Name: Paliperidone

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Type: small molecule

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Groups: approved

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Indication: For the treatment of schizophrenia.

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Accession Number: DB01267 ( DB01267)

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Description: Paliperidone is the primary active metabolite of the older antipsychotic risperidone. While its specific mechanism of action is unknown, it is believed that paliperidone and risperidone act via similar if not the same pathways. It has been proposed that the drug's therapeutic activity in schizophrenia is mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism. Paliperidone is also active as an antagonist at alpha 1 and alpha 2 adrenergic receptors and H1 histaminergic receptors, which may explain some of the other effects of the drug. Paliperidone was approved by the FDA for treatment of schizophrenia on December 20, 2006.

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Structure:

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Prescription Products:

Name	Dosage	Strength	Route	Marketing Start	Marketing End	Country
Invega	tablet, extended release	6 mg/1	oral	19-12-2006		US
Invega	tablet, extended release	3 mg/1	oral	27-03-2013		US
Invega	tablet (extended-release)	12 mg	oral	01-01-1970		Canada
Invega	tablet, extended release	3 mg/1	oral	19-12-2006		US
Invega	tablet, extended release	6 mg/1	oral	19-12-2006		US
Invega	tablet, extended release	9 mg/1	oral	19-12-2006		US
Invega	tablet, extended release	1.5 mg/1	oral	10-09-2009		US
Invega	tablet, extended release	3 mg/1	oral	19-12-2006		US
Invega	tablet (extended-release)	3 mg	oral	02-10-2007		Canada
Invega	tablet (extended-release)	6 mg	oral	02-10-2007		Canada
Invega	tablet (extended-release)	9 mg	oral	02-10-2007		Canada
Invega Sustenna	suspension (extended-release)	50 mg	intramuscular	21-07-2010		Canada
Invega Sustenna	suspension (extended-release)	75 mg	intramuscular	21-07-2010		Canada
Invega Sustenna	suspension (extended-release)	100 mg	intramuscular	21-07-2010		Canada
Invega Sustenna	suspension (extended-release)	150 mg	intramuscular	21-07-2010		Canada
Invega Sustenna	injection	39 mg/.25mL	intramuscular	31-07-2009		US
Invega Sustenna	injection	78 mg/.5mL	intramuscular	31-07-2009		US
Invega Sustenna	injection	117 mg/.75mL	intramuscular	31-07-2009		US
Invega Sustenna	injection	156 mg/mL	intramuscular	31-07-2009		US
Invega Sustenna	injection	234 mg/1.5mL	intramuscular	31-07-2009		US
Invega Sustenna	suspension (extended-release)	25 mg	intramuscular	01-01-1970		Canada
Invega Trinza	injection, suspension, extended release	273 mg/.875mL	intramuscular	19-05-2015		US
Invega Trinza	injection, suspension, extended release	410 mg/1.315mL	intramuscular	19-05-2015		US
Invega Trinza	injection, suspension, extended release	546 mg/1.75mL	intramuscular	19-05-2015		US
Invega Trinza	injection, suspension, extended release	819 mg/2.625mL	intramuscular	19-05-2015		US
Paliperidone	tablet, extended release	1.5 mg/1	oral	29-09-2015		US
Paliperidone	tablet, extended release	3 mg/1	oral	01-03-2015		US
Paliperidone	tablet, extended release	1.5 mg/1	oral	24-09-2015		US
Paliperidone	tablet, extended release	3 mg/1	oral	24-09-2015		US
Paliperidone	tablet, extended release	6 mg/1	oral	24-09-2015		US
Paliperidone	tablet, extended release	9 mg/1	oral	24-09-2015		US

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Generic Prescription Products:

Name	Dosage	Strength	Route	Marketing Start	Marketing End	Country
Paliperidone	tablet, film coated, extended release	1.5 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	3 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	6 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	9 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	1.5 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	3 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	6 mg/1	oral	24-09-2015		US
Paliperidone	tablet, film coated, extended release	9 mg/1	oral	24-09-2015		US

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Over the Counter Products: Not Available

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International Brands

• No Brands

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Brand Names

• No Brands

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Brand Mixtures

Brand Name	Ingredients
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone

Brand Name	Ingredients
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega Trinza	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Paliperidone	Paliperidone
Paliperidone	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega Sustenna	Paliperidone
Invega	Paliperidone
Invega Sustenna	Paliperidone

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Categories

• Antipsychotic Agents

Indication: For the treatment of schizophrenia.

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Pharmacodynamics: Not Available

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Mechanism of action: Paliperidone is the major active metabolite of risperidone. The mechanism of action of paliperidone, as with other drugs having efficacy in schizophrenia, is unknown, but it has been proposed that the drug's therapeutic activity in schizophrenia is mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism.

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Absorption: The absolute oral bioavailability of paliperidone following paliperidone administration is 28%.

