Paliperidone palmitate (Invega Sustenna®) is an extended-release injectable second-generation (“atypical”) antipsychotic. Here is basic information about this medication.

FDA-approved indications

1. Treatment of schizophrenia
2. Treatment of schizoaffective disorder as monotherapy and as an adjunct to mood stabilizers or antidepressants

Dosage

A. Schizophrenia

Initiation (IM deltoid): Administer 234 mg on day 1; 156 mg on day 8

Monthly maintenance dose (IM deltoid or gluteal): 39–234 mg (administered 5 weeks after first injection)

Maximum monthly dose: 234 mg

(Recommended maintenance dose for schizophrenia is 117 mg, though some patients may benefit from higher or lower doses within available strengths)

B. Schizoaffective disorder

Initiation (IM deltoid): 234 mg on day 1; 156 mg on day 8

Monthly maintenance dose (IM deltoid or gluteal): 78–234 mg (based upon tolerability and efficacy)

Maximum monthly dose: 234 mg

C) Use in specific population: patients with renal impairment

Mild renal impairment (creatinine clearance 50-80 mL/min): Administer 156 mg on treatment day 1 and 117 mg one week later, both on deltoid muscle. Follow with monthly injections of 78 mg in either the deltoid or gluteal muscle.

Moderate to severe renal impairment (creatinine clearance<50 mL/min): Invega  Sustenna® is not recommended

Dosage forms and strengths

Extended-release injectable suspension: 39 mg, 78 mg, 117 mg, 156 mg, and 234 mg

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.