Understanding the Perseris Injection
Perseris is a long-acting injectable (LAI) atypical antipsychotic medication used for the treatment of schizophrenia in adults. It is administered as a subcutaneous injection, meaning it goes under the skin, unlike intramuscular injections used for other LAIs. This is due to a unique technology that forms a depot (a small bump) under the skin, which continuously releases the medication over a month. Administration should only be done by a qualified healthcare professional following specific preparation and injection techniques. Before starting Perseris, a patient's tolerance to oral risperidone is typically established.
Preliminary Considerations
The Perseris kit, usually stored refrigerated, needs to reach room temperature for at least 15 minutes before mixing. The kit includes a liquid and a powder syringe that must be combined accurately to form the injectable suspension.
Step-by-Step Preparation and Handling Protocol
- Gather Supplies: Collect the Perseris kit, gloves, alcohol pads, and a sharps container.
- Allow to Acclimatize: Let the kit warm to room temperature (68°F to 77°F) for at least 15 minutes.
- Inspect Syringes: Verify the liquid and powder syringes for clarity and color.
- Mix the Contents: Connect the syringes and gently transfer the liquid into the powder syringe and back five times. Then, mix more vigorously for 55 cycles until a uniform suspension forms.
- Prepare the Injection Syringe: Transfer the mixture into the liquid syringe, then detach the empty powder syringe.
- Attach Needle: Securely attach the sterile safety needle to the liquid syringe.
Selecting and Preparing the Injection Site
Choosing and preparing the injection site correctly helps minimize irritation and ensures the medication depot forms properly. Approved sites include the abdomen and the back of the upper arm.
- Site Selection: Choose an area with sufficient subcutaneous tissue, free from skin issues like nodules or irritation.
- Avoid Irritated Skin: Do not inject into areas that are irritated, red, bruised, infected, or scarred.
- Site Rotation: Rotate the injection site monthly for long-term treatment.
- Cleaning: Clean the selected site with an alcohol pad.
The Injection Process
- Remove Excess Air: Hold the syringe upright and expel any air bubbles.
- Pinch the Skin: Gently pinch the skin to lift the subcutaneous tissue away from the muscle.
- Insert Needle: Insert the needle fully into the pinched subcutaneous tissue, usually at a 45-degree angle.
- Inject Medication: Inject the medication slowly and steadily.
- Withdraw and Dispose: Withdraw the needle at the insertion angle, lock the safety guard, and dispose of components in a sharps container. Do not rub the area.
Comparison of Risperidone Injectable Formulations
| Feature | Perseris (Risperidone) | Risperdal Consta (Risperidone) |
|---|---|---|
| Injection Route | Subcutaneous (under the skin) | Intramuscular (into the muscle) |
| Frequency | Once monthly | Every two weeks |
| Oral Overlap | No oral supplementation is required at initiation. | Requires oral risperidone for three weeks after the first injection. |
| Preparation | Requires mixing two syringe components after warming to room temperature. | Requires reconstitution of microspheres from powder with a diluent. |
| Injection Sites | Abdomen or back of upper arm. | Deltoid or gluteal muscle. |
| Depot Type | Subcutaneous tissue depot. | Muscle depot. |
| Post-Injection | A lump may be present for several weeks; do not rub. | A lump is not typically noted; massage may be discouraged. |
Patient Aftercare and Education
Patients should be informed about potential after-effects and care instructions:
- A temporary lump may appear at the injection site, which is normal and will disappear over time as the medication is absorbed.
- Advise patients not to rub or massage the injection site to ensure proper medication release from the depot.
- Caution patients to avoid tight clothing or items that could rub or put pressure on the injection site.
- Encourage reporting any side effects to a healthcare provider.
Conclusion
Precise administration is vital for Perseris to work effectively and safely. Healthcare providers must follow the detailed preparation and injection steps to ensure the subcutaneous depot forms correctly, providing a month-long release of risperidone. The subcutaneous method requires specific handling compared to other injectable antipsychotics. Educating patients on post-injection care is also crucial for treatment success. More detailed clinical guidance is available on the Perseris HCP website.
