Paliperidone (Oral)

It should not be used for treating behavioral problems in seniors or older adult patients with Alzheimer's disease or dementia.


Paliperidone is only available with the doctor's prescription. In the United States, paliperidone is sold under the following brand name:

  • Invega

Paliperidone is used for treating specific mood/mental disorders such as schizoaffective disorder and schizophrenia. It is responsible for decreasing hallucinations, hence helping you to think positively and more clearly about yourself. Also, it will help you feel less agitated and participate in the more active part of your everyday life.

It belongs to a group of class of drugs known as atypical antipsychotics that work by helping to restore the balance of particular natural substances in the brain.

Paliperidone is an antipsychotic medication which works by changing effects of chemicals in the brain. The use of this drug on psychotic conditions that are related to dementia is disapproved since it can increase the risk of death in the seniors or older adults who suffer from dementia-related conditions.

It is convenient for adults and teenagers with schizophrenia who are at least 12 years of age.

Paliperidone can also be used for other purposes not listed in the medication guide. Consult your doctor to learn more about the uses of this medicine.

Conditions Treated

Type Of Medicine

  • Atypical antipsychotics

Side Effects

Apart from the needed benefits of paliperidone, it may also pose some side effects. Although not all of the following unwanted effects may occur, if they do, they will need medical attention. Call your healthcare professional immediately if any of these side effects occur.

More common side effects:

  • Difficulty in speaking
  • Increased body movements
  • Drooling
  • Irregular, pounding or fast pulse or heartbeat
  • Nervousness or fear
  • Loss of balance control
  • Muscle stiffness trembling or jerking
  • Nausea
  • Uncontrollable movements, mainly of the neck, face, and back
  • Trouble in having a bowel movement
  • Restlessness
  • Stiffness of limbs
  • Shuffled walk
  • Twisting motions of the body
  • A headache
  • Vomiting
  • Inability to sit still

Less common side effects:

  • Chest pain
  • Muscle tightness or tension
  • Cold sweats
  • Mask-like face
  • Confusion
  • Fainting
  • A cough
  • Increased blood pressure
  • Difficulty with swallowing
  • Spasms of the eyelid or increased blinking
  • Dizziness
  • Loss of balance control
  • Unusual facial expressions
  • Excessive muscle tone
  • Slurred speech
  • Inability to move your eyes
  • Sticking out of the tongue
  • Slow heartbeat
  • Tremors
  • Shaking or trembling of the hands and fingers
  • Significant weakness or tiredness
  • Pain in the arms or legs
  • Trouble with swallowing, speaking or breathing
  • Slowed movements
  • Jerky movements of the mouth, face, head, and neck
  • Uncontrollable twisting movements of the arms, neck, trunk, or legs

Keep in mind that if the doctor has prescribed paliperidone tablets to you, it's because he/she has judged that the medical benefits of the drug outweigh its risk of side effects. Therefore many people using this medicine may not have serious side effects.

Paliperidone medication can rarely make your blood sugar rise, hence causing or worsening diabetes. Inform your doctor immediately if you have symptoms of high blood sugar (i.e. increased urination/thirst) If you already have diabetes, check your blood sugar level regularly as instructed and share your results with your doctor. He/she may want to change your diabetes medication, your diet or your exercise program.

Paliperidone can also lead to a rise in your blood cholesterol levels or a significant weight gain. These effects, together with diabetes can increase the chances of developing heart disease.

Rarely can this medication cause a condition called tardive dyskinesia. In some occasions, this problem can be permanent. Inform your doctor right away if you uncontrolled or unusual movements of the arms, legs, face, lips, tongue or mouth.

Males may experience a prolonged or painful erection that may last up to four hours or more. In such cases, stop using the medicine and seek medical help immediately, or permanent conditions could occur.

Paliperidone medication can increase a particular natural substance (prolactin) that is made by your body. For females, increased prolactin can lead to stopped/missed periods, unwanted breast milk, or difficulty in becoming pregnant. For males, it can lead to decreased sexual ability, enlarged breasts, or an inability to produce sperm. Talk your doctor right away if you develop any of these symptoms.

The side effects mentioned above is not the complete list of side effects that can occur in patients using paliperidone. If you witness unusual effects, call with your doctor at once for medical advice. Also, you may report the unwanted impacts to the FDA at 1-800-FDA-1088.


