For patients who have never taken oral paliperidone or oral or injectable risperidone, tolerability should be established with oral paliperidone or oral risperidone prior to initiating treatment with Invega Sustenna.
Adults: Initially 150 mg on day 1 and 100 mg 1 week later, both administered in the deltoid muscle. The recommended subsequent monthly dose is 75 mg; this can be increased or decreased in the range of 25-150 mg based on individual patient tolerability and/or efficacy. Following the 2nd dose, monthly doses can be administered in either the deltoid or gluteal muscle.
There are no systematically collected data to specifically address switching schizophrenic patients from other antipsychotics to Invega Sustenna, or concerning concomitant administration with other antipsychotics. Previous oral antipsychotics can be discontinued at the time of initiation of treatment with Invega Sustenna.
When switching patients from previous long-acting injectable antipsychotics, initiate Invega Sustenna therapy in place of the next scheduled injection. Invega Sustenna therapy should then be continued at monthy intervals. The 1-week initiation dosing regimen as described is not required.
If Invega Sustenna is discontinued, its prolonged-release characteristics must be considered. As recommended with other antipsychotic medications, the need to continuing existing extrapyramidal symptoms (EPS) medication should be re-evaluated periodically.
Elderly >60 years: In general, recommended dosing of Invega Sustenna for elderly patients with normal renal function is the same as for younger adult patients with normal renal function. However, dose adjustment may be required due to age-related decreases in creatinine clearance.