Risperidone (Oral Route)

Risperidone is a behavioral medication that is used in the treatment of patients with bipolar disorder, schizophrenia and irritability associated with autistic disorder.

Overview

Risperidone is a behavioral drug that can be prescribed in the treatment of bipolar disorder, schizophrenia and for irritability related to autistic disorder in patients.

This medication is not suitable for the treatment of other behavioral problems, including in adults who have dementia.

Your doctor will prescribe this medication as Risperdal M-Tab or RisperiDONE M-Tab. The treatment is administered as a disintegrating tablet, as a tablet or as an oral solution.

Conditions Treated

  • Bipolar disorder
  • Schizophrenia
  • Autistic disorder, Irritability related to

Type of Medicine

  • Atypical antipsychotic

Side Effects

In addition to the desired effects of this medication, it can also have unwanted side effects on the patient. The patient should be alert to these side effects and in some cases may need to seek medical attention.

You should contact your doctor immediately if you experience any of the following side effects from the use of this treatment:

Occurring more commonly:

  • Aggressive behavior
  • Agitation or inability to rest
  • Anxiousness
  • Changes to vision that may include a blurring of vision
  • Difficulty in speaking
  • Difficulty in swallowing
  • Difficulty trying to concentrate
  • Inability to rotate the eyes
  • Increase in the volume or frequency of urine produced
  • Itching of the skin
  • Loss of usual control of balance
  • Masklike facial appearance
  • Muscle spasming affecting the face, neck and back
  • Problems or difficulty with urinating
  • Problems remembering things
  • Restlessness or need to keep moving and change position
  • Skin rash
  • Stiffness of the arms and/or legs
  • Tic-like movements or twitches
  • Trembling and/or shaking of the fingers and hands
  • Trouble sleep
  • Uncontrolled twisting body movement
  • Unusual shuffling walk
  • Weakness of the arms and/or legs

Occurring less commonly:

  • Back pains
  • Chest pains
  • Problems with speech
  • Sudden numbness of the face, arms or legs
  • Sudden weakness of the face, arms or legs
  • Vision problems

Occurring only rarely:

  • Clammy skin with pale appearance
  • Confusion or disorientation
  • Dizziness
  • Drowsiness
  • Extreme feelings of thirst
  • Headaches
  • Inappropriate erection of the penis
  • Increased thirstiness
  • Lip puckering
  • Loss of hunger
  • Muscle cramping
  • Painful or prolonged erection of the penis
  • Puffing out of the cheeks
  • Quick and shallow breath
  • Quick and weak heartbeat
  • Reduced coordination
  • Sense of excitement or activity that is uncontrollable
  • Shivering when warm
  • Uncontrolled chewing of the mouth
  • Uncontrolled tongue movements
  • Uncontrolled twists of the neck, trunk, arms or legs
  • Unusual bleeding
  • Unusual body positions
  • Unusual bruising
  • Unusual facial expressions

Other side effects can also occur that would not normally require the patient to seek medical attention. In some cases these side effects will abate over time as the body gets used to the treatment. If the following side effects become bothersome or are ongoing, however, then you can contact your doctor for advice on how to alleviate them:

Occurring more commonly:

  • Constipation
  • Coughing
  • Diarrhea
  • Dryness of the mouth
  • Headaches
  • Heartburn
  • Increase in dream activity
  • Increase in length of sleep
  • Nausea
  • Runny nose
  • Sleepiness
  • Soreness of the throat
  • Stuffy nose
  • Unusual drowsiness
  • Unusual tiredness
  • Unusual weakness
  • Weight gain

Occurring less commonly:

