Samtani MN, et al. Potential for Cognitive and Motor Impairment: Somnolence, sedation, and dizziness were reported as adverse reactions in subjects treated with INVEGA. Effective April 1, 2023, Tufts Health Together-MassHealth MCO Plan and ACPPs, in conjunction with the other Medicaid managed care organizations (MCOs) in the Commonwealth, will be utilizing MassHealth's Unified Formulary for pharmacy medications and for select medical benefit drugs. A once-a-month paliperidone palmitate extended release injectable suspension (e.g., INVEGASUSTENNA, An every-three-month paliperidone palmitate extended release injectable suspension (e.g., INVEGATRINZA. From risperidone tablets to INVEGASUSTENNA, Recommended dosing of INVEGASUSTENNA for adults with schizophrenia transitioning from risperidone tablets1,2. invega sustenna to abilify maintena So i'm going to be switching over to abilify maintena from invega sustenna. Care should be taken to avoid inadvertent injection into a blood vessel. Thank you. However, some patients may require treatment with INVEGA SUSTENNA or INVEGA TRINZA despite the presence of the syndrome. Pregnancy/Nursing:INVEGA SUSTENNA may cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure. I am very big but i have just randomly lost 3 stone after being on abilify 10mg and on respiridone 2mg and Valium 2mg ;When required Fern; Jan 26, 2022; Psychosis Forum; 2 3. More common side effects in people taking Invega for schizoaffective disorder include: extrapyramidal symptoms. See full prescribing information for complete boxed warning. The metabolic changes include hyperglycemia, dyslipidemia, and body weight gain. You are currently not accessing the Outpatient Sample Program portal with Google Chrome. Paliperidone extended-release injection is in a class of medications called atypical antipsychotics. Pregnancy/Nursing: INVEGA may cause extrapyramidal and/or withdrawal symptoms in neonates with third trimester exposure. INVEGA HAFYERA, an every-six-month injection, is an atypical antipsychotic indicated for the treatment of schizophrenia in adults after they have been adequately treated with: A once-a-month paliperidone palmitate extended release injectable suspension (e.g., INVEGA SUSTENNA ) for at least four months or. 2018 Jun;72(6):e13089. I was at my staff meeting yesterday. Maintenance dose conversion between oral risperidone and paliperidone palmitate 1 month: practical guidance based on pharmacokinetic simulations. Introduction. The recommended maintenance dose for treatment of schizophrenia is 117 mg. I know people feel better cognitively when lowering from 100mg to 75mg of sustenna. Avoid the use of drugs that also increase QTc interval and in patients with risk factors for prolonged QTc interval. Monitoring should be considered in patients for whom this may be of concern. I would think Abilify Maintena or even Aristada/Aristada Initio would be better. The effect that symptomatic suppression has upon the long-term course of the syndrome is unknown. If the fourth or subsequent doses are missed: If more than 4 weeks and less than 6 weeks have elapsed since the last injection, administer the injection as soon as possible. Periodically reassess the need for continued treatment. RISPERDAL can pass into human breast milk. If administering a strong inducer is necessary, consider managing the patient using paliperidone extended-release tablets. INVEGAis indicated for the treatment of schizophrenia in adults. Leukopenia, Neutropenia and Agranulocytosis have been reported with antipsychotics, including INVEGA SUSTENNA. Switching Antipsychotic Drugs Approaches to switching medication vary in the rate of change and extent of any overlap of agents. IMPORTANT SAFETY INFORMATION FOR RISPERDAL(risperidone). If signs and symptoms of TD appear in a patient on INVEGA SUSTENNA, drug discontinuation should be considered. Consider discontinuing INVEGA TRINZA and INVEGA SUSTENNA at the first sign of a clinically significant decline in WBC in the absence of other causative factors. Our Privacy Policy is located at Privacy Policy. Commonly Observed Adverse Reactions for RISPERDAL CONSTA: The most common adverse reactions in clinical trials in patients with schizophrenia (5%) were headache, Parkinsonism, dizziness, akathisia, fatigue, constipation, dyspepsia, sedation, weight increase, pain in extremities, and dry mouth. Both hyperthermia and hypothermia have been reported in association with oral RISPERDAL. Patients starting treatment with APS who have or are at risk for diabetes mellitus should undergo fasting blood glucose testing at the beginning of and during treatment. October 2013; Addendum March 2016. Monitoring should be considered in patients for whom this may be of concern. 