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Volume of distribution:

• 487 L

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Protein binding: The plasma protein binding of racemic paliperidone is 74%.

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Metabolism: Not Available

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Route of elimination: One week following administration of a single oral dose of 1 mg immediate-release 14C-paliperidone to 5 healthy volunteers, 59% (range 51% – 67%) of the dose was excreted unchanged into urine, 32% (26% – 41%) of the dose was recovered as metabolites, and 6% – 12% of the dose was not recovered.

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Half life: The terminal elimination half-life of paliperidone is approximately 23 hours.

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Clearance: Not Available

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Toxicity: The possibility of obtundation, seizures, or dystonic reaction of the head and neck following overdose may create a risk of aspiration with induced emesis.

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Affected organisms

• Not Available

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SNP Mediated Adverse Drug Reactions

• Not Available

Manufacturers:

• Not Available

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Packagers:

• Alza Corp.
• Interquim SA
• Janssen-Ortho Inc.
• Murfreesboro Pharmaceutical Nursing Supply
• Ortho Mcneil Janssen Pharmaceutical Inc.
• Physician Partners Ltd.
• Quality Care
• Rebel Distributors Corp.

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Dosage forms

Form	Route	Strength
Tablet (extended-release)	oral	12 mg
Tablet (extended-release)	oral	3 mg
Tablet (extended-release)	oral	6 mg
Tablet (extended-release)	oral	9 mg
Injection	intramuscular	117 mg/.75mL
Injection	intramuscular	156 mg/mL
Injection	intramuscular	234 mg/1.5mL
Injection	intramuscular	39 mg/.25mL
Injection	intramuscular	78 mg/.5mL
Suspension (extended-release)	intramuscular	100 mg
Suspension (extended-release)	intramuscular	150 mg
Suspension (extended-release)	intramuscular	25 mg
Suspension (extended-release)	intramuscular	50 mg
Suspension (extended-release)	intramuscular	75 mg
Injection, suspension, extended release	intramuscular	273 mg/.875mL
Injection, suspension, extended release	intramuscular	410 mg/1.315mL
Injection, suspension, extended release	intramuscular	546 mg/1.75mL
Injection, suspension, extended release	intramuscular	819 mg/2.625mL
Tablet, extended release	oral	1.5 mg/1
Tablet, extended release	oral	3 mg/1
Tablet, extended release	oral	6 mg/1
Tablet, extended release	oral	9 mg/1
Tablet, film coated, extended release	oral	1.5 mg/1
Tablet, film coated, extended release	oral	3 mg/1
Tablet, film coated, extended release	oral	6 mg/1
Tablet, film coated, extended release	oral	9 mg/1

Form	Route	Strength
Tablet (extended-release)	oral	12 mg
Tablet (extended-release)	oral	3 mg
Tablet (extended-release)	oral	6 mg
Tablet (extended-release)	oral	9 mg
Injection	intramuscular	117 mg/.75mL
Injection	intramuscular	156 mg/mL
Injection	intramuscular	234 mg/1.5mL
Injection	intramuscular	39 mg/.25mL
Injection	intramuscular	78 mg/.5mL
Suspension (extended-release)	intramuscular	100 mg
Suspension (extended-release)	intramuscular	150 mg
Suspension (extended-release)	intramuscular	25 mg
Suspension (extended-release)	intramuscular	50 mg
Suspension (extended-release)	intramuscular	75 mg
Injection, suspension, extended release	intramuscular	273 mg/.875mL
Injection, suspension, extended release	intramuscular	410 mg/1.315mL
Injection, suspension, extended release	intramuscular	546 mg/1.75mL
Injection, suspension, extended release	intramuscular	819 mg/2.625mL
Tablet, extended release	oral	1.5 mg/1
Tablet, extended release	oral	3 mg/1
Tablet, extended release	oral	6 mg/1
Tablet, extended release	oral	9 mg/1
Tablet, film coated, extended release	oral	1.5 mg/1
Tablet, film coated, extended release	oral	3 mg/1
Tablet, film coated, extended release	oral	6 mg/1
Tablet, film coated, extended release	oral	9 mg/1

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Prices

Unit description	Cost	Unit
Invega er 1.5 mg tablet	$15.72	tablet
Invega er 3 mg tablet	$23.09	tablet
Invega er 9 mg tablet	$23.59	tablet
Invega er 6 mg tablet	$28.62	tablet
Invega sustenna 39 mg pref syringe	$296.45	syringe

Unit description	Cost	Unit
Invega er 1.5 mg tablet	$15.72	tablet
Invega er 3 mg tablet	$23.09	tablet
Invega er 9 mg tablet	$23.59	tablet
Invega er 6 mg tablet	$28.62	tablet
Invega sustenna 39 mg pref syringe	$296.45	syringe