  • Body aches
  • Body pain
  • Cessation of menstrual bleeding
  • Changes to or loss of voice
  • Chills when warm
  • Congestion of the ear
  • Dandruff
  • Darkened coloration of skin
  • Decrease in interest in sexual intercourse
  • Decreased sexual ability or performance
  • Decreased sexual desire
  • Dryness of the skin
  • Feverishness
  • Inability to have an erection
  • Inability to keep an erection
  • Increased body movement or exaggeration of usual movements
  • Increased salivation of the mouth
  • Irregularity of usual menstrual periods
  • Joint pains
  • Oiliness of the skin
  • Shortness of breath
  • Sneezing
  • Stomach pains
  • Swollen or sore breasts
  • Tenderness surrounding the eyes and cheekbones
  • Tightness across the chest
  • Toothache
  • Troubled breathing
  • Unusual production of breast milk
  • Vomiting
  • Weight loss

It is also possible for other side effects that have not been listed herein to occur. If you experience other side effects then you should get in touch with your doctor for advice. If you believe that your health is at immediate risk, however, then you should always contact the emergency services to seek urgent medical attention.

Dosage

Risperidone should only ever be used as directed by a doctor. You should never use more than prescribed, take it more frequently than prescribed, or take it for a longer period than prescribed. Doing so will increase your chance of exposure to a wide range of side effects.

This medication can be taken with or without food.

Follow these instructions for use:

For the use of the oral solution:

  • Use the provided measuring equipment to select the correct dose.
  • Consume the medication direct from the measuring equipment. Ensure that you consume all of the measured liquid.
  • Drink a beverage straight after consumption of the medication.
  • Do not take this treatment with cola or tea.
  • Rinse the measuring equipment and return to storage case.
  • Ensure the medication is sealed and stored out of the reach of children.

For the use of the oral disintegrating tablet:

  • Keep medication in the original sealed packaging until you are ready to consume.
  • Separate one tablet by tearing along the perforations.
  • Bend the corner of the package and peel foil off.
  • Do not force the tablet through the foil as this may damage it.
  • Ensure your hands are dry and then remove the tablet.
  • Place disintegrating tablet directly and immediately on your tongue.
  • Swallow the tablet whole.
  • Do not chew or break the tablet.

The dose of medication that each patient takes will depend on the condition being treated and on other factors. You should never change the dose as prescribed by your doctor without being ordered to do so. The following information is a guideline only and should not be used for changing your dosing of Risperidone.

For oral dosage in all forms (Tablets, disintegrating tablets and solution):

For the treatment of bipolar disorder:

  • Adults – Initially 2-3mg once daily.

Dose may be adjusted to no more than 6mg taken daily.

  • Geriatric adults – Initially 0.5mg taken twice daily.

Dose may be adjusted to no more than 6mg taken daily.

  • Children aged between 10-17 – Initially 0.5mg once daily.

Dose may be adjusted to no more than 6mg taken daily.

  • Children aged below 10 – Use to be determined by the doctor.

For the treatment of irritability related to autistic disorder:

  • Children aged between 5-16 weighing more than 20kg – Initially 0.5mg once daily.

Dose may be adjusted by the doctor.

  • Children aged between 5-16 weighing less than 20kg – Initially 0.25mg once daily.

Dose may be adjusted by the doctor.

  • Children aged below 5 – Use to be determined by the doctor.

For the treatment of schizophrenia:

  • Adults – Initially 2mg once daily.

Dose may be adjusted to no more than 16mg taken daily.

  • Geriatric adults – Initially 0.5mg taken twice daily.

Dose may be adjusted to no more than 6mg taken daily.

  • Children aged between 13-17 – Initially 0.5mg once daily.

Dose may be adjusted to no more than 6mg taken daily.

  • Children aged below 13 – Use to be determined by the doctor.

If you miss a dose of this medication then you should take it as soon as you are able to. If, however, it is close to your next dose then you should skip the next dose and return to your schedule as usual. Never take a double dose to catch up as this will expose you to significant risk of experiencing unwanted side effects.

