Risperidone (Intramuscular)

Risperidone is also known by US brand name Risperdal Consta and is an injection used in the treatment of schizophrenia and bipolar disorder.

Overview

Risperidone injection is a medication that is used to treat the symptoms of psychotic disorders, such as schizophrenia. It can be used alone or in combination with other medicines (e.g. valproate or lithium) to treat patients suffering from bipolar disorder. This medication should not be used to treat behavioral problems in older adults suffering from dementia. It works by controlling symptoms of disturbing behavior and agitation associated with mania and schizophrenia.This medication is only available via a prescription from your doctor and is available in the dosage form powder for suspension and extended release.

Condition(s) treated?

  • Schizophrenia

Type of medicine?

  • Injection

Side Effects

Along with its intended effects, there can be some unwanted side effects associated with taking risperidone. Not all of these side effects may be present, but if they are, they may require medical attention.

Inform your doctor or a healthcare professional urgently if you suffer from any of the following side effects while taking Risperidone.

More common side effects

  • Agitation

Less common side effects

Rare side effects

Some side effects that occur usually don't require medical attention. You may find that your symptoms improve as your body begins to adjust to the medication. If, however, the side effects are causing problems in day-to-day life, you should contact your local pharmacist or doctor for information on ways to prevent or ease the side effects. Remember you can report all side effects to the FDA on 1-800-FDA-1088.

More common side effects

Less common side effects

  • Absent, missed, or irregular menstrual periods

Dosage

The final dosage of all medications will depend on a number of circumstances. Your age, weight, and height, how you react to the first dose, the condition you are being treated for, how severe the condition is and any current medications you are currently taking. The following doses are typical of what is usually given for treatment. You should never stop, start or change a dose without consulting with a healthcare professional or your doctor beforehand.

Typical Adult Dose for Schizophrenia

Long lasting IM injection

For those who haven't taken the oral risperidone, it is recommended to establish individual tolerability levels with the oral formulation before starting treatment with long-acting injection.

Begin with an initial dose of 25 mg IM every two weeks

Titration dose: The dose can be increased to 37.5 mg or 50 mg if required. Note that dose titration should occur no more than every four weeks as expected drug release starts three weeks after injection.

The maximum dose given should be no more than 50 mg IM every two weeks.

  • This drug should be administered by a healthcare professional as a gluteal injection or deep IM deltoid. It cannot be administered via IV.

Typical Adult Dose for Bipolar Disorder

Long-acting IM Injection

For those who haven't taken the oral risperidone, it is recommended to establish individual tolerability levels with the oral formulation before starting treatment with long-acting injection.

Begin with an initial dose of 25 mg IM every two weeks

Titration dose: The dose can be increased to 37.5 mg or 50 mg if required. Note that dose titration should occur no more than every four weeks as expected drug release starts three weeks after injection.

The maximum dose given should be 50 mg IM every two weeks.

  • This drug should be administered by a healthcare professional as a gluteal injection or deep IM deltoid. It cannot be administered via IV.

Typical Geriatric Dose for Schizophrenia

Begin with an initial dose of 25 mg IM every two weeks

Titration dose: The dose can be increased to 37.5 mg or 50 mg if required. Note that dose titration should occur no more than every four weeks as expected drug release starts three weeks after injection.

The maximum dose given should be no more than 50 mg IM every two weeks.

Typical Geriatric Dose for Bipolar Disorder

Begin with an initial dose of 25 mg IM every two weeks

Titration dose: The dose can be increased to 37.5 mg or 50 mg if required. Note that dose titration should occur no more than every four weeks as expected drug release starts three weeks after injection.

The maximum dose given should be 50 mg IM every two weeks

Interactions

Drug interactions can cause unwanted side effects or lessen the effectiveness of either drug. To prevent these interactions, it's important that you inform your healthcare professional or a doctor of all the different medications you are currently taken and have taken in the past. This includes prescription/non-prescription drugs, vitamins, and herbal remedies. You should also inform your doctor of any other medical conditions you suffer from, have suffered from, or run in your family history.

