What Strength is Trevicta? An Overview of Available Doses
Trevicta is a prolonged-release suspension containing the active substance paliperidone palmitate. It is administered every three months as an intramuscular injection by a healthcare professional. This long-acting formulation is intended for the maintenance treatment of schizophrenia in adult patients who have been clinically stable on the once-monthly paliperidone palmitate injectable (sold as Xeplion or Invega Sustenna).
The specific strengths of Trevicta are determined by the patient's previous monthly dose. The Trevicta dose is approximately 3.5 times the dose of the monthly injection. The four available strengths of Trevicta (paliperidone equivalent) are:
- One strength of Trevicta is used for patients previously on a lower monthly dose of Xeplion.
- Another strength is for those stabilized on a slightly higher monthly dose.
- A third strength is suitable for patients previously receiving a moderate monthly dose.
- The highest strength of Trevicta is intended for patients who were on the highest monthly dose of Xeplion.
Patients must be stable on the monthly formulation, preferably for at least four months, before transitioning to the 3-monthly injection.
Administering the Trevicta Injection
As a long-acting injectable, Trevicta must be administered by a healthcare professional. Proper technique is crucial to ensure the full dose is administered correctly.
Key considerations for administration include:
- Vigorous shaking: The syringe must be shaken vigorously for at least 15 seconds to ensure a homogeneous suspension before injection.
- Injection sites: The injection can be administered into either the deltoid (arm) or gluteal (buttock) muscle. Sites should be alternated between the left and right sides.
- Needle selection: The specific needle length and gauge depend on the injection site and patient's weight, to ensure proper intramuscular delivery.
- Dosing schedule: Trevicta is administered once every three months, with a flexible dosing window of plus or minus two weeks.
Comparison of Paliperidone Palmitate Formulations
While Trevicta offers the longest dosing interval, it is part of a family of paliperidone palmitate injections that differ in frequency. It is important to note that Trevicta is typically used for long-term maintenance in patients who have been stabilized on a shorter-acting version.
| Feature | Trevicta (3-month injection) | Xeplion / Invega Sustenna (1-month injection) | Invega (Oral tablet) |
|---|---|---|---|
| Dosing Frequency | Every 3 months (quarterly) | Once a month (monthly) | Once daily |
| Strengths | Available in four strengths determined by prior monthly dose | Available in several strengths | Available in several strengths |
| Primary Use | Long-term maintenance treatment after stabilization | Maintenance treatment and initial stabilization | Acute and maintenance treatment |
| Switching Protocol | Transition from monthly injection after stability is achieved | Can be used without oral stabilization in some cases | Can be initiated immediately, dose can be adjusted more quickly |
| Patient Commitment | Less frequent injections, but longer-lasting effects | More frequent injections required | Daily medication adherence is necessary |
The Pharmacology of Trevicta: How it Works
Trevicta is an antipsychotic medication, with its active ingredient, paliperidone, being the major active metabolite of risperidone. Paliperidone functions by blocking dopamine and 5-hydroxytryptamine (serotonin) receptors in the brain. This action helps to normalize brain activity and alleviate the symptoms associated with schizophrenia, such as hallucinations, delusions, and disorganized thinking.
The formulation of Trevicta involves attaching paliperidone to a fatty acid, which creates a long-acting ester. This ester is slowly hydrolyzed by the body after intramuscular injection, releasing paliperidone gradually over several months. This mechanism allows for a sustained therapeutic effect, reducing the need for daily medication and potentially improving treatment adherence.
Potential Side Effects and Treatment Management
Like all medications, Trevicta can cause side effects. Common side effects reported in clinical studies include headache, anxiety, difficulty sleeping (insomnia), injection site reactions (pain, redness, swelling), upper respiratory tract infections, and increased weight. Due to its prolonged action, side effects may last for several months. Close monitoring is essential during the transition to Trevicta. It is not advised for patients with moderate to severe kidney problems.
Conclusion
Understanding what strength is Trevicta is vital for both patients and healthcare providers. Trevicta is available in four specific strengths, with the dose determined by the patient's prior stability on a monthly paliperidone injection. Its 3-monthly administration schedule makes it a convenient and effective option for the maintenance treatment of schizophrenia, offering an alternative to more frequent dosing regimens for stable patients. As a long-acting injectable, it ensures consistent medication levels, potentially improving treatment adherence and long-term outcomes for those living with schizophrenia. For comprehensive details, patients should always refer to the official package leaflet or consult their doctor.
