What are the different types of Invega? An Overview of Oral and Injectable Forms

October 11, 2025 •

4 min read

Over 95% of patients in one clinical trial adhered to their prescribed long-acting injectable Invega Sustenna regimen, highlighting the benefits of less frequent dosing over daily oral medication. What are the different types of Invega? This article details the oral extended-release tablets and the various long-acting injectable versions.

Quick Summary

Invega, an atypical antipsychotic medication, is available as an oral tablet and three distinct long-acting injectable formulations. These include the once-monthly Sustenna, the quarterly Trinza, and the twice-yearly Hafyera.

Key Points

Oral vs. Injectable Invega: The medication is available as a daily extended-release oral tablet (Invega) and three long-acting injectable (LAI) suspensions (Sustenna, Trinza, and Hafyera).
Invega Sustenna: This once-monthly injection is often the starting point for LAI therapy and is used for both schizophrenia and schizoaffective disorder.
Invega Trinza: Administered every three months, this option is for patients stable on once-monthly Sustenna and is approved only for schizophrenia.
Invega Hafyera: The twice-yearly formulation is for patients who have been adequately treated with and tolerated either Sustenna or Trinza.
Improved Adherence: The long-acting injectable forms can significantly improve medication adherence and lower relapse rates compared to daily oral medication.
Required Prior Treatment: To progress to the longer-acting Trinza or Hafyera injections, a patient must be stabilized on a shorter-acting version first.
Administration Method: All injectable versions are administered by a healthcare professional into a muscle, either the arm (deltoid) or buttocks (gluteal).

The medication Invega is an atypical antipsychotic prescribed to treat conditions such as schizophrenia and schizoaffective disorder. The active ingredient, paliperidone, is a metabolite of the antipsychotic risperidone. The different types of Invega are categorized primarily by their method of administration and how long their therapeutic effect lasts. This is achieved through various formulations of paliperidone, including an oral extended-release tablet and several long-acting injectable (LAI) forms known as paliperidone palmitate.

Oral Invega: The Extended-Release Tablet

The most straightforward form of the medication is the oral extended-release tablet, simply called Invega. This tablet is taken once daily, with or without food. Because it is an extended-release formulation, it is designed to release the medication slowly into the body over 24 hours, ensuring a consistent therapeutic level of paliperidone in the bloodstream. Oral Invega is often prescribed initially to determine a patient's tolerance to the medication before considering a switch to one of the longer-acting injectable options.

The Long-Acting Injectable (LAI) Versions

The injectable versions of Invega utilize a chemical compound called paliperidone palmitate, which is a prodrug that is slowly broken down by the body into the active paliperidone over an extended period. This provides a sustained therapeutic effect, eliminating the need for daily pills and addressing potential issues with medication adherence. The three primary LAI types are Invega Sustenna, Invega Trinza, and Invega Hafyera, each with a different dosing interval.

Invega Sustenna: Once-Monthly Injection

Invega Sustenna was the first long-acting injectable version of Invega to be approved. It is administered once a month by a healthcare professional via intramuscular injection into the deltoid (arm) or gluteal (buttock) muscle. To achieve stable therapeutic levels quickly, the treatment is initiated with two loading doses, given one week apart. Sustenna is approved for the treatment of both schizophrenia and schizoaffective disorder.

Invega Trinza: Once-Every-Three-Months Injection

For patients who have been adequately treated with Invega Sustenna for at least four months and have demonstrated good tolerance, a healthcare provider may transition them to Invega Trinza. This injectable is administered once every three months, offering patients an even less frequent dosing schedule. Trinza is only approved for treating schizophrenia, not schizoaffective disorder.

Invega Hafyera: Once-Every-Six-Months Injection

Invega Hafyera represents the longest-acting formulation, requiring administration only once every six months. This option is only available for patients who have already been treated with and tolerated either Invega Sustenna for at least four months or Invega Trinza for at least one three-month cycle. Like Trinza, Hafyera is indicated solely for the treatment of schizophrenia.

