Invega Sustenna (paliperidone palmitate)
Brand name: Invega® Sustenna®.
Active ingredient name: Paliperidone palmitate.
Type of medication: Atypical antipsychotic.
Available in Canada from: Janssen Inc.
Form: Injection.
Generic: No.
Listed on Ontario formulary: Yes (with suggested criteria for coverage*).
*This product has a therapeutic note which suggests that a physician should prescribe it for the treatment of schizophrenia or schizoaffective disorders in patients who have: a history of non-adherence; AND one of the following:
(1) Inadequate control or significant side effects from two or more formulary oral antipsychotic medications, including at least one atypical agent; OR
(2) Inadequate control or significant side-effects from one or more conventional depot antipsychotic agents.
OHIP+ coverage: Yes (with suggested criteria for coverage*).
*This product has a therapeutic note which suggests that a physician should prescribe it for the treatment of schizophrenia or schizoaffective disorders in patients who have: a history of non-adherence; AND one of the following:
(1) Inadequate control or significant side effects from two or more formulary oral antipsychotic medications, including at least one atypical agent; OR
(2) Inadequate control or significant side effects from one or more conventional depot antipsychotic agents.
Note: Invega® Sustenna® is also available in tablet form as Invega®.
What is Invega Sustenna used for?
Invega Sustenna is used to treat the symptoms of schizophrenia and psychotic illnesses in adults. It may be used to treat other conditions as well. Discuss the reason you are taking Invega Sustenna with your doctor.
How should I take Invega Sustenna?
Invega Sustenna is available in prefilled syringes containing 50 mg, 75 mg, 100 mg, and 150 mg of paliperidone palmitate. You will receive a monthly injection, so you do not need to take medication every day. The injection will be given to you by a healthcare provider, usually a nurse. You may receive the injection in a clinic, in your doctor’s office or you may have a community nurse who comes to your home. After you receive your first dose of Invega Sustenna you will need to get a second dose one week later. From then on, you will only need to get a dose once a month. Your doctor will decide on the best dosage for you and will adjust the dose based on your response.
What are the most common side effects seen with Invega Sustenna?
The most common side effects of Invega Sustenna include:
- Headache
- Insomnia
- Constipation
- Nausea
- Vomiting
- Injection-site pain
- Weight gain
- Feeling of restlessness (akathisia)
- Dizziness
- Abnormal movements (extrapyramidal side effects)
What are rare but potentially serious side effects seen with Invega Sustenna?
- Decreased white blood cell count (agranulocytosis)
- Cerebrovascular event (stroke)
- Anaphylactic reaction (severe allergy)
- Diabetic ketoacidosis (DKA)
- Neuroleptic malignant syndrome (NMS)
Warnings/Precautions
Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotic medication. Most deaths appear to be either cardiovascular or infectious. Invega Sustenna is not approved for the treatment of dementia-related psychosis. Some individuals with dementia may, however, be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.
What medications interact with Invega Sustenna?
Tell all your doctors, pharmacists and dentist that you are taking Invega Sustenna. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription, and herbal and vitamin products. When the levels of a medication are increased or decreased in your bloodstream, this can affect the medication’s efficacy and safety.
The following types of medications may interact with Invega Sustenna:
- Certain medications for allergies (e.g., Benadryl [diphenhydramine])
- Certain medications for sleep (e.g., lorazepam, zopiclone)
- Certain medications for pain (e.g., fentanyl)
Avoid drinking alcohol or using illegal drugs while taking Invega Sustenna.