Yes, Paliperidone Is Available in Tablets
While some may know paliperidone for its long-acting injectable forms, it is indeed available as a daily oral tablet. The oral formulation is sold under the brand name Invega® and is approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia and schizoaffective disorder in adults. These tablets are designed for once-daily, controlled release dosing.
The Oral Tablet: Invega® Extended-Release
Invega® oral tablets use a drug delivery technology called the OROS® (Osmotic-controlled Release Oral System). This system provides a steady release of medication over 24 hours. To work properly, the tablets must be swallowed whole with liquid and should not be chewed, crushed, or divided. The tablet's outer shell is not absorbed and may be visible in stool, which is normal.
The Alternative: Long-Acting Injectable (LAI) Formulations
Paliperidone is also available in long-acting injectable forms. These formulations, including Invega Sustenna® (monthly) and Invega Trinza® (every three months), are administered by healthcare professionals and are designed to improve medication adherence. Invega Hafyera® is administered every six months for patients stabilized on other LAI forms. These injectables use paliperidone palmitate for extended intramuscular release. More details on these formulations and a comparison table can be found on {Link: iTrustWellness.com https://itrustwellness.com/paliperidone-long-acting-injections-empowering-mental-health-with-extended-treatment}.
The Active Metabolite of Risperidone
Paliperidone is the main active metabolite of risperidone. When the body processes risperidone, it creates paliperidone, leading to similar effects. However, paliperidone has less liver metabolism, which can reduce certain drug interactions.
Who Are Oral Tablets and Injectable Forms Suited For?
Choosing between oral and injectable forms depends on factors like patient preference and adherence needs.
Oral Tablets May Be Preferable For:
- Starting treatment: To evaluate response and tolerability.
- Adjusting dosage: Daily dosing allows for easier changes.
- Patients who prefer self-management.
Injectable Forms May Be Preferable For:
- Patients with adherence challenges.
- Preventing relapse: LAIs can be more effective long-term, especially for noncompliant patients.
- Maintaining stable drug levels: LAIs can reduce side effects linked to fluctuating levels.
Important Considerations and Potential Side Effects
Both forms have potential side effects. Common oral side effects include drowsiness and weight gain. More serious effects can occur with both, such as tardive dyskinesia, neuroleptic malignant syndrome, and metabolic changes. Injection site reactions are possible with LAIs. All paliperidone formulations carry a boxed warning about increased mortality in elderly patients with dementia-related psychosis and are not approved for this use.
Conclusion: Making the Right Choice with Your Doctor
Paliperidone is an antipsychotic available as the oral Invega® tablet for daily use and in various long-acting injectable forms. Each offers advantages, with oral providing daily consistency and injectables improving adherence through less frequent dosing. The decision should be made with a healthcare provider, considering individual needs and treatment goals. Paliperidone, as the active metabolite of risperidone, shares effects but has formulation and metabolic differences.
How Paliperidone Is Available
- Extended-release oral tablets (brand name Invega®).
- Long-acting injectable suspensions (Invega Sustenna® - monthly, Invega Trinza® - every 3 months, Invega Hafyera® - every 6 months).
- As the active metabolite of oral risperidone.
For more information on paliperidone, resources like the {Link: NAMI https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Paliperidone-(Invega)} are available.