Paliperidone is available in the following dosage form:

  • Tablet, Extended Release

The dose of paliperidone will be different for different patients. Ensure you follow your doctor's instructions or the directions available on the label. The following dosage information includes the average doses of the drug. Therefore, if your dose is different, do not adjust it unless your doctor asks you to do so:

  • For adults 6 mg (milligrams) once per day, each morning. Some adults may need only 3 mg per day. The doctor can adjust your dose if necessary, but the dose never exceeds 12 mg per day.
  • For teenagers aged 12 to 17 and weigh 51 kg (112lbs) and above 3 mg once per day, each morning. The doctor may increase your dose if required, but the dose does not exceed 12 mg per day.
  • For teenagers aged 12 to 17, and weigh less than 51 kg 3 mg once per day, each morning. The doctor can change your dose if needed, but the dose never exceeds 6 mg per day.

The quantity of medicine that you use depends on the strength of the medication. Also, the number of doses you take per day, the time allocated between doses, and the length of time you take the medicine depend on the medical problem for which you are using the drug.

The extended-release tablet can be taken with or without food. Swallow it with a liquid (juice or water). Avoid crushing, breaking or chewing it. By so doing, you may release all of the drugs at once, hence increasing the chances of side effects.

Use this medication exactly as instructed by your healthcare professional. Do not take more of it, don't use it more often and don't use it longer than your doctor ordered. By so doing, it could increase the risk of side effects.

An empty tablet shell can appear in your stool. The effect is harmless since the body has already absorbed the medicine.

To get the most benefit of paliperidone, take it regularly. To help you remember, always take this drug at the same time each day. Even if you feel better before you complete your dose, it's important to continue using this medication to its full prescription course. Don't stop using the medicine unless your doctor advises you to do so. Talk to your doctor if the condition worsens or persists.

Missed Dose

If you forget using a dose of this medicine, it is important that you take it as soon as you think about it. However, if it's close enough to your next dose, skip the missed dose and resume your regular dosing schedule. Never double dose.


Supposing you overdose, and experience severe symptoms like troubled breathing or passing out, call 911. Also, you can call the poison control center immediately. Symptoms of overdose can include:

  • Severe dizziness/drowsiness
  • Irregular/fast heartbeat
  • Uncontrolled/unusual movements.

Never share your medicine with others since it may cause other medical issues. Since someone has the same symptoms as you have, it doesn't mean that they are suffering from the same condition as you are.


Some drugs are known to interact with each other. Therefore they should not be used together all. In some cases, the use of two different medicines may be encouraged even if interaction can occur. In these cases, the doctor may need to adjust the dose or consider other necessary precautions. When you are using paliperidone medication, it is very vital that your doctor knows if you are using any of the medicines listed below. The following interactions are not necessarily all-inclusive since they have been selected by their potential significance.

It is not recommended to use paliperidone with the following medicines. The doctor may, therefore, decide against treating you with this medication or adjust some of the other drugs you take;

  • Amifampridine
  • Pimozide
  • Amisulpride
  • Piperaquine
  • Bepridil
  • Saquinavir
  • Bromopride
  • Sparfloxacin
  • Cisapride
  • Terfenadine
  • Dronedarone
  • Thioridazine
  • Mesoridazine
  • Ziprasidone
  • Metoclopramide

Also, it's not recommended to use the following paliperidone with the following medicines, but in some cases, it may be required. If both drugs are prescribed together, the doctor can change your dose or how often you take one or both medicines:

  • Acecainide
  • Anagrelide
  • Ajmaline
  • Apomorphine
  • Alfentanil
  • Aripiprazole
  • Alfuzosin
  • Arsenic Trioxide
  • Amiodarone
  • Azithromycin
  • Artemether
  • Amitriptyline
  • Asenapine
  • Amoxapine
  • Azimilide
  • Bedaquiline
  • Butorphanol
  • Buprenorphine
  • Bretylium
  • Buserelin
  • Chlorpromazine
  • Chloroquine
  • Citalopram
  • Ciprofloxacin
  • Crizotinib
  • Clarithromycin
  • Codeine
  • Clozapine
  • Clomipramine
  • Cyclobenzaprine
  • Desipramine
  • Dabrafenib
  • Deslorelin
  • Dasatinib
  • Dihydrocodeine
  • Degarelix
  • Disopyramide
  • Delamanid
  • Dolasetron
  • Droperidol
  • Domperidone
  • Donepezil
  • Dofetilide
  • Escitalopram
  • Eliglustat
  • Efavirenz
  • Erythromycin
  • Fluoxetine
  • Fentanyl
  • Fluconazole
  • Flecainide
  • Fingolimod
  • Granisetron
  • Gatifloxacin
  • Gonadorelin
  • Gemifloxacin
  • Goserelin
  • Histrelin
  • Hydroxychloroquine
  • Haloperidol
  • Halofantrine
  • Hydrocodone
  • Hydroxyzine
  • Hydroquinidine
  • Hydromorphone
  • Ivabradine
  • Ibutilide
  • Imipramine
  • Iloperidone
  • Ketoconazole
  • Lumefantrine
  • Lapatinib
  • Levofloxacin
  • Leuprolide
  • Lopinavir
  • Moxifloxacin
  • Mefloquine
  • Morphine Sulfate Liposome
  • Meperidine
  • Morphine
  • Methadone
  • Mifepristone
  • Metronidazole
  • Nortriptyline
  • Nafarelin
  • Norfloxacin
  • Nilotinib
  • Oxymorphone
  • Octreotide
  • Ondansetron
  • Ofloxacin
  • Oxycodone
  • Protriptyline
  • Panobinostat
  • Propafenone
  • Pasireotide
  • Promethazine
  • Pazopanib
  • Prochlorperazine
  • Pentazocine
  • Pitolisant
  • Perflutren Lipid Microsphere
  • Procainamide
  • Pimavanserin
  • Posaconazole
  • Quetiapine
  • Quinine
  • Quinidine
  • Remifentanil
  • Ranolazine
  • Sodium Phosphate, Monobasic
  • Salmeterol
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Sematilide
  • Solifenacin
  • Sevoflurane
  • Sunitinib
  • Simeprevir
  • Sufentanil
  • Sulpiride
  • Sotalol
  • Sorafenib
  • Triptorelin
  • Tacrolimus
  • Trimipramine
  • Tapentadol
  • Trifluoperazine
  • Tedisamil
  • Trazodone
  • Telavancin
  • Tizanidine
  • Telithromycin
  • Tramadol
  • Tetrabenazine
  • Toremifene
  • Voriconazole
  • Vardenafil
  • Vandetanib
  • Vinflunine
  • Vemurafenib
  • Zuclopenthixol

Taking paliperidone with any of these medicines can lead to an increased risk of particular side effects, but the usage of both drugs can be the best treatment for you. Supposing both medications are prescribed together, your healthcare professional may adjust your dose or change how often you take one or both medicines:

  • Paroxetine
  • Carbamazepine

Some medicines cannot be used at or around the time of eating food or also eating certain types of food since it may cause an interaction. The use of alcohol or tobacco with some medicines can also make interactions to occur. Consult with your doctor the use of medications with food, alcohol, or tobacco.

The presence of other medical conditions can alter the use of this medicine. Ensure you open up to your doctor about any other medical problems, including;

Apart from the presence of this medical conditions affecting the use of paliperidone, they can also lead to serious health problems or severe side effects. Therefore use with caution.

The decision to use this medication is upon you and your doctor. The choice is determined by the benefits of the medicine weighed against the risks it can pose. For paliperidone, the following conditions should be considered when making this decision;

  • Allergies
  • Pediatric
  • Geriatric
  • Breastfeeding
  • Pregnancy


It's necessary for your doctor to check your progression with this medication at regular visits to ensure that the drug is working correctly for you. A blood test may be required to check for any side effects.

Stop using this medicine if you experience symptoms of a serious health condition known as the neuroleptic malignant syndrome (NMS). The symptoms may include:

  • Tiredness
  • Seizures
  • Abnormal pale skin
  • Difficulty with breathing
  • Severe muscle stiffness
  • Fast heartbeat
  • Loss of bladder control
  • High fever
  • Increased sweating
  • Low or high blood pressure

Paliperidone can lead to a movement disorder known as tardive dyskinesia. Seek medical attention if you experience the following side effects;

  • Puffing of the cheeks
  • Lip puckering or smacking
  • Uncontrollable chewing movements
  • Rapid movements of the tongue
  • Uncontrollable motions of the legs and arms

If you have diabetes, this medication can affect your blood sugar levels. If you experience increased urination or increased thirst, a change in your blood sugar test or a difference in the results of your urine, check with your doctor immediately.