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Patents

Country	Patent Number	Approved	Expires (estimated)
2000786	Canada	1999-01-26	2009-10-16
2494234	Canada	2009-10-27	2023-07-28
5254556	United States	1993-10-27	2010-10-27
6555544	United States	1998-11-10	2018-11-10

Drug Interactions

Drug	Interaction
Acetohexamide	The therapeutic efficacy of Acetohexamide can be decreased when used in combination with Paliperidone.
Almotriptan	The risk or severity of adverse effects can be increased when Almotriptan is combined with Paliperidone.
Alogliptin	The therapeutic efficacy of Alogliptin can be decreased when used in combination with Paliperidone.
Amisulpride	The risk or severity of adverse effects can be increased when Paliperidone is combined with Amisulpride.
Amitriptyline	The risk or severity of adverse effects can be increased when Amitriptyline is combined with Paliperidone.
Amoxapine	The risk or severity of adverse effects can be increased when Amoxapine is combined with Paliperidone.
Amphetamine	Paliperidone may decrease the stimulatory activities of Amphetamine.
Azelastine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Azelastine.
Baclofen	The risk or severity of adverse effects can be increased when Baclofen is combined with Paliperidone.
Benzphetamine	Paliperidone may decrease the stimulatory activities of Benzphetamine.
Brimonidine	Brimonidine may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Bromocriptine	The therapeutic efficacy of Bromocriptine can be decreased when used in combination with Paliperidone.
Buprenorphine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.
Buspirone	The risk or severity of adverse effects can be increased when Buspirone is combined with Paliperidone.
Cabergoline	The risk or severity of adverse effects can be increased when Cabergoline is combined with Paliperidone.
Canagliflozin	The therapeutic efficacy of Canagliflozin can be decreased when used in combination with Paliperidone.
Carbamazepine	The serum concentration of Paliperidone can be decreased when it is combined with Carbamazepine.
Cathinone	Paliperidone may decrease the stimulatory activities of Cathinone.
Chlorpropamide	The therapeutic efficacy of Chlorpropamide can be decreased when used in combination with Paliperidone.
Citalopram	Citalopram may increase the QTc-prolonging activities of Paliperidone.
Clomipramine	The risk or severity of adverse effects can be increased when Clomipramine is combined with Paliperidone.
Cyclobenzaprine	The risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Paliperidone.
Desipramine	The risk or severity of adverse effects can be increased when Desipramine is combined with Paliperidone.
Desvenlafaxine	The risk or severity of adverse effects can be increased when Desvenlafaxine is combined with Paliperidone.
Dextroamphetamine	Paliperidone may decrease the stimulatory activities of Dextroamphetamine.
Dextromethorphan	The risk or severity of adverse effects can be increased when Dextromethorphan is combined with Paliperidone.
Dihydroergotamine	The risk or severity of adverse effects can be increased when Dihydroergotamine is combined with Paliperidone.
Dofetilide	Dofetilide may increase the QTc-prolonging activities of Paliperidone.
Donepezil	Donepezil may increase the central neurotoxic activities of Paliperidone.
Doxepin	The risk or severity of adverse effects can be increased when Doxepin is combined with Paliperidone.
Doxylamine	Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Dronabinol	Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Duloxetine	The risk or severity of adverse effects can be increased when Duloxetine is combined with Paliperidone.
Eletriptan	The risk or severity of adverse effects can be increased when Eletriptan is combined with Paliperidone.
Ergoloid mesylate	The risk or severity of adverse effects can be increased when Ergoloid mesylate is combined with Paliperidone.
Ergonovine	The risk or severity of adverse effects can be increased when Ergonovine is combined with Paliperidone.
Ergotamine	The risk or severity of adverse effects can be increased when Ergotamine is combined with Paliperidone.
Escitalopram	The risk or severity of adverse effects can be increased when Escitalopram is combined with Paliperidone.
Ethanol	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Ethanol.
Fentanyl	The risk or severity of adverse effects can be increased when Fentanyl is combined with Paliperidone.
Fluoxetine	The risk or severity of adverse effects can be increased when Fluoxetine is combined with Paliperidone.
Fluvoxamine	The risk or severity of adverse effects can be increased when Fluvoxamine is combined with Paliperidone.
Fosphenytoin	The serum concentration of Paliperidone can be decreased when it is combined with Fosphenytoin.
Frovatriptan	The risk or severity of adverse effects can be increased when Frovatriptan is combined with Paliperidone.