39 mg dose was not . Manage NMS with immediate discontinuation of ABILIFY MAINTENA, intensive symptomatic treatment, and monitoring. Periodically reassess the need for continued treatment. Aripiprazole Long-acting Injection (Abilify Maintena, ARISTADA) National Drug Monograph. In patients with a history of clinically significant low white blood cell count (WBC)/absolute neutrophil count (ANC) or drug-induced leukopenia/neutropenia, perform a complete blood count frequently during the first few months of therapy. As the number of long-acting injectable antipsychotic medication options increases, the need has grown for commensurate data pertaining to safety and outcomes when switching between different LAIs (Correll et al., 2016).In particular, clinicians may hesitate to recommend a medication change because they are unsure about the relative safety of switching a patient from one long . Care should be taken to avoid inadvertent injection into a blood vessel. To switch pt currently @ steady state on different long-acting inj antipsychotic to SUSTENNA: Give test dose po paliperidone or risperidone. The efficacy of INVEGAin schizophrenia was established in three 6-week trials in adults, as well as one maintenance trial in adults. Conversely, on discontinuation of the strong inducer, it may be necessary to decrease the dose of INVEGA. INVEGATRINZA[Prescribing Information]. Monitor patients closely for adverse reactions and discontinue the regimen as soon as possible if a severe adverse reaction occurs. Advise patients to notify their healthcare professional if they become pregnant or intend to become pregnant during treatment with INVEGA SUSTENNA. Seizures: RISPERDAL CONSTA should be used cautiously in patients with a history of seizures. INVEGA HAFYERA is not approved for use in patients with dementia-related psychosis. (dose range 175-525mg) Consider either: Invega Sustenna 25-150mg IM q month OR Abililfy Maintena 300-400mg IM q month OR Risperdal Consta 12.5mg-50mg IM q 14 days Expert Opinion: Due to its specific pharmacological and tolerability profile, AOM represents a suitable alternative for patients with schizophrenia requiring a switch to a new LAI treatment because of lack of efficacy or persistent side effects from another LAI. Paliperidone (Invega) is available as a lower-cost generic. If more than 6 weeks have elapsed since the last injection, restart . Body Temperature Regulation: Disruption of body temperature regulation has been attributed to antipsychotic agents. Use the lowest effective dose of each LAIA to limit adverse effects and improve tolerability of the regimen. Please click here to read the full Prescribing Information, including Boxed WARNING, for RISPERDAL CONSTA. INVEGA SUSTENNA can pass into human breast milk. o Invega Sustenna $250-$1700 per month o Zyprexa Relprevv $550 - $1000 per month o First Generation long acting injections $45 - $100 per month . INVEGA SUSTENNA and INVEGA TRINZA are not approved for use in patients with dementia-related psychosis. indigestion. Click here to start your patients on the path to just 2 DOSES A YEAR. (5.1). I have always wanted a clinical tool that offered a blueprint for cross-tapering from one antipsychotic medication to another, and particularly one that took medication half-life into account. Gastrointestinal: INVEGA should ordinarily not be administered to patients with pre-existing severe gastrointestinal narrowing. Cerebrovascular Adverse Reactions: Cerebrovascular adverse reactions (e.g., stroke, transient ischemic attacks), including fatalities, were reported at a higher incidence in elderly patients with dementia-related psychosis taking risperidone, aripiprazole, and olanzapine compared to placebo. INDICATION. IMPORTANT SAFETY INFORMATION FOR INVEGA SUSTENNA (paliperidone palmitate) Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. And I just sat there in my damage suffering not capable of understanding practically anything or capable of doing anything but . If NMS is suspected, immediately discontinue INVEGA HAFYERA and provide symptomatic treatment and monitoring. Administration: For intramuscular injection only by a healthcare professional using only the needlesprovided in the INVEGA TRINZA or INVEGA SUSTENNA kits. Seizures: INVEGA HAFYERAshould be used cautiously in patients with ahistory of seizures or with conditions that potentially lower seizure threshold. The benefits of breastfeeding should be considered along with the mothers clinical need for INVEGA SUSTENNA and any potential adverse effects on the breastfed infant from INVEGA SUSTENNA or the mothers underlying condition. Titusville, NJ: Janssen Pharmaceuticals, Inc.; July 2022. Then start Invega Sustenna @ desired maint. Dyslipidemia: