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Transitioning From Other Antipsychotics
Before transitioning to INVEGA SUSTENNA®
Establish tolerability in patients who have not taken oral paliperidone, oral risperidone, or injectable risperidone.1 Learn about initiation and maintenance dosing for INVEGA SUSTENNA®.
Recommended dosing for adults with schizophrenia1
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*The first monthly maintenance dose should be administered 5 weeks after the first injection (regardless of the timing of the second injection).
†The recommended maintenance dose for treatment of schizophrenia is 117 mg. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg).
- Patients previously stabilized on different doses of paliperidone extended-release tablets can attain similar paliperidone steady-state exposure during maintenance treatment with INVEGA SUSTENNA® monthly doses1
- No oral supplementation required1
- Please refer to the dosage and administration section of the Prescribing Information for important information on how to administer INVEGA SUSTENNA®
IMPORTANT SAFETY INFORMATION and INDICATION for INVEGA® (paliperidone)
INVEGA® is indicated for the treatment of schizophrenia in adults. The efficacy of INVEGA® in schizophrenia was established in three 6-week trials in adults, as well as one maintenance trial in adults.
INVEGA® is an atypical antipsychotic indicated for the treatment of schizophrenia.
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
See full prescribing information for complete boxed warning.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. INVEGA® is not approved for use in patients with dementia-related psychosis. (5.1)
Commonly observed adverse reactions (incidence ≥5% and at least twice that for placebo in adults with schizophrenia) were: extrapyramidal symptoms, tachycardia, and akathisia.
Please see full Prescribing Information, including Boxed WARNING, for INVEGA®.
From risperidone tablets to INVEGA SUSTENNA®
Recommended dosing of INVEGA SUSTENNA® for adults with schizophrenia transitioning from risperidone tablets1,2
The recommended maintenance dose for treatment of schizophrenia is 117 mg. Some patients may benefit from lower or higher maintenance doses within the additional available strengths.
*The first monthly maintenance dose should be administered 5 weeks after the first injection (regardless of the timing of the second injection).
There are no systematically collected data to specifically address transitioning patients with schizophrenia from other antipsychotics to INVEGA SUSTENNA®.
This information is based on pharmacokinetic (PK) modeling performed to compare steady-state exposure during maintenance treatment between risperidone tablets and INVEGA SUSTENNA® (after both the 234 mg/156 mg deltoid starting doses). This information is not included in the INVEGA SUSTENNA® Prescribing Information.
- 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 muscle1
- No oral supplementation required1
- Please refer to the Dosing and Administration section of the Prescribing Information for important information on how to administer INVEGA SUSTENNA®
- The INVEGA SUSTENNA® Prescribing Information does not specifically address conversion of risperidone tablets to INVEGA SUSTENNA®
IMPORTANT SAFETY INFORMATION and INDICATION for RISPERDAL® (risperidone)
RISPERDAL® is an atypical antipsychotic indicated for the treatment of schizophrenia.
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
See full prescribing information for complete boxed warning.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. RISPERDAL® (risperidone) is not approved for use in patients with dementia-related psychosis. [See Warnings and Precautions (5.1)
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.
Please see full Prescribing Information, including Boxed WARNING, for RISPERDAL®.
From RISPERDAL CONSTA® (risperidone) to INVEGA SUSTENNA®
*Administered 1 month after the initial dose.
†The recommended maintenance dose for treatment of schizophrenia is 117 mg. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg).
‡Dose at study entry.
- Follow recommendations for transitioning patients from long-acting injectable antipsychotics1
- During the open-label stabilization phase of a long-term maintenance trial for INVEGA TRINZA® for the treatment of schizophrenia, enrolled patients treated with RISPERDAL CONSTA® long-acting injection were switched to INVEGA SUSTENNA® in place of the next scheduled injection at a dose determined by the conversion guide below4
- Please refer to the Dosing and Administration section of the Prescribing Information for important information on how to administer INVEGA SUSTENNA®
- It is important to note that the INVEGA SUSTENNA® conversion dose may not reflect the eventual stabilization dose that was achieved during the remainder of the open-label transition phase
- The RISPERDAL CONSTA® Prescribing Information does not specifically address conversion from INVEGA SUSTENNA® to RISPERDAL CONSTA®
- Transition dosing was based on internal Janssen pharmacokinetic modeling, and is not included in the INVEGA SUSTENNA® Prescribing Information3
IMPORTANT SAFETY INFORMATION and INDICATION for RISPERDAL CONSTA® (risperidone)
RISPERDAL CONSTA® (risperidone) long-acting injection is indicated for the treatment of schizophrenia.
WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
See full Prescribing Information for complete boxed warning.
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. RISPERDAL CONSTA® is not approved for use in patients with dementia-related psychosis. (5.1)
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.
Please see full Prescribing Information, including Boxed WARNING, for RISPERDAL CONSTA®.
From long-acting injectable (LAI) antipsychotic to INVEGA SUSTENNA®
*Administered 1 month after the initial dose.
†The 234 mg INVEGA SUSTENNA® strength was used in the pivotal clinical trial for INVEGA TRINZA® as an initiation dose for patients who were being transitioned from another LAT antipsychotic. Some patients may benefit from lower initiation doses within the available strengths (39 mg, 78 mg, 117 mg, and 156 mg).
‡The recommended maintenance dose for treatment of schizophrenia is 117 mg. Some patients may benefit from lower or higher maintenance doses within the additional available strengths (39 mg, 78 mg, 156 mg, and 234 mg).
- If your patients have never taken oral paliperidone or oral or injectable risperidone, it is recommended to establish tolerability prior to initiating treatment with INVEGA SUSTENNA®1
- Initiate INVEGA SUSTENNA® in place of the next scheduled injection. INVEGA SUSTENNA® should be continued at monthly intervals1
- No oral supplementation required1
- Maintenance doses may be administered in either the deltoid or the gluteal muscle1
-
To avoid a missed monthly maintenance dose, patients may be given the injection within ± 7 days of the monthly time point1
- Utilizing the maintenance dosing window to help avoid missed doses should be considered the exception rather than the rule
- It is important to note that the INVEGA SUSTENNA® conversion dose might not reflect the eventual stabilization dose achieved during the remainder of the open-label transition phase
- Please refer to the dosage and administration section of the Prescribing Information for important information on how to administer INVEGA SUSTENNA®
References: 1. INVEGA SUSTENNA® [Prescribing Information]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; July 2022. 2. Russu A, Kern Sliwa J, Ravenstijn P, et al. Maintenance dose conversion between oral risperidone and paliperidone palmitate 1 month: practical guidance based on pharmacokinetic simulations. Int J Clin Pract. 2018 Jun;72(6):e13089. 3. Samtani MN, et al. Dosing and switching strategies for paliperidone palmitate: based on population pharmacokinetic modelling and clinical trial data. CNS Drugs. 2011;25(10):829-845. doi:10.2165/11591690-000000000-00000 4. INVEGA TRINZA® [Prescribing Information]. Titusville, NJ: Janssen Pharmaceuticals, Inc.; August 2021.