Galantamine	Galantamine may increase the central neurotoxic activities of Paliperidone.
Gliclazide	The therapeutic efficacy of Gliclazide can be decreased when used in combination with Paliperidone.
Glimepiride	The therapeutic efficacy of Glimepiride can be decreased when used in combination with Paliperidone.
Gliquidone	The therapeutic efficacy of Gliquidone can be decreased when used in combination with Paliperidone.
Glyburide	The therapeutic efficacy of Glyburide can be decreased when used in combination with Paliperidone.
Goserelin	Goserelin may increase the QTc-prolonging activities of Paliperidone.
Hydrocodone	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.
Imipramine	The risk or severity of adverse effects can be increased when Imipramine is combined with Paliperidone.
Insulin Aspart	The therapeutic efficacy of Insulin Aspart can be decreased when used in combination with Paliperidone.
Insulin Detemir	The therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Paliperidone.
Insulin Glargine	The therapeutic efficacy of Insulin Glargine can be decreased when used in combination with Paliperidone.
Insulin Glulisine	The therapeutic efficacy of Insulin Glulisine can be decreased when used in combination with Paliperidone.
Insulin Lispro	The therapeutic efficacy of Insulin Lispro can be decreased when used in combination with Paliperidone.
Insulin Regular	The therapeutic efficacy of Insulin Regular can be decreased when used in combination with Paliperidone.
Insulin, isophane	The therapeutic efficacy of Insulin, isophane can be decreased when used in combination with Paliperidone.
Isocarboxazid	The risk or severity of adverse effects can be increased when Isocarboxazid is combined with Paliperidone.
Itraconazole	Itraconazole may increase the QTc-prolonging activities of Paliperidone.
Ivabradine	Ivabradine may increase the QTc-prolonging activities of Paliperidone.
Leuprolide	Leuprolide may increase the QTc-prolonging activities of Paliperidone.
Levomilnacipran	The risk or severity of adverse effects can be increased when Levomilnacipran is combined with Paliperidone.
Linagliptin	The therapeutic efficacy of Linagliptin can be decreased when used in combination with Paliperidone.
Linezolid	The risk or severity of adverse effects can be increased when Linezolid is combined with Paliperidone.
Lisdexamfetamine	Paliperidone may decrease the stimulatory activities of Lisdexamfetamine.
Lithium	Lithium may increase the neurotoxic activities of Paliperidone.
Lorazepam	The risk or severity of adverse effects can be increased when Lorazepam is combined with Paliperidone.
Lorcaserin	The risk or severity of adverse effects can be increased when Lorcaserin is combined with Paliperidone.
Lumacaftor	The serum concentration of Paliperidone can be decreased when it is combined with Lumacaftor.
Magnesium Sulfate	Magnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Maprotiline	The risk or severity of adverse effects can be increased when Maprotiline is combined with Paliperidone.
Metformin	The therapeutic efficacy of Metformin can be decreased when used in combination with Paliperidone.
Methadone	The risk or severity of adverse effects can be increased when Methadone is combined with Paliperidone.
Methamphetamine	Paliperidone may decrease the stimulatory activities of Methamphetamine.
Methotrimeprazine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.
Methylphenidate	The risk or severity of adverse effects can be increased when Paliperidone is combined with Methylphenidate.
Metoclopramide	The risk or severity of adverse effects can be increased when Metoclopramide is combined with Paliperidone.
Metyrosine	Paliperidone may increase the sedative activities of Metyrosine.
Mifepristone	Mifepristone may increase the QTc-prolonging activities of Paliperidone.
Milnacipran	The risk or severity of adverse effects can be increased when Milnacipran is combined with Paliperidone.
Minocycline	Minocycline may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Moclobemide	The risk or severity of adverse effects can be increased when Moclobemide is combined with Paliperidone.
Nabilone	Nabilone may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Naratriptan	The risk or severity of adverse effects can be increased when Naratriptan is combined with Paliperidone.
Nefazodone	The risk or severity of adverse effects can be increased when Nefazodone is combined with Paliperidone.
Nortriptyline	The risk or severity of adverse effects can be increased when Nortriptyline is combined with Paliperidone.
Octreotide	Octreotide may increase the QTc-prolonging activities of Paliperidone.
Orphenadrine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
Paraldehyde	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
Paroxetine	The risk or severity of adverse effects can be increased when Paliperidone is combined with Paroxetine.