Undesirable alterations have been observed in patients treated with atypicalantipsychotics. Some patients require continuation of antidiabetic treatment despite discontinuation of the suspect drug. Legal Notice |Privacy Policy |Medical Information Center. Paliperidone has a prolactin-elevating effect similar to risperidone, which is associated with higher levels of prolactin elevation than other antipsychotic agents. Orthostatic Hypotension and Syncope: INVEGA TRINZA and INVEGA SUSTENNA may induce orthostatic hypotension in some patients due to its alpha-adrenergic blocking activity. Body Temperature Regulation: Disruption of body temperature regulation has been attributed to antipsychotic agents. Clinical monitoring of weight is recommended. . Hyperprolactinemia: As with other drugs that antagonize dopamine D2 receptors, risperidone elevates prolactin levels and the elevation persists during chronic administration. Paliperidone should also be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias. How do I switch from oral Abilify to Maintena? RISPERDAL CONSTA can pass into human breast milk. At the first sign of a clinically significantdecline in WBC, and in the absence of other causative factors, discontinuation ofRISPERDAL CONSTA should be considered. The recommended maintenance dose for treatment of schizophrenia is 117 mg. As I posted recently, I am switching from Invega Sustenna to Abilify Maintena. If signs and symptoms of TD appear in a patient on INVEGA HAFYERA, drug discontinuation should be considered. cp-51055v9. Commonly Observed Adverse Reactions for INVEGA SUSTENNA: The most common adverse reactions in clinical trials in patients with schizophrenia (5% and twice placebo) were injection site reactions, somnolence/sedation, dizziness, akathisia and extrapyramidal disorder. Long-acting injectables (LAIs) are Injectable medications used for individuals living with mental illness. Paliperidone has a prolactin-elevating effect similar to risperidone, which is associated with higher levels of prolactin elevation than other antipsychotic agents. Although the prevalence of the syndrome appears to be highest among the elderly, especially elderly women, it is impossible to predict which patients will develop the syndrome. Certain circumstances may increase the risk of the occurrence of torsades de pointes and/or sudden death in association with the use of drugs that prolong the QTc interval. Garbled February 25, 2023, 11:37am 1. Please click here to read the full Prescribing Information, including Boxed WARNING, for RISPERDAL. Advise patients to notify their healthcare professional if they become pregnant or intend to become pregnant during treatment with RISPERDAL. Seizures:INVEGA SUSTENNA should be used cautiously in patients with a history of seizures or with conditions that potentially lower seizure threshold. INVEGA HAFYERA can pass into human breast milk. #2. Drug Switching From Drug Switching To; 1-3: 4-6: 7-9: 10-Methodology References Methodology. The net savings from the switch were estimated at $16,620 per month. Seizures: INVEGA TRINZA and INVEGA SUSTENNA should be used cautiously in patients with ahistory of seizures or with conditions that potentially lower seizure threshold. INVEGA TRINZA and INVEGA SUSTENNA have the potential to impair judgment, thinking, or motor skills. If NMS is suspected, immediately discontinue RISPERDAL CONSTA and provide symptomatic treatment and monitoring. If NMS is suspected, immediately discontinue INVEGA SUSTENNA and provide symptomatic treatment and monitoring. Switching from Abilify Maintena to Aristada The recommended starting and maintenance dose of Abilify Maintena is 400mg a month. Both hyperthermia and hypothermia have been reported in association with RISPERDAL CONSTA use. Fertility:RISPERDAL may cause a reversible reduction in fertility in females. Patients with severe neutropenia should discontinue RISPERDAL and follow their WBC until recovery. IMPORTANT SAFETY INFORMATION FOR INVEGA (paliperidone). Use cautiously in patients at risk for aspiration pneumonia. IMPORTANT SAFETY INFORMATION and INDICATION for RISPERDAL(risperidone). Is switching from 100mg of invega sustenna to 200mg of Abilify maintena a dose reduction? VA Pharmacy Benefits Management Services, Medical Advisory Panel, and VISN Pharmacist Executives. Third party trademarks used herein are trademarks of their respective owners. Abilify prices, coupons and patient assistance programs abilify (aripiprazole). For patients, particularly the elderly, with diseases, conditions, or medications that could exacerbate these effects, assess the risk of falls when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy. These metabolic changes include hyperglycemia, dyslipidemia, and