Interactions

Different medications taken at the same time can interact with one another in the body. In some cases they can react violently and cause serious medical implications in the patient. In other cases medications may prevent each other from working or may expose the patient to a greater risk or severity of side effects. As such it is vital that you inform your doctor of any and all medication that you take whether it is prescribed, an over the counter medication, a herbal remedy, or a vitamin supplement. All of these can interact with Risperidone. This is particularly important in the following cases, however, this list is not all-inclusive and has been selected only for severity.

The following medications are not recommended for use alongside Risperidone. Your doctor may choose not to prescribe Risperidone or may change one or more of the other medications you are taking:

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

The use of the following treatments would not usually be recommended in patients who are also taking Risperidone. In some cases you may be prescribed both by your doctor and this may still be the best treatment for you. Your doctor may wish to make changes to the dose you take or the frequency with which you use the medications:

  • Zuclopenthixol
  • Zotepine
  • Vinflunine
  • Vemurafenib
  • Vandetanib
  • Triptorelin
  • Trimipramine
  • Trimethoprim
  • Trifluoperazine
  • Tramadol
  • Tetrabenazine
  • Telithromycin
  • Tedisamil
  • Tapentadol
  • Tacrolimus
  • Sultopride
  • Sulpiride
  • Sulfamethoxazole
  • Sufentanil
  • Spiramycin
  • Sotalol
  • Simvastatin
  • Sevoflurane
  • Sertraline
  • Sertindole
  • Sematilide
  • Remifentanil
  • Quetiapine
  • Protriptyline
  • Propafenone
  • Prochlorperazine
  • Procainamide
  • Probucol
  • Pitolisant
  • Pimavanserin
  • Pentazocine
  • Pentamidine
  • Pazopanib
  • Pasireotide
  • Paroxetine
  • Panobinostat
  • Oxymorphone
  • Oxycodone
  • Ondansetron
  • Octreotide
  • Nortriptyline
  • Nafarelin
  • Moxifloxacin
  • Morphine Sulfate Liposome
  • Morphine
  • Milnacipran
  • Metronidazole
  • Meperidine
  • Mefloquine
  • Lorcainide
  • Lithium
  • Linezolid
  • Levofloxacin
  • Leuprolide
  • Ketoconazole
  • Ivabradine
  • Itraconazole
  • Imipramine
  • Ibutilide
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydroquinidine
  • Hydromorphone
  • Hydrocodone
  • Histrelin
  • Haloperidol
  • Halofantrine
  • Goserelin
  • Gonadorelin
  • Ginkgo Biloba
  • Gemifloxacin
  • Foscarnet
  • Fluoxetine
  • Fluconazole
  • Flecainide
  • Fentanyl
  • Escitalopram
  • Erythromycin
  • Enflurane
  • Encainide
  • Efavirenz
  • Droperidol
  • Doxepin
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dofetilide
  • Disopyramide
  • Dihydrocodeine
  • Dibenzepin
  • Deslorelin
  • Desipramine
  • Delamanid
  • Degarelix
  • Dabrafenib
  • Crizotinib
  • Codeine
  • Clarithromycin
  • Citalopram
  • Chlorpromazine
  • Chloroquine
  • Chloral Hydrate
  • Butorphanol
  • Buserelin
  • Bupropion
  • Buprenorphine
  • Bretylium
  • Azimilide
  • Astemizole
  • Asenapine
  • Arsenic Trioxide
  • Aripiprazole
  • Aprindine
  • Anagrelide
  • Amitriptyline
  • Amiodarone
  • Alfentanil
  • Ajmaline
  • Acecainide

Use of Risperidone alongside or in conjunction with the following medications will increase the risk of occurrence and severity of certain side effects. In some cases this may still be the best treatment for you and you may be prescribed both. Your doctor may wish to amend the doses that you take of one or other treatment and may wish to adjust the frequency of use:

  • Valproic Acid
  • Ritonavir
  • Ranitidine
  • Phenytoin
  • Phenobarbital
  • Midodrine
  • Methadone
  • Levorphanol
  • Lamotrigine
  • Fosphenytoin
  • Cimetidine
  • Carbamazepine

Medical conditions from which you suffer can also be affected by the use of this medication. In some cases medications for the treatment of certain conditions may negatively impact on other medical conditions from which they suffer. In other cases the presence of a medical condition can increase the side effects of a medication. You should inform your doctor of all medical conditions from which you suffer and from which you have suffered in the past before you receive a prescription of Risperidone. This is particularly important with the following conditions, however, this list has been selected for severity and other interactions may occur:

Do not use in patients who have:

  • Had an allergic reaction to paliperidone previously.

