorder, Invega Sustenna is thought to work by affecting the activity of certain neurotransmitters (chemical messengers in the brain). These may include serotonin and dopamine.