Perampanel	Perampanel may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Pethidine	The risk or severity of adverse effects can be increased when Pethidine is combined with Paliperidone.
Phendimetrazine	Paliperidone may decrease the stimulatory activities of Phendimetrazine.
Phenelzine	The risk or severity of adverse effects can be increased when Phenelzine is combined with Paliperidone.
Phenobarbital	The serum concentration of Paliperidone can be decreased when it is combined with Phenobarbital.
Phentermine	Paliperidone may decrease the stimulatory activities of Phentermine.
Phenytoin	The serum concentration of Paliperidone can be decreased when it is combined with Phenytoin.
Primidone	The serum concentration of Paliperidone can be decreased when it is combined with Primidone.
Procarbazine	The risk or severity of adverse effects can be increased when Procarbazine is combined with Paliperidone.
Promethazine	The risk or severity of adverse effects can be increased when Promethazine is combined with Paliperidone.
Protriptyline	The risk or severity of adverse effects can be increased when Protriptyline is combined with Paliperidone.
Quinagolide	The therapeutic efficacy of Quinagolide can be decreased when used in combination with Paliperidone.
Rasagiline	The risk or severity of adverse effects can be increased when Rasagiline is combined with Paliperidone.
Repaglinide	The therapeutic efficacy of Repaglinide can be decreased when used in combination with Paliperidone.
Rifampicin	The serum concentration of Paliperidone can be decreased when it is combined with Rifampicin.
Risperidone	The risk or severity of adverse effects can be increased when Risperidone is combined with Paliperidone.
Rivastigmine	Rivastigmine may increase the central neurotoxic activities of Paliperidone.
Rizatriptan	The risk or severity of adverse effects can be increased when Rizatriptan is combined with Paliperidone.
Rufinamide	The risk or severity of adverse effects can be increased when Rufinamide is combined with Paliperidone.
Saquinavir	The serum concentration of Paliperidone can be increased when it is combined with Saquinavir.
Saxagliptin	The therapeutic efficacy of Saxagliptin can be decreased when used in combination with Paliperidone.
Selegiline	The risk or severity of adverse effects can be increased when Selegiline is combined with Paliperidone.
Sertraline	The risk or severity of adverse effects can be increased when Sertraline is combined with Paliperidone.
Sodium oxybate	Sodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
St. John's Wort	The serum concentration of Paliperidone can be decreased when it is combined with St. John's Wort.
Sulpiride	The risk or severity of adverse effects can be increased when Paliperidone is combined with Sulpiride.
Sumatriptan	The risk or severity of adverse effects can be increased when Sumatriptan is combined with Paliperidone.
Suvorexant	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.
Tacrine	Tacrine may increase the central neurotoxic activities of Paliperidone.
Tapentadol	Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Tedizolid Phosphate	The risk or severity of adverse effects can be increased when Tedizolid Phosphate is combined with Paliperidone.
Tesmilifene	The serum concentration of Paliperidone can be decreased when it is combined with Tesmilifene.
Tetrabenazine	The risk or severity of adverse effects can be increased when Tetrabenazine is combined with Paliperidone.
Thalidomide	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
Tolbutamide	The therapeutic efficacy of Tolbutamide can be decreased when used in combination with Paliperidone.
Tramadol	The risk or severity of adverse effects can be increased when Tramadol is combined with Paliperidone.
Tranylcypromine	The risk or severity of adverse effects can be increased when Tranylcypromine is combined with Paliperidone.
Trazodone	The risk or severity of adverse effects can be increased when Trazodone is combined with Paliperidone.
Trimipramine	The risk or severity of adverse effects can be increased when Trimipramine is combined with Paliperidone.
Valproic Acid	The serum concentration of Paliperidone can be increased when it is combined with Valproic Acid.
Venlafaxine	The risk or severity of adverse effects can be increased when Venlafaxine is combined with Paliperidone.
Verapamil	The serum concentration of Paliperidone can be increased when it is combined with Verapamil.
Vilazodone	The risk or severity of adverse effects can be increased when Vilazodone is combined with Paliperidone.
Vildagliptin	The therapeutic efficacy of Vildagliptin can be decreased when used in combination with Paliperidone.
Vortioxetine	The risk or severity of adverse effects can be increased when Vortioxetine is combined with Paliperidone.
Zolmitriptan	The risk or severity of adverse effects can be increased when Zolmitriptan is combined with Paliperidone.
Zolpidem	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.

