What is Xeplion?
Xeplion is the trade name for paliperidone palmitate, a prolonged-release suspension used for the maintenance treatment of schizophrenia in adults. As a long-acting injectable (LAI), it can improve adherence by eliminating the need for daily oral medication. The active substance, paliperidone, is a dopamine and serotonin antagonist that helps manage the symptoms of schizophrenia. This medication is for intramuscular use only and must be administered by a qualified healthcare professional.
How to Prepare a Xeplion Injection
Proper preparation of the Xeplion syringe is a critical step before administration. The pre-filled syringe requires careful handling due to its suspension format. To prepare, shake the syringe vigorously for at least 10 seconds to make the suspension uniform. Attach the appropriate safety needle from the kit based on the patient's weight and injection site. Hold the syringe upright and remove any air by moving the plunger forward.
The Initial and Maintenance Administration Schedule
Xeplion administration follows a specific schedule to ensure therapeutic concentrations are reached and maintained.
Initial Administration
Treatment begins with two deltoid injections a week apart.
Monthly Maintenance Administration
Monthly maintenance injections follow the initial two doses, typically starting one month after the second dose. These administrations can be given in either the deltoid or gluteal muscle, with alternating sites.
Intramuscular Injection Technique
A healthcare professional must inject Xeplion deep into the muscle, avoiding blood vessels.
Deltoid Injection Technique
Inject 1 to 2 inches below the acromion process, at a 90° angle. Alternate between deltoid muscles.
Gluteal Injection Technique
Locate the upper-outer quadrant of the gluteal area to avoid the sciatic nerve. Inject deep into the muscle and alternate between the left and right gluteal muscles.
Needle Selection Based on Patient Weight and Injection Site
The Xeplion kit includes needles of different sizes to ensure proper delivery. The table below outlines needle selection:
| Injection Site | Patient Weight | Needle Size (US) | Needle Size (Metric) |
|---|---|---|---|
| Deltoid (Arm) | < 90 kg (approx. 198 lbs) | 1-inch, 23 gauge | 25.4 mm, 0.64 mm |
| Deltoid (Arm) | ≥ 90 kg (approx. 198 lbs) | 1½-inch, 22 gauge | 38.1 mm, 0.72 mm |
| Gluteal (Buttocks) | All weights | 1½-inch, 22 gauge | 38.1 mm, 0.72 mm |
Managing Missed Administrations
Missing an administration can affect the medication's therapeutic level. If an administration is missed, a healthcare professional must be consulted immediately to determine the correct re-initiation protocol, which may include additional loading administrations.
Patient Monitoring and Post-Injection Care
After administration, several steps are needed: apply pressure to the injection site with gauze; activate the needle's safety feature for safe disposal; and monitor the patient for immediate reactions like dizziness. Ongoing monitoring for side effects such as weight gain or extrapyramidal symptoms is also essential.
Conclusion
How to administer Xeplion is a precise process requiring healthcare professional administration and strict adherence to protocol for safety and effectiveness. Correct preparation, administration frequency, injection technique, and needle selection are vital steps. This monthly injectable provides consistent schizophrenia management but is not for self-administration. Understanding these procedures is key for both medical staff and patients.
For more information on Xeplion, healthcare professionals can refer to the official {Link: European Medicines Agency ec.europa.eu/health/documents/community-register/2015/20151216133533/anx_133533_en.pdf}.