The use of this medication alongside any of the following drugs is not recommended. Your doctor may decide to avoid treating you with this drug or change some of the other medications you are currently taking.

  • Amisulpride

The use of this medication alongside any of the following medications is not usually recommended. However, in some cases, it may the best treatment for you. In this case, your doctor may alter your dose or change the frequency in which you use either medication.

  • Acecainide

The use of this medication alongside any of the following medications could cause an increased risk of side effects, but sometimes it's the best treatment choice for you. If both these medications are prescribed together, your doctor may alter the dose or change the frequency of when you use one or the other.

  • Carbamazepine

Over 1,000 drugs can react with this medication. Some of them are listed below. This list is not complete. You should let your doctor know if you are taking any of the following drugs:

  • Abarelix

The presence of other medical conditions can affect the use of this medication. Ensure you inform your doctor if you suffer from any other medical conditions, including:

  • Allergic reaction to paliperidone (Invega®)

Warnings

Use in pediatric population

Studies have not been conducted on the relationship of age to the effects of risperidone injection on the pediatric population. Therefore efficacy and safety have not been established.

Use in geriatric population

Older patients may be more sensitive to the effects of risperidone. This can increase the chance of side effects occurring during treatment. This medication should not be used to treat behavioral problems in older adults who suffer from dementia.

Studies conducted to date have not indicated any geriatric-specific problems that could limit the effectiveness of risperidone injection in the geriatric population. However, older patients are more likely to have age-related heart problems, which may require extra caution and dose adjustments for those patients receiving this injection.

Use during pregnancy and breastfeeding

This drug is under FDA pregnancy category C.

Taking any antipsychotic medication during the last three months of pregnancy can cause issues with the newborn, such as breathing problems, withdrawal symptoms, feeding problems, tremors, fussiness and stiff or limp muscles. However, you may experience other problems including withdrawal symptoms if you stop taking your medication during pregnancy. If you fall pregnant while taking this medication, do not stop taking it without speaking with a doctor or healthcare professional first.

With regards to breastfeeding an infant, risperidone can pass into breast milk and could cause side effects in the nursing infant. Therefore you should not breastfeed your baby whilst on this medication.

Use during pregnancy and breastfeeding

This drug is under FDA pregnancy category C.

Taking any antipsychotic medication during the last three months of pregnancy can cause issues with the newborn, such as breathing problems, withdrawal symptoms, feeding problems, tremors, fussiness and stiff or limp muscles. However, you may other problems including withdrawal symptoms if you stop taking your medication during pregnancy. If you fall pregnant while taking this medication, do not stop taking it without speaking with a doctor or healthcare professional first.

With regards to breastfeeding an infant, risperidone can pass into breast milk and could cause side effects in the nursing infant. Therefore you should not breastfeed your baby while on this medication.

Risperidone can impair your reactions or thinking. You should be careful when conducting any activities that require you to be alert, such as driving.

Avoid getting up too fast from a lying or sitting position as you may feel dizzy. Severe drowsiness or dizziness can cause fractures, falls, or other injuries.

Avoid drinking alcohol at all costs. This could lead to dangerous side effects.

When you are taking this drug, you may find you are more sensitive to temperature extremes such as very cold or hot conditions. Avoid becoming overheated and dehydrated or becoming too cold. Drink plenty of fluids, especially when exercising and in hot weather.

Storage

This injection should be stored in a refrigerator and protected from light. It can be un-refrigerated at temperatures that don't exceed 25ºC for any longer than a period of one week.

Once this solution has been reconstituted, it must be used immediately. Physical and chemical stability has been demonstrated for 24 hours at 25ºC.

Summary

When used correctly, risperidone is successful in the treatment of a variety of psychotic disorders. Do note, however, that there are many drugs and other conditions that interact with the effectiveness of this drug and produce harmful side effects. It's therefore important that you inform your doctor of everything you are currently taking and have taken. The safety of this drug has not been established in those under 13 years old. You should discuss with your doctor if you fall pregnant whilst taking this medication and you should not breastfeed whilst taking risperidone.