Drug	Interaction
Acetohexamide	The therapeutic efficacy of Acetohexamide can be decreased when used in combination with Paliperidone.
Almotriptan	The risk or severity of adverse effects can be increased when Almotriptan is combined with Paliperidone.
Alogliptin	The therapeutic efficacy of Alogliptin can be decreased when used in combination with Paliperidone.
Amisulpride	The risk or severity of adverse effects can be increased when Paliperidone is combined with Amisulpride.
Amitriptyline	The risk or severity of adverse effects can be increased when Amitriptyline is combined with Paliperidone.
Amoxapine	The risk or severity of adverse effects can be increased when Amoxapine is combined with Paliperidone.
Amphetamine	Paliperidone may decrease the stimulatory activities of Amphetamine.
Azelastine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Azelastine.
Baclofen	The risk or severity of adverse effects can be increased when Baclofen is combined with Paliperidone.
Benzphetamine	Paliperidone may decrease the stimulatory activities of Benzphetamine.
Brimonidine	Brimonidine may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Bromocriptine	The therapeutic efficacy of Bromocriptine can be decreased when used in combination with Paliperidone.
Buprenorphine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.
Buspirone	The risk or severity of adverse effects can be increased when Buspirone is combined with Paliperidone.
Cabergoline	The risk or severity of adverse effects can be increased when Cabergoline is combined with Paliperidone.
Canagliflozin	The therapeutic efficacy of Canagliflozin can be decreased when used in combination with Paliperidone.
Carbamazepine	The serum concentration of Paliperidone can be decreased when it is combined with Carbamazepine.
Cathinone	Paliperidone may decrease the stimulatory activities of Cathinone.
Chlorpropamide	The therapeutic efficacy of Chlorpropamide can be decreased when used in combination with Paliperidone.
Citalopram	Citalopram may increase the QTc-prolonging activities of Paliperidone.
Clomipramine	The risk or severity of adverse effects can be increased when Clomipramine is combined with Paliperidone.
Cyclobenzaprine	The risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Paliperidone.
Desipramine	The risk or severity of adverse effects can be increased when Desipramine is combined with Paliperidone.
Desvenlafaxine	The risk or severity of adverse effects can be increased when Desvenlafaxine is combined with Paliperidone.
Dextroamphetamine	Paliperidone may decrease the stimulatory activities of Dextroamphetamine.
Dextromethorphan	The risk or severity of adverse effects can be increased when Dextromethorphan is combined with Paliperidone.
Dihydroergotamine	The risk or severity of adverse effects can be increased when Dihydroergotamine is combined with Paliperidone.
Dofetilide	Dofetilide may increase the QTc-prolonging activities of Paliperidone.
Donepezil	Donepezil may increase the central neurotoxic activities of Paliperidone.
Doxepin	The risk or severity of adverse effects can be increased when Doxepin is combined with Paliperidone.
Doxylamine	Doxylamine may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Dronabinol	Dronabinol may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Duloxetine	The risk or severity of adverse effects can be increased when Duloxetine is combined with Paliperidone.
Eletriptan	The risk or severity of adverse effects can be increased when Eletriptan is combined with Paliperidone.
Ergoloid mesylate	The risk or severity of adverse effects can be increased when Ergoloid mesylate is combined with Paliperidone.
Ergonovine	The risk or severity of adverse effects can be increased when Ergonovine is combined with Paliperidone.
Ergotamine	The risk or severity of adverse effects can be increased when Ergotamine is combined with Paliperidone.
Escitalopram	The risk or severity of adverse effects can be increased when Escitalopram is combined with Paliperidone.
Ethanol	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Ethanol.
Fentanyl	The risk or severity of adverse effects can be increased when Fentanyl is combined with Paliperidone.
Fluoxetine	The risk or severity of adverse effects can be increased when Fluoxetine is combined with Paliperidone.
Fluvoxamine	The risk or severity of adverse effects can be increased when Fluvoxamine is combined with Paliperidone.
Fosphenytoin	The serum concentration of Paliperidone can be decreased when it is combined with Fosphenytoin.
Frovatriptan	The risk or severity of adverse effects can be increased when Frovatriptan is combined with Paliperidone.
Galantamine	Galantamine may increase the central neurotoxic activities of Paliperidone.
Gliclazide	The therapeutic efficacy of Gliclazide can be decreased when used in combination with Paliperidone.
Glimepiride	The therapeutic efficacy of Glimepiride can be decreased when used in combination with Paliperidone.
Gliquidone	The therapeutic efficacy of Gliquidone can be decreased when used in combination with Paliperidone.
Glyburide	The therapeutic efficacy of Glyburide can be decreased when used in combination with Paliperidone.
Goserelin	Goserelin may increase the QTc-prolonging activities of Paliperidone.
Hydrocodone	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.
Imipramine	The risk or severity of adverse effects can be increased when Imipramine is combined with Paliperidone.
Insulin Aspart	The therapeutic efficacy of Insulin Aspart can be decreased when used in combination with Paliperidone.
Insulin Detemir	The therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Paliperidone.
Insulin Glargine	The therapeutic efficacy of Insulin Glargine can be decreased when used in combination with Paliperidone.
Insulin Glulisine	The therapeutic efficacy of Insulin Glulisine can be decreased when used in combination with Paliperidone.
Insulin Lispro	The therapeutic efficacy of Insulin Lispro can be decreased when used in combination with Paliperidone.
Insulin Regular	The therapeutic efficacy of Insulin Regular can be decreased when used in combination with Paliperidone.
Insulin, isophane	The therapeutic efficacy of Insulin, isophane can be decreased when used in combination with Paliperidone.
Isocarboxazid	The risk or severity of adverse effects can be increased when Isocarboxazid is combined with Paliperidone.
Itraconazole	Itraconazole may increase the QTc-prolonging activities of Paliperidone.
Ivabradine	Ivabradine may increase the QTc-prolonging activities of Paliperidone.
Leuprolide	Leuprolide may increase the QTc-prolonging activities of Paliperidone.
Levomilnacipran	The risk or severity of adverse effects can be increased when Levomilnacipran is combined with Paliperidone.
Linagliptin	The therapeutic efficacy of Linagliptin can be decreased when used in combination with Paliperidone.
Linezolid	The risk or severity of adverse effects can be increased when Linezolid is combined with Paliperidone.
Lisdexamfetamine	Paliperidone may decrease the stimulatory activities of Lisdexamfetamine.
Lithium	Lithium may increase the neurotoxic activities of Paliperidone.
Lorazepam	The risk or severity of adverse effects can be increased when Lorazepam is combined with Paliperidone.