You may experience lightheadedness, dizziness or fainting especially when you get up from a sitting or lying position suddenly. Getting up slowly might be a solution. If these effects worsen or continue to be bothersome, seek medical attention.

Paliperidone may temporarily lower the number of the white blood cells in your blood hence increasing the risk of getting an infection. Try to avoid people with infections if possible. Consult your doctor if you presume to get an infection or if you experience hoarseness or a cough, chills or a fever, side or lower back pain, and difficult or painful urination.

Some people may be affected by feeling irritable, agitated or they could display other abnormal behaviors with the use of this medication. Some may even have tendencies and suicidal thoughts or become more depressed. If you or child notices these side effects, make sure you talk to your doctor right away.

Paliperidone medication can decrease how much you sweat on a regular basis, hence making your body too hot. Therefore if your body gets too hot because of not sweating enough, you might feel weak, dizzy, confused or tired. You may have an upset stomach or even vomit. Avoid places that are hot and avoid getting too hot while exercising. If you are too hot and you cannot cool down, call your doctor for guidance.

You may experience an increase in body weight. Your healthcare professional may want to check your weight regularly while you or your child is on this medication.

Avoid using other medicines unless they have been prescribed your doctor. The other medications to be avoided includes prescription and nonprescription (over-the-counter [OTC]) medicines or herbal and vitamin supplements.

Before using this medicine, ensure you inform your pharmacists or doctor if you are allergic to paliperidone or if you have any other allergies. Paliperidone can contain inactive ingredients that can lead to allergic reactions or other health problems.

Paliperidone can cause a condition which affects the heart rhythm (QT prolongation). QT prolongation can rarely cause dangerous irregular/fast heartbeat and other effects(such as fainting, severe dizziness) which need immediate medical attention.

A patient taking this medication can be drowsy or dizzy. Therefore they should not be involved in those activities that need alertness such as using machinery or driving. Before engaging in such activities, ensure you are okay and that you can perform them safely. Avoid any alcoholic beverages.

Before getting any surgery including com/health/coma/">glaucoma/cataract eye surgery, inform your dentist or doctor if you are using or have ever used paliperidone medication, and about every other products you are using including herbal products, prescription drugs, and nonprescription drugs.

Seniors or older adults can be more sensitive to the unwanted effects of this medicine such as dizziness, drowsiness, lightheadedness or QT prolongation since they can have a high risk of falling.

Pregnant women should use this medication only when it is needed. There is a slight risk for babies who are born to the mothers who have used this drug during the last trimester to develop specific symptoms such as; drowsiness, muscle shakiness or stiffness, constant crying, or breathing/feeding difficulties. If you notice any of those symptoms in your newborn particularly during their first month, inform the doctor right away.

Breastfeeding mothers should avoid using paliperidone since the drug passes into the breast milk and can have unwanted effects on a nursing infant. Talk to your doctor before breastfeeding your baby.

Since untreated mood/mental problems (such as depression, schizophrenia, and schizoaffective disorders) may be a serious condition, don't stop taking your medication unless you are directed to do so by your doctor. If you are planning to be pregnant or suspect that you might be pregnant, talk to your doctor. Discuss with him/her the about both the benefits and the risks of using this medicine during pregnancy.

If your symptoms or your teenage child's symptoms don't improve or if they worsen, seek medical assistance.


Store this medication in the original closed container at room temperature, away from direct light or sunlight, away from excess heat and moisture (Do not store it in the bathroom). Keep it from freezing.

Keep all the medications out of reach of pets and children. Do not keep any medicine that is no longer in use or outdated medicine. Ask your pharmacists or the local waste disposal company about the proper way to dispose of medications that are not in use. Don't pour your medications into a drain or flush them down the toilet unless instructed to do so.


Paliperidone is an extended-release tablet to be taken orally for treating the symptoms of psychotic disorders such as schizophrenia. It works by changing the activities of some natural substances in the brain. The dose should be taken only by adults and teenagers not less than 12 years. Take your dosage of its fully prescribed course to avoid altering the purpose of this medicine. The medicine may also be used for other conditions not mentioned in the medical guide.

Apart from the benefits of this medication, it also has some well-known side effects and interactions with other medicines and dietary plans. You may be at risk of death if you are an elderly patient with dementia-related psychosis, do not use this medication. Seek medical attention if you experience any prolonged, stubborn and severe side effects while on this drug. Also, make sure you open up to your doctor about any medicines and dietary plans that you are using to get the best medical advice.