Advantages of Long-Acting Injectables

Long-acting injectable antipsychotics offer significant advantages, particularly for individuals who struggle with daily medication routines. Studies have shown that patients on LAIs experience a lower risk of relapse compared to those on daily oral medication. This is often due to improved treatment adherence, as the injections are administered by a healthcare professional, ensuring consistent dosing. The reduced frequency of medication administration can also lead to increased patient autonomy and a greater sense of control over their treatment.

Comparison of Invega Formulations


Feature	Oral Invega	Invega Sustenna	Invega Trinza	Invega Hafyera
Dosing Frequency	Once daily	Once monthly	Once every 3 months	Once every 6 months
Active Ingredient	Paliperidone	Paliperidone palmitate	Paliperidone palmitate	Paliperidone palmitate
Indications	Schizophrenia and schizoaffective disorder	Schizophrenia and schizoaffective disorder	Schizophrenia only	Schizophrenia only
Administration	Oral tablet	Intramuscular injection	Intramuscular injection	Intramuscular injection
Required Prior Treatment	None	None (initiating LAI therapy)	At least 4 months of Invega Sustenna	At least 4 months of Sustenna or 1 cycle of Trinza

Key Considerations for Choosing an Invega Type

The decision regarding which Invega formulation is right for a patient is a clinical one, made in consultation with a healthcare provider. Factors to consider include:

Patient Preference: Some patients may prefer the simplicity of a daily pill, while others may favor the reduced frequency of an injection.
Treatment Adherence History: For individuals with a history of struggling to take daily medication, a long-acting injection can be a more reliable option.
Disease Stability: The longer-acting injections, Trinza and Hafyera, are only for patients who have already been stabilized on shorter-acting forms.
Potential Side Effects: While all forms share similar potential side effects, individual tolerance and response vary. The slower release of injectable forms can sometimes lead to different side effect profiles, including injection-site reactions.
Contraindications: Invega formulations are not approved for elderly patients with dementia-related psychosis due to an increased risk of death.

Conclusion

Invega is available in four different types to suit the varying needs of patients with schizophrenia and schizoaffective disorder. The oral extended-release tablet provides a daily dosing schedule, while the long-acting injectable forms—Sustenna, Trinza, and Hafyera—offer once-monthly, quarterly, and twice-yearly options, respectively. The longer-acting formulations are particularly beneficial for improving medication adherence and reducing the risk of relapse for stabilized patients. Ultimately, the choice of the most appropriate Invega type is a collaborative decision between a patient and their healthcare provider, weighing the pros and cons of each formulation to achieve the best possible treatment outcomes. For more detailed information on specific side effects and administration, consulting official prescribing information is recommended, such as that provided by the Mayo Clinic.

Frequently Asked Questions

Invega oral tablets are taken daily. Invega Sustenna is injected once a month, Invega Trinza is injected once every three months, and Invega Hafyera is injected twice a year, or once every six months.

Invega oral tablets and the once-monthly Invega Sustenna injection are both approved for treating schizoaffective disorder. The longer-acting Invega Trinza (quarterly) and Invega Hafyera (twice-yearly) are indicated only for schizophrenia.

A patient must be adequately treated and stabilized on a shorter-acting formulation before transitioning. To switch to Invega Trinza, a patient must be stable on Invega Sustenna for at least 4 months. To switch to Invega Hafyera, a patient must be stable on Sustenna for at least 4 months or Trinza for at least one three-month cycle.

The 'better' option is highly individual. Injectable forms can greatly improve adherence and reduce relapse risk, but require a clinical setting for administration. Oral tablets offer more dosing flexibility but require consistent daily self-administration. Patient preference, medication adherence history, and medical advice all factor into the decision.

All injectable versions of Invega must be administered by a healthcare professional, such as a doctor or nurse, in a clinical setting like a doctor's office, clinic, or hospital.

Forgetting a dose of injectable Invega should be addressed with a healthcare provider immediately. Depending on the specific medication (Sustenna, Trinza, or Hafyera) and the timing of the missed dose, the healthcare provider will determine the appropriate steps, which may involve a specific schedule to resume therapy.

Invega is the brand name, while paliperidone is the active ingredient. The oral tablet contains paliperidone, and the long-acting injectable versions (Sustenna, Trinza, and Hafyera) contain paliperidone palmitate, a compound that releases paliperidone over time.