Lorcaserin	The risk or severity of adverse effects can be increased when Lorcaserin is combined with Paliperidone.
Lumacaftor	The serum concentration of Paliperidone can be decreased when it is combined with Lumacaftor.
Magnesium Sulfate	Magnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Maprotiline	The risk or severity of adverse effects can be increased when Maprotiline is combined with Paliperidone.
Metformin	The therapeutic efficacy of Metformin can be decreased when used in combination with Paliperidone.
Methadone	The risk or severity of adverse effects can be increased when Methadone is combined with Paliperidone.
Methamphetamine	Paliperidone may decrease the stimulatory activities of Methamphetamine.
Methotrimeprazine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.
Methylphenidate	The risk or severity of adverse effects can be increased when Paliperidone is combined with Methylphenidate.
Metoclopramide	The risk or severity of adverse effects can be increased when Metoclopramide is combined with Paliperidone.
Metyrosine	Paliperidone may increase the sedative activities of Metyrosine.
Mifepristone	Mifepristone may increase the QTc-prolonging activities of Paliperidone.
Milnacipran	The risk or severity of adverse effects can be increased when Milnacipran is combined with Paliperidone.
Minocycline	Minocycline may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Moclobemide	The risk or severity of adverse effects can be increased when Moclobemide is combined with Paliperidone.
Nabilone	Nabilone may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Naratriptan	The risk or severity of adverse effects can be increased when Naratriptan is combined with Paliperidone.
Nefazodone	The risk or severity of adverse effects can be increased when Nefazodone is combined with Paliperidone.
Nortriptyline	The risk or severity of adverse effects can be increased when Nortriptyline is combined with Paliperidone.
Octreotide	Octreotide may increase the QTc-prolonging activities of Paliperidone.
Orphenadrine	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.
Paraldehyde	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.
Paroxetine	The risk or severity of adverse effects can be increased when Paliperidone is combined with Paroxetine.
Perampanel	Perampanel may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Pethidine	The risk or severity of adverse effects can be increased when Pethidine is combined with Paliperidone.
Phendimetrazine	Paliperidone may decrease the stimulatory activities of Phendimetrazine.
Phenelzine	The risk or severity of adverse effects can be increased when Phenelzine is combined with Paliperidone.
Phenobarbital	The serum concentration of Paliperidone can be decreased when it is combined with Phenobarbital.
Phentermine	Paliperidone may decrease the stimulatory activities of Phentermine.
Phenytoin	The serum concentration of Paliperidone can be decreased when it is combined with Phenytoin.
Primidone	The serum concentration of Paliperidone can be decreased when it is combined with Primidone.
Procarbazine	The risk or severity of adverse effects can be increased when Procarbazine is combined with Paliperidone.
Promethazine	The risk or severity of adverse effects can be increased when Promethazine is combined with Paliperidone.
Protriptyline	The risk or severity of adverse effects can be increased when Protriptyline is combined with Paliperidone.
Quinagolide	The therapeutic efficacy of Quinagolide can be decreased when used in combination with Paliperidone.
Rasagiline	The risk or severity of adverse effects can be increased when Rasagiline is combined with Paliperidone.
Repaglinide	The therapeutic efficacy of Repaglinide can be decreased when used in combination with Paliperidone.
Rifampicin	The serum concentration of Paliperidone can be decreased when it is combined with Rifampicin.
Risperidone	The risk or severity of adverse effects can be increased when Risperidone is combined with Paliperidone.
Rivastigmine	Rivastigmine may increase the central neurotoxic activities of Paliperidone.
Rizatriptan	The risk or severity of adverse effects can be increased when Rizatriptan is combined with Paliperidone.
Rufinamide	The risk or severity of adverse effects can be increased when Rufinamide is combined with Paliperidone.
Saquinavir	The serum concentration of Paliperidone can be increased when it is combined with Saquinavir.
Saxagliptin	The therapeutic efficacy of Saxagliptin can be decreased when used in combination with Paliperidone.
Selegiline	The risk or severity of adverse effects can be increased when Selegiline is combined with Paliperidone.
Sertraline	The risk or severity of adverse effects can be increased when Sertraline is combined with Paliperidone.
Sodium oxybate	Sodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
St. John's Wort	The serum concentration of Paliperidone can be decreased when it is combined with St. John's Wort.
Sulpiride	The risk or severity of adverse effects can be increased when Paliperidone is combined with Sulpiride.
Sumatriptan	The risk or severity of adverse effects can be increased when Sumatriptan is combined with Paliperidone.
Suvorexant	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.
Tacrine	Tacrine may increase the central neurotoxic activities of Paliperidone.
Tapentadol	Tapentadol may increase the central nervous system depressant (CNS depressant) activities of Paliperidone.
Tedizolid Phosphate	The risk or severity of adverse effects can be increased when Tedizolid Phosphate is combined with Paliperidone.
Tesmilifene	The serum concentration of Paliperidone can be decreased when it is combined with Tesmilifene.
Tetrabenazine	The risk or severity of adverse effects can be increased when Tetrabenazine is combined with Paliperidone.
Thalidomide	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.
Tolbutamide	The therapeutic efficacy of Tolbutamide can be decreased when used in combination with Paliperidone.
Tramadol	The risk or severity of adverse effects can be increased when Tramadol is combined with Paliperidone.
Tranylcypromine	The risk or severity of adverse effects can be increased when Tranylcypromine is combined with Paliperidone.
Trazodone	The risk or severity of adverse effects can be increased when Trazodone is combined with Paliperidone.
Trimipramine	The risk or severity of adverse effects can be increased when Trimipramine is combined with Paliperidone.
Valproic Acid	The serum concentration of Paliperidone can be increased when it is combined with Valproic Acid.
Venlafaxine	The risk or severity of adverse effects can be increased when Venlafaxine is combined with Paliperidone.
Verapamil	The serum concentration of Paliperidone can be increased when it is combined with Verapamil.
Vilazodone	The risk or severity of adverse effects can be increased when Vilazodone is combined with Paliperidone.
Vildagliptin	The therapeutic efficacy of Vildagliptin can be decreased when used in combination with Paliperidone.
Vortioxetine	The risk or severity of adverse effects can be increased when Vortioxetine is combined with Paliperidone.
Zolmitriptan	The risk or severity of adverse effects can be increased when Zolmitriptan is combined with Paliperidone.
Zolpidem	Paliperidone may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.

