Invega Sustenna

Invega Sustenna is a prescription medication used for the treatment of schizophrenia and schizoaffective disorder. Invega Sustenna belongs to a group of drugs called atypical antipsychotics. It may work by changing the activity of certain natural substances in the brain.

This medication is available in an injectable form to be given directly into a muscle (IM) by a healthcare professional. It is given once, then one week later, than every month thereafter.

Invega Sustenna is a prescription medication used in the treatment of schizophrenia and schizoaffective disorder.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Janssen Pharmaceuticals, Inc.

Invega Sustenna may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness
• extreme tiredness
• weakness
• headache
• dry mouth
• increased saliva
• weight gain
• stomach pain
• injection site reactions

Some side effects can be serious. If you experience any of these, call your doctor immediately:

• fever
• muscle pain or stiffness
• confusion
• fast, pounding, or irregular heartbeat
• sweating
• unusual movements of your face or body that you cannot control
• slow or stiff movements
• restlessness
• painful erection of the penis that lasts for hours

Invega Sustenna may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Some medicines may interact with Invega Sustenna which may increase side effects, and increase or decrease the action of either drug. Your doctor may need to change the doses of your medicines or carefully monitor for side effects if you are taking medicines that interact with Invega Sustenna.

Tell your doctor about the medicines you take including prescription and nonprescription medications, vitamins, nutritional supplements, and herbal supplements. Especially tell your doctor if you take:

• antidepressants
• certain antibiotics such as erythromycin (E.E.S., E-Mycin, Erythrocin), and moxifloxacin (Avelox)
• certain antipsychotics such as chlorpromazine (Thorazine), pimozide (Orap), risperidone (Risperdal) and thioridazine
• levodopa (in Sinemet, in Stalevo)
• medications for anxiety
• high blood pressure medicines 
• medications for seizures
• medications for irregular heartbeat such as amiodarone (Cordarone), disopyramide (Norpace), dofetilide (Tikosyn), procainamide (Procanbid, Pronestyl), quinidine (Quinidex), and sotalol (Betapace, Betapace AF)
• sedatives
• sleeping pills
• tranquilizers

• Invega Sustenna has caused some rare, but serious side effects including Neuroleptic Malignant Syndrome (NMS), Tardive Dyskinesia (TD) and changes in heart rhythm. It has also been associated with high blood sugar and diabetes, changes in cholesterol and triglycerides, and weight gain. Invega Sustenna and similar medicines have been associated with decreases in white blood cell counts.
• Invega Sustenna should be used with caution in people with a seizure disorder or those at increased risk for seizures.
• Tell your doctor if you are allergic to paliperidone the active ingredient of Invega Sustenna, risperidone (Risperdal) or any other medications.
• Tell your doctor if you have heart problems. If you have or have ever had a rare heart problem that may cause fainting or irregular heartbeat (prolonged QT interval) or a heart attack, you should tell your doctor before taking Invega Sustenna.
• Tell  your doctor if you have or have ever had any condition that causes blockage or narrowing of the esophagus, stomach, or intestines. Also tell your doctor if you have inflammatory bowel disease (IBD), and kidney or liver disease.
• Tell your doctor if you are pregnant, planning to become pregnant or breastfeeding. Invega Sustenna may harm your unborn baby or your nursing baby.
• Invega Sustenna may cause drowsiness. You should not drive a car or operate machinery until you know how it will affect you. You should not drink alcohol while on Invega Sustenna. Alcohol may add to the drowsiness caused by paliperidone.
• While receiving Invega Sustenna, you may experience increases in your blood sugar (hyperglycemia) even if you don't already have diabetes. You may be at an increased risk of developing diabetes if you receive Invega Sustenna or take similar medicines.
• Invega Sustenna may make it harder for your body to cool down during exercise or in hot weather. 
• Get out of bed slowly, resting your feet on the floor before standing, to avoid dizziness, lightheadedness, and fainting while receiving Invega Sustenna.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Invega Sustenna there are no specific foods that you must exclude from your diet when receiving Invega Sustenna.

Tell your doctor and pharmacist if you:

• are allergic to paliperidone, risperidone (Risperdal), or any other medications
• have inflammatory bowel disease (IBD)
• have kidney or liver disease
• have or have ever had a prolonged QT interval (a rare heart problem that may cause fainting or irregular heartbeat)
• have a slow or irregular heartbeat
• have had a heart attack
• have low levels of potassium or magnesium in your blood
• have had a seizure
• have had a stroke
• have had a head injury
• have a brain tumor
• have Parkinson's disease (a disorder of the nervous system that causes difficulties with movement, muscle control, and balance)
• have diabetes
• have breast cancer
• have had surgery involving the intestines
• have any condition that causes blockage or narrowing of the esophagus (tube that connects the mouth and stomach), stomach, or intestines such as cystic fibrosis (an inborn disease that causes problems with breathing, digestion, and reproduction), and inflammatory bowel disease (a group of conditions that cause swelling of the lining of the intestines)

Tell your doctor if you are pregnant, or if you plan to become pregnant or are breastfeeding. If you become pregnant while receiving Invega Sustenna, call your doctor. 

If you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving Invega Sustenna.

Tell your doctor if you plan to exercise or be exposed to extreme heat.

Tell your doctor about the medicines you take including prescription and nonprescription medications, vitamins, nutritional supplements, and herbal supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Invega Sustenna falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if Invega Sustenna is excreted in human breast milk or if it will harm your nursing baby.

This medication is available in an injectable form to be given directly into a muscle (IM, of your arm or your buttocks, by a healthcare professional. It is given once, then one week later, than every month thereafter.

Take Invega Sustenna exactly as your healthcare provider tells you to.

Your healthcare provider will tell you how much Invega Sustenna you will receive and when you will receive it.

When you receive your first dose of Invega Sustenna you will need to get a second dose 1 week later. After that you will only need to get a dose 1 time a month.

Invega Sustenna may affect your ability to make decisions, think clearly, or react quickly.Do not drive, operate heavy machinery, or do other dangerous activities until you know how Invega Sustenna affects you.

Avoid getting overheated or dehydrated.

This medication is available in an injectable form to be dosed by a healthcare professional. It is given once, then one week later, than every month thereafter.

If you have never taken oral paliperidone (Invega) or risperidone (Riperdal), your doctor probably start you on the tablets first before he starts you on the injection. 

The recommended monthly maintenance dose for the treatment of schizophrenia is 39-234 mg. 

The recommended monthly maintenance dose for the treatment of schizoaffective disorder is 78-234 mg.

Since this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Keep all of your appointments with your doctor. 

WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS

• Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.

• Invega Sustenna is not approved for use in patients with dementia-related psychosis.