body weight gain. Periodically reassess the need for continued treatment. Orthostatic Hypotension and Syncope: RISPERDAL CONSTA may induce orthostatic hypotension in some patients due to its alpha-adrenergic blocking activity. Once redirected to the new portal, please re-register your account. Pharmacokinetically and pharmacologically the lowest risk strategy for switching is to have a drug free interval. Patients should be cautioned about performing activities that require mental alertness such as operating hazardous machinery, including motor vehicles, until they are reasonably certain that INVEGA TRINZA and INVEGA SUSTENNA do not adversely affect them. In patients who do require chronic treatment, use the lowest dose and the shortest duration of treatment producing a satisfactory clinical response. Metabolic Changes: Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular/cerebrovascular risk. Clinical signs of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability. The following adverse reactions occurred more frequently (a 2% difference vs. placebo) in the long-term study in patients with schizoaffective disorder: weight increased, nasopharyngitis, headache, hyperprolactinemia, and pyrexia. INVEGA (paliperidone) extended-release tablets are indicated for the treatment ofschizophrenia. The recommended initiation dosing regimen (234 mg/156 mg on Day 1/Day 8) is not required. Patients who develop symptoms of hyperglycemia should also undergo fasting blood glucose testing. Patients should be advised that there is a pregnancy registry that monitors outcomes in women exposed to INVEGA SUSTENNA during pregnancy. Potential for Cognitive and Motor Impairment: Somnolence, sedation, and dizziness were reported as adverse reactions in subjects treated with INVEGA SUSTENNA. For paliperidone palmitate (Invega Sustenna), many different doses were tried in clinical trials and 25 mg given by injection every four weeks was the minimum dose that was statistically significantly better than placebo, that is, the "minimum effective dose." . Patients with clinically significant neutropenia should be carefully monitored for fever or other symptoms or signs of infection and treated promptly. Common side effects of Abilify and Invega include: drowsiness dizziness headache lightheadedness We encourage you to read the full IMPORTANT SAFETY INFORMATION and Prescribing Information, including Boxed WARNING, before prescribing INVEGA SUSTENNA for your patients. Commonly observed adverse reactions (incidence 5% and at least twice that for placebo in adults with schizophrenia) were: extrapyramidal symptoms, tachycardia, and akathisia. From long-acting injectable (LAI) antipsychotic to INVEGASUSTENNA. Certain circumstances may increase the risk of the occurrence of torsade de pointes and/or sudden death in association with the use of drugs that prolong the QTc interval. 1 A third common indication is patient and/or caregiver request. (5.1). Switching to Invega Hafyera from a PP3M* Product: If last dose of PP3M was 546 mg, initial dose of Invega Hafyera is 1,092 mg. Hyperprolactinemia: As with other drugs that antagonize dopamine D2 receptors, INVEGA SUSTENNA elevates prolactin levels, and the elevation persists during chronic administration. constipation. Leukopenia, Neutropenia, and Agranulocytosis have been reported temporally related to antipsychotic agents, including RISPERDAL. Administration: For intramuscular injection only by a healthcare professional using only the needles provided in the INVEGA SUSTENNA kit. If signs and symptoms of TD appear in a patient on INVEGA, drug discontinuation should be considered. Invega Sustenna ("Sustenna" or paliperidone palmitate) is a long-acting injectable (LAI) formulation of paliperidone. It was the first available second-generation antipsychotic LAI to provides coverage for 4 weeks. Dose can be reduced to 300 mg in patients with adverse reactions. Patients with a history of clinically significant low white bloodcell count (WBC) or drug-induced leukopenia/neutropenia should have frequent complete bloodcell counts during the first few months of therapy. INVEGA SUSTENNA has the potential to impair judgment, thinking, or motor skills. 