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Food Interactions:

• Avoid alcohol.

Kingdom: Organic compounds

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Super Class: Not Available

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Class: Not Available

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Sub Class: Not Available

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Direct Parent: Not Available

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Alternative Parents:

• Aralkylamines
• Aryl fluorides
• Azacyclic compounds
• Benzisoxazoles
• Fluorobenzenes
• Heteroaromatic compounds
• Hydrocarbon derivatives
• Isoxazoles
• Lactams
• Organofluorides
• Oxacyclic compounds
• Oxazoles
• Piperidines
• Pyridines and derivatives
• Pyrimidones
• Secondary alcohols
• Trialkylamines

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substituent:

• Alcohol
• Amine
• Aralkylamine
• Aromatic heteropolycyclic compound
• Aryl fluoride
• Aryl halide
• Azacycle
• Azole
• Benzenoid
• Benzisoxazole
• Fluorobenzene
• Heteroaromatic compound
• Hydrocarbon derivative
• Isoxazole
• Lactam
• Organofluoride
• Organohalogen compound
• Organonitrogen compound
• Organooxygen compound
• Oxacycle
• Oxazole
• Piperidine
• Pyridine
• Pyridopyrimidine
• Pyrimidine
• Pyrimidone
• Secondary alcohol
• Tertiary aliphatic amine
• Tertiary amine

Synthesis Reference: Santiago Ini, Naama Chasid, Kobi Chen, Osnat Porter-Kleks, "Pure paliperidone and processes for preparing thereof." U.S. Patent US20080171876, issued July 17, 2008.

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General Reference: # Jones MP, Nicholl D, Trakas K: Efficacy and tolerability of paliperidone ER and other oral atypical antipsychotics in schizophrenia. Int J Clin Pharmacol Ther. 2010 Jun;48(6):383-99. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/20497747 # Urichuk L, Prior TI, Dursun S, Baker G: Metabolism of atypical antipsychotics: involvement of cytochrome p450 enzymes and relevance for drug-drug interactions. Curr Drug Metab. 2008 Jun;9(5):410-8. "Pubmed":http://www.ncbi.nlm.nih.gov/pubmed/18537577

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External Links:

Resource	Link
RxList	http://www.rxlist.com/cgi/generic/invega.htm
PDRhealth	http://www.pdrhealth.com/drugs/rx/rx-mono.aspx?contentFileName=inv1883.html&contentName=Invega&contentId=405
Drugs.com	http://www.drugs.com/cdi/paliperidone.html

Resource	Link
RxList	http://www.rxlist.com/cgi/generic/invega.htm
PDRhealth	http://www.pdrhealth.com/drugs/rx/rx-mono.aspx?contentFileName=inv1883.html&contentName=Invega&contentId=405
Drugs.com	http://www.drugs.com/cdi/paliperidone.html

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ATC Codes:

• Array

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AHFS Codes:

• 28:16.08.04

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MSDS: Download