What is Trevicta 525 used for?: Overview
Before taking any medication, it is essential to consult with a healthcare professional for accurate information and guidance.
Trevicta, which contains the active ingredient paliperidone palmitate, is primarily used for the long-term, or maintenance, treatment of schizophrenia in adult patients. It is administered as an intramuscular injection once every three months. It is important to note that Trevicta is not an initial treatment for schizophrenia. It is only prescribed to adults who have been clinically stabilized and treated with the once-monthly version of the same medication (known as Invega Sustenna or Xeplion). This makes it a convenient option for patients who require ongoing treatment but prefer fewer injections.
The convenience of a quarterly injection is designed to improve adherence to treatment, which is crucial for managing a long-term condition like schizophrenia. Poor medication adherence is a significant risk factor for relapse, and this long-acting formulation helps to ensure a consistent level of medication in the body over time.
How Trevicta 525 works in the brain
The efficacy of Trevicta stems from its active substance, paliperidone, which is an atypical antipsychotic. Paliperidone is the major active metabolite of risperidone, another well-known antipsychotic. Its mechanism of action involves interacting with specific neurotransmitter receptors in the brain:
- Dopamine (D2) receptor blockade: Paliperidone strongly binds to and blocks dopamine D2 receptors. In schizophrenia, an overactive dopamine system is associated with positive symptoms like hallucinations and delusions. By blocking these receptors, paliperidone helps to normalize brain activity and reduce these symptoms.
- Serotonin (5-HT2A) receptor blockade: The medication also binds strongly to serotonin 5-HT2A receptors. This serotonin antagonism is believed to contribute to its atypical profile and may help to reduce the risk of certain side effects, particularly extrapyramidal symptoms.
In Trevicta, the paliperidone is attached to a fatty acid, creating a prolonged-release formulation. Once injected, the medication is released slowly and steadily into the bloodstream over three months, maintaining a therapeutic level in the patient's system.
The Trevicta 525 administration process
Trevicta is an injectable medication that must be administered by a qualified healthcare professional. The process is specific to ensure correct delivery and effectiveness:
- Frequency and timing: The injection is given once every three months, within a flexible window of two weeks before or after the scheduled date.
- Injection site: It is administered intramuscularly, deep into either the deltoid muscle of the upper arm or the gluteal muscle of the buttocks. Injection sites are often alternated between sides to minimize discomfort.
- Preparation: The syringe must be shaken vigorously for at least 15 seconds to ensure the suspension is homogeneous before injection.
- Transitioning from monthly injection: When transitioning from the monthly injection, the healthcare provider will determine the appropriate Trevicta dose.
Side effects and precautions
Like all medications, Trevicta has potential side effects. Patients should discuss any concerns with their healthcare provider.
Common side effects
- Injection site reactions (pain, swelling, redness)
- Weight gain
- Headache
- Insomnia
- Anxiety
- Upper respiratory tract infections
Important precautions
- Dementia-related psychosis: Trevicta and similar medications are not approved for use in older adults with dementia-related psychosis due to an increased risk of stroke or death.
- Renal impairment: Patients with moderate or severe kidney problems should not use Trevicta. A dose adjustment may be required for those with mild renal impairment.
- Diabetes and hyperglycemia: The medication can affect blood sugar levels, so monitoring for hyperglycemia is necessary, especially for patients with a history of diabetes.
- Tardive Dyskinesia: A serious and potentially irreversible movement disorder can occur, particularly with high doses or long-term use. The risk increases with age.
- Cardiovascular risks: There is a risk of orthostatic hypotension (dizziness upon standing) and QT prolongation (an electrical abnormality of the heart).
- Pregnancy and breastfeeding: It is not recommended during pregnancy unless clearly necessary and should be avoided during breastfeeding.
Comparison of Paliperidone Long-Acting Injections
| Feature | Invega Sustenna (Monthly Injection) | Trevicta (3-Monthly Injection) |
|---|---|---|
| Injection Frequency | Once a month | Once every three months |
| Target Population | Adult patients with schizophrenia and schizoaffective disorder, can be used for initial treatment. | Adult patients with schizophrenia who are clinically stable on the monthly injection. |
| Mechanism | Contains paliperidone palmitate for sustained release over 1 month. | Contains paliperidone palmitate for sustained release over 3 months. |
| Transition | Can be started after an oral paliperidone test period, with a loading dose schedule. | Patients must be stabilized on the monthly injection for at least four months before switching. |
| Adherence | Improves medication adherence compared to oral medication. | Offers greater convenience and potential for even better adherence due to reduced frequency. |
| Cost | Less expensive than Trevicta due to lower concentration per dose. | Often more expensive per dose but potentially cost-effective in the long run for specific patients. |
Conclusion: The role of Trevicta 525 in managing schizophrenia
Trevicta plays a crucial role in the long-term management of schizophrenia for clinically stable adult patients. By providing a convenient, three-monthly injection, it offers a simplified treatment regimen that can significantly improve medication adherence compared to both daily oral medication and monthly injections. The long-acting formulation ensures a consistent level of the active medication, paliperidone, which helps prevent symptom relapse and promotes stability. While its use requires patients to first be stabilized on the monthly paliperidone injection, the transition offers a pathway to a less frequent dosing schedule. As with any antipsychotic, it is essential for patients to be monitored by a healthcare professional to manage potential side effects and ensure the treatment remains safe and effective. For more authoritative information, healthcare providers may refer to the European Medicines Agency (EMA) product information.