2.6 Switching from Other Antipsychotics 2.7 Instructions for Use 3 DOSAGE FORMS AND STRENGTHS 4 CONTRAINDICATIONS 5 WARNINGS AND PRECAUTIONS 5.1 Increased Mortality in Elderly Patients with Dementia-Related Psychosis 5.2 Cerebrovascular Adverse Reactions, Including . . Priapism has been reported. By using this offer, you are certifying that you meet the eligibility criteria (not a member of a federal, state, or government insurance program) and will comply with the terms and conditions described in the . INVEGA TRINZA and INVEGA SUSTENNA should be used with caution in patients with known cardiovascular disease, cerebrovascular disease or conditions that would predispose patients to hypotension (e.g., dehydration, hypovolemia, treatment with antihypertensive medications). Please see fullPrescribing Information, including Boxed WARNING, for INVEGA. Since RISPERDAL has the potential to impair judgment, thinking or motor skills, patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that RISPERDAL therapy does not affect them adversely. QT Prolongation: Paliperidone causes a modest increase in the corrected QT (QTc) interval. 2011;25(10):829-845. doi:10.2165/11591690-000000000-00000 4. comment sorted by Best Top New Controversial Q&A Add a Comment NotConnor365 depressive subtype My new psychiatrist said he would switch me to Abilify. INVEGA TRINZA and INVEGA SUSTENNA can pass into human breast milk. This information is based on pharmacokinetic (PK) modeling performed to compare steady-state exposure during maintenance treatment between risperidone tablets and INVEGASUSTENNA (after both the 234 mg/156 mg deltoid starting doses). RISPERDALCONSTA (risperidone) long-acting injection is indicated for the treatment of schizophrenia. Seizures: INVEGA should be used cautiously in patients with a history of seizures or with conditions that potentially lower seizure threshold. Titusville, NJ: Janssen Pharmaceuticals, Inc.; August 2021. These medicines are not approved for the treatment of patients with dementia-related psychosis. Int Clin Psychopharmacol 2011;26(1):35-42. Invega Hafye J3490 Invega Sustenna J2426 Invega Trinza J2426 Ixifi Q5109 Kalbitor J1290 Krystexxa J2507 Kymriah Q2042 Lemtrada J0202 Leqvio J1306 Aripiprazole Prolonged Release Suspension for Injection (Abilify Maintena) (300 mg and 400 mg Vial) [Internet]. INVEGASUSTENNA (paliperidone palmitate) is an atypical antipsychotic indicated for the treatment of schizophrenia in adults. I have been recently considering switching from Invega Sustenna to Abilify Maintena because of the weight gain and the prolactin elevation. maintenance treatment of bipolar I disorder in adults. Switching to billing under the pharmacy benefit resulted in a monthly gain of $2,100. Seizures: RISPERDAL should be used cautiously in patients with a history of seizures. INVEGA SUSTENNA (paliperidone palmitate) is an atypical antipsychotic . WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS. Prescription only Invega Sustenna is a long-acting form of paliperidone that is injected into the deltoid or gluteal muscle once a month after an initial loading dose. All patients treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia. Orthostatic Hypotension and Syncope: INVEGA SUSTENNA may induce orthostatic hypotension in some patients due to its alpha-adrenergic blocking activity. 2. for switching. Drug Interactions: Strong CYP3A4/P-glycoprotein (P-gp) inducers: It may be necessary to increase the dose of INVEGA when a strong inducer of both CYP3A4 and P-gp (eg, carbamazepine, rifampin, St. John's wort) is co-administered. INVEGAis not approved for use in patients with dementia-related psychosis. Detailed protocols for switching between LAIs have not been established, but it is recommended that there is oral overlap of 1-2 weeks when switching to aripiprazole LAI (Abilify Maintena). All rights reserved. INVEGA SUSTENNA is not approved for use inpatients withdementia-related psychosis. It's released slowly in your body so you only have to take it once a day. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Manifestations and features are consistent with NMS. No studies have been conducted with oral paliperidone, INVEGA SUSTENNA, or INVEGA TRINZA in elderly patients with dementia. Advise patients to notify their healthcare professional if they become pregnant or intend to become pregnant during treatment with INVEGA TRINZA or INVEGA SUSTENNA. Replies 26 Views 1K. Alabama, US. RISPERDAL is not approved for use in patients with dementia-related psychosis. INVEGA should only be used in patients who are able to swallow the tablet whole. Dysphagia: Esophageal dysmotility and aspiration have been associated with antipsychotic drug use. Treated with INVEGA SUSTENNA If the Last Dose of INVEGA SUSTENNA is: Initiate INVEGA TRINZA at the Following Dose: 78 mg 273 mg 117 mg 410 mg 156 mg 546 mg 234 mg 819 mg Conversion from the INVEGA SUSTENNA. In patients who do require chronic treatment, use the lowest dose and the shortest duration of treatment producing a satisfactory clinical response. Conditions that lower seizure threshold may be more prevalent in patients 65 years or older. QT Prolongation: Paliperidone causes a modest increase in the corrected QT (QTc) interval. Commonly