Side effects of Risperidone can be worsened in patients who suffer from:

  • Alzheimer's disease
  • Dehydration
  • History of heart attack
  • Heart disease
  • Blood vessel disease
  • History or irregular heart rhythm
  • Hypotension
  • Hypovolemia
  • History of stroke
  • Difficulty swallowing

The following conditions may be worsened by the use of Risperidone:

  • Blood problems
  • Bone marrow problems
  • Diabetes
  • Hyperglycemia
  • Hyperprolactinemia
  • History of neuroleptic malignant syndrome (NMS)
  • Parkinson disease
  • Priapism
  • History of seizures

Side effects of Risperidone may be increased because of a slower rate of removal from the body in patients with the following:

  • Kidney disease
  • Liver disease

Patients with the following condition should not use the oral disintegrating Risperidone tablets:

  • Phenylketonuria

Warnings

Before beginning use of this treatment the patient should consider all of the side effects, interactions and risks of use in relation to the benefits of use. This should be considered with your doctor and you should ensure that you have also considered the following factors:

Allergies

You should inform your doctor if you have ever reacted unusually to any medication. This is particularly important if you have previously reacted to paliperidone previously as this will make Risperidone unsuitable for your use. You should also inform your doctor of any allergies you have to dyes, preservatives, foods, animals and other substances.

Pediatric

Safety and efficiency has not been established for the following ages in the treatment of the following conditions:

  • Safety and efficiency unknown below the age of 13 for the treatment of schizophrenia
  • Safety and efficiency unknown below the age of 10 for the treatment of Bipolar disorder
  • Safety and efficiency unknown below the age of 5 for the treatment of autistic disorder

Discuss child use with your doctor before treatment begins.

Geriatric

Elderly patients are required to receive a smaller initial dose of treatment. While no age related limitations are known, it is likely that the elderly will have other medical conditions that may require adjustments to dosing or extra caution to be observed. Be alert for problems of the liver, heart, kidney and blood that may impact the use of Risperidone in elderly patients.

Pregnancy

It is unknown whether Risperidone is harmful to the development of children. Some tests on antipsychotic drugs have shown an impact on a developing fetus. You should weigh the benefits of use against the potential risk for your child and discuss this with your doctor. If you are pregnant before use then inform your doctor and if you believe you have become pregnant during use then you should inform your doctor right away. If you are already taking the treatment and wish to have a child then you should discuss options with your doctor.

Breastfeeding

No adequate studies to determine the risk of use have been carried out for Risperidone. You should discuss the risks and potential benefits with your doctor before use if you are nursing an infant.

During use of this treatment you should ensure that you make regular visits to your doctor to check that the treatment is working properly and to check for unwanted side effects. You may be required to undergo blood tests during use.

Neuroleptic malignant syndrome (NMS) can develop during treatment with this medication. If you experience the following symptoms of NMS then you should contact your doctor immediately:

  • Changed blood pressure
  • Difficulty breathing
  • High fever
  • Increased heartrate
  • Increased sweating in cool conditions
  • Loss of control of the bladder
  • Muscle stiffness
  • Paled skin
  • Tiredness

Tardie dyskinesia can develop during treatment with this medication. You should contact your doctor immediately if you experience any of the following symptoms:

  • Lip puckering
  • Lip smacking
  • Puffing cheeks
  • Rapid tongue movements
  • Uncontrolled arm movements
  • Uncontrolled chewing of the mouth
  • Uncontrolled leg movements

This medication can cause the body to carry more sugar in the blood. Diabetic patients should be aware of this and should inform their doctor of any changes to blood or urine tests. Patients who experience an increased level of thirst or frequency of urination should inform their doctor.