Observed Adverse Reactions for RISPERDAL: The most common adverse reactions in all clinical trials were (5% and twice placebo) were parkinsonism, akathisia, dystonia, tremor, sedation, dizziness, anxiety, blurred vision, nausea, vomiting, upper abdominal pain, stomach discomfort, dyspepsia, diarrhea, salivary hypersecretion, constipation, dry mouth, increased appetite, increased weight, fatigue, rash, nasal congestion, upper respiratory tract infection, nasopharyngitis, and pharyngolaryngeal pain. QT Prolongation: Paliperidone causes a modest increase in the corrected QT (QTc) interval. INVEGA SUSTENNA (paliperidone palmitate) is indicated for the treatment of: Schizophrenia in adults. Periodically reassess the need for continued treatment. See full prescribing information for complete Boxed Warning. I have no personal experience with the depot antipsychotic shots, but I have heard from almost everyone who has had the Invega depot shots (of any form) have said they feel numb and like they can't think (like they're braindead). Additional signs may include elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), and acute renal failure. 1, 2 LAIs are usually the same medication that is taken in pill form but when injected they allow for the slow release of medication into the blood over a longer period of time. Drug Interactions:Strong CYP3A4/P-glycoprotein (P-gp) inducers: Avoid using a strong inducer of CYP3A4 and/or P-gp (e.g. For other LAIs, patients should have tolerated the corresponding oral antipsychotic . Hyperprolactinemia: As with other drugs that antagonize dopamine D2 receptors, RISPERDAL elevates prolactin levels and the elevation persists during chronic administration. RISPERDAL CONSTA (risperidone) long-acting injection is indicated for the treatment of schizophrenia. Consider discontinuing INVEGA HAFYERA at the first sign of a clinically significant decline in WBC in the absence of other causative factors. RISPERDAL CONSTA is not approved for use in patients with dementia-related psychosis. 3. RISPERDAL should be used with caution in patients with known cardiovascular disease, cerebrovascular disease or conditions that would predispose patients to hypotension (e.g., dehydration, hypovolemia, treatment with antihypertensive medications). The incidence of CAEs was significantly higher than with placebo. The purpose of VA PBM Services drug monographs is to provide a comprehensive drug review for making formulary decisions. These 2 LAIs have different pharmacologic activities: aripiprazole is a partial agonist at dopamine D 2 and serotonin 5HT 1A receptors and antagonist at 5HT 2A receptors (Abilify Maintena Prescribing Information, 2016), whereas paliperidone is an antagonist at D 2 and 5HT 2A receptors (Invega Sustenna Prescribing Information, 2015). Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. The benefits of breastfeeding should be considered along with the mothers clinical need for RISPERDAL CONSTA and any potential adverse effect on the breastfed infant from RISPERDAL CONSTA or the mothers underlying condition. Patients previously stabilized on different doses of paliperidone extended-release tablets can attain similar paliperidone steady-state exposure during maintenance treatment with INVEGASUSTENNA, Please refer to the dosage and administration section of the Prescribing Information for important information on how to administer INVEGASUSTENNA, All patients transitioning from oral antipsychotics must follow the recommended initiation dosing of 234 mg (Day 1), 156 mg (Day 8), both administered in the deltoid muscle, Please refer to the Dosing and Administration section of the Prescribing Information for important information on how to administer INVEGASUSTENNA, Follow recommendations for transitioning patients from long-acting injectable antipsychotics, During the open-label stabilization phase of a long-term maintenance trial for INVEGATRINZA, It is important to note that the INVEGASUSTENNA, Transition dosing was based on internal Janssen pharmacokinetic modeling, and is not included in the INVEGASUSTENNA, If your patients have never taken oral paliperidone or oral or injectable risperidone, it is recommended to establish tolerability prior to initiating treatment with INVEGASUSTENNA, Maintenance doses may be administered in either the deltoid or the gluteal muscle, To avoid a missed monthly maintenance dose, patients may be given the injection within 7 days of the monthly time point, Utilizing the maintenance dosing window to help avoid missed doses should be considered the exception rather than the rule, Inpatient Hospital Pharmacy Free Trial Program, Switching antipsychotics | INVEGA SUSTENNA HCP.

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