Risperidone can make the patient dizzy or less alert. This can be more pronounced when rising from a sitting or lying position. Alleviate this by rising slowly and inform your doctor if this condition becomes worse.

Remember that it is your legal responsibility to ensure that you are save to drive or operate machinery before doing so. If this medication makes you drowsy, dizzy or less alert than usual then you should not do so.

Risperidone can lower the count of white blood cells in the patient and in doing so exposes the patient to a greater risk of infection. You should avoid contact with people with infections for the first few weeks of treatment. You should contact your doctor straight away if you believe you have picked up an infection or are developing a cough or cold.

The use of Risperidone can affect your body’s ability to regulate temperature and cool you down. You should take extra care to prevent yourself from overheating from exercise or from hot weather. You should also take care not to become too cold as you may become drowsy or clumsy in the cold.

This medication may result in weight gain. Your doctor will need to weigh you regularly during use.

Do not stop use of this medication without talking to your doctor. This medication should always be reduced gradually before stopping. This will help to prevent a worsening of your condition from abrupt cessation of treatment.

This medication can make the affects of alcohol, antihistamines and depressants more potent. You should check with your doctor before taking any of these and you should limit the amount of alcohol that you consume during use.

Ensure that any doctor, dentist or surgeon is aware that you are taking this medication before you undergo any tests or treatment. This medication may affect results and may intensify the effects of anesthetics that they use.

The prolonged use of this medication may increase the levels of prolactin in your blood. This can result in the following symptoms and you should inform your doctor if you begin to experience them:

  • Breast soreness
  • Breast swelling
  • Decreased ability or performance sexually
  • Decreased desire for or interest in sexual intercourse
  • Inability to have or keep an erection
  • Irregularity of menstrual periods
  • Stopping of menstruation
  • Unusual breast milk production

You should never take any other medications unless you have first discussed them with your doctor. This medication can interact with a wide range of other medications and use of other treatment can cause severe side effects.

Storage

Keep this medication in a sealed container out of the reach of children at all times.

Keep this medication away from direct light, away from moisture and away from heat. Prevent from freezing at all times.

Disintegrating tablets should be kept in their original packaging until immediately before use.

Dispose of any unwanted or unnecessary medication properly as directed by your healthcare professional.

Summary

Risperidone is an atypical antipsychotic medication that is used in the treatment of certain behavioral disorders. It can be used in the treatment of bipolar disorder, schizophrenia and in irritability associated with autistic disorder.

This treatment is not suitable for other behavioral problems including those caused by the onset of dementia.

This treatment can be used in both children and adults for the treatment of these conditions.

Risperidone is a prescription medication that should only be taken as directed by the doctor. It is usually taken as a daily dose and patients should follow a close schedule to ensure the effects are as desired. The treatment is administered as a tablet, a disintegrating tablet or as a solution and can be taken with or without food. It should not be taken with cola or with tea.

Risperidone has a wide range of serious potential side effects that the patient should be aware of before beginning treatment. The patient should be alert to changes in the body and know what symptoms to look out for that may signal the development of other serious medical conditions.

This medication should not be abruptly stopped as this will potentially cause the condition of the patient to worsen dramatically. Patients who wish to cease use should talk to their doctor first and the treatment will be gradually reduced to avoid any sudden changes in the patient.

Risperidone interacts with a wide range of other medications and you should be certain to inform your doctor of all other treatments you are receiving before beginning this treatment. You should then also be sure to inform any doctors examining you or treating you in the future that you are taking Risperidone as it may impact tests and other treatments that they need to administer to you.

 

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Last Reviewed:
January 31, 2018
Last Updated:
January 27, 2018
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