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REAL LIFE. REAL RESULTS.

Thinking about my goals gives me hope.
Rafael, being treated with INVEGA® SUSTENNA® for schizophrenia.

Schizophrenia

Provides Rapid and Sustained Plasma Levels for Up to 30 Days1,2

Plasma / PK Chart of INVEGA® SUSTENNA®

*Starting doses must be administered in the deltoid muscle.

Due to the difference in median pharmacokinetic profiles between the 2 products (INVEGA® SUSTENNA® and INVEGA® Oral), caution should be exercised when making a direct comparison of their pharmacokinetic properties.

For patients who have never taken oral paliperidone or oral or injectable risperidone, it is recommended to establish tolerability with oral paliperidone or oral risperidone prior to initiating treatment with INVEGA® SUSTENNA®.1

Once-Monthly Dosing for the Treatment of Schizophrenia and Schizoaffective Disorder (After Starting Doses)1

NOTE: Prior to use, establish tolerability with oral paliperidone or oral risperidone. Each injection must be administered only by a healthcare professional. No oral supplementation is needed.

Paliperidone is contraindicated in patients with a known hypersensitivity to either paliperidone, risperidone, or to any excipients of the formulation.

How to Administer INVEGA® SUSTENNA®1

How to switch patients to INVEGA® SUSTENNA® from other antipsychotics1

  • Rule out hypersensitivity if a patient has not taken oral paliperidone or oral or injectable risperidone in the past
  • Paliperidone is contraindicated in patients with a known hypersensitivity to either paliperidone or to any excipients of the formulation
...
  • Previous oral antipsychotics can be discontinued at the time of initiation of treatment with INVEGA® SUSTENNA®
  • Starting doses must be administered in the deltoid muscle
  • No need for oral supplementation
...
...
  • Initiate INVEGA® SUSTENNA® therapy in place of the next scheduled injection. INVEGA® SUSTENNA® should then be continued at monthly intervals
  • The two starting doses are not required
  • Maintenance doses may be administered in either the deltoid or gluteal muscle
  • No need for oral supplementation

Dosage Adjustments

Renal impairment1

  • INVEGA® SUSTENNA® has not been systematically studied in patients with renal impairment
  • The dose of INVEGA® SUSTENNA® should be reduced in patients with mild renal impairment (creatinine clearance ≥50 mL/min to <80 mL/min [Cockcroft-Gault Formula])
    • Recommended starting dose of INVEGA® SUSTENNA® is 156 mg on Day 1 and 117 mg 1 week later, both administered in the deltoid muscle
    • Follow with monthly injections of 78 mg in either the deltoid or gluteal muscle
  • INVEGA® SUSTENNA® is not recommended in patients with moderate or severe renal impairment (creatinine clearance <50 mL/min)

Coadministration with strong inducers of both CYP3A4 and P-glycoprotein1

  • When strong inducers of both CYP3A4 and P-glycoprotein (eg, carbamazepine, rifampin, St John’s wort) are added, it may be necessary to increase the dose of INVEGA® SUSTENNA®
  • When the strong inducer is discontinued, it may be necessary to decrease the dose of INVEGA® SUSTENNA®

Pregnancy/Nursing1

  • Adequate and well controlled studies with INVEGA® SUSTENNA® have not been conducted in pregnant women. Neonates exposed to antipsychotic drugs during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery
  • INVEGA® SUSTENNA® should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus

What to Do When a Dose Is Missed

Missed monthly maintenance dose Dosing schedule
4 to 6 weeks since last injection Resume regular monthly dosing as soon as possible at patient’s previously stabilized dose, followed by injections at monthly intervals.
>6 weeks to 6 months since last injection

*If the patient was stabilized on 234 mg, the first 2 doses should be 156 mg.

Continue dosing at patient’s previously stabilized dose* by giving:
  • 1.Deltoid injection as soon as possible
  • 2.Deltoid injection 1 week later at same dose
  • 3.Resume monthly deltoid or gluteal injections at patient’s previously stabilized dose 1 month after second dose
>6 months since last injection Restart dosing with normal starting plan:
  • 1.234-mg deltoid injection at Day 1
  • 2.156-mg deltoid injection 1 week later
  • 3.Resume regular monthly dosing in either deltoid or gluteal muscle
Missed second starting dose Dosing schedule
<4 weeks from first injection Administer the second starting dose of 156 mg in the deltoid muscle as soon as possible.
  • 1.It is recommended to administer a third injection of 117 mg in either the deltoid or gluteal muscle 5 weeks after the first injection (regardless of the timing of the second injection).
  • 2.Resume regular monthly dosing in either the deltoid or gluteal muscle.
4-7 weeks from first injection Resume dosing with 2 injections of 156 mg:
  • 1.Deltoid injection as soon as possible
  • 2.Deltoid injection 1 week later
  • 3.Regular monthly dosing in either the deltoid or gluteal muscle
>7 weeks from first injection Restart dosing with normal initiation plan:
  • 1.234-mg deltoid injection at Day 1
  • 2.156-mg deltoid injection 1 week after
  • 3.Resume regular monthly dosing in either deltoid or gluteal muscle

INVEGA® SUSTENNA® has a proven safety and tolerability profile. Explore the data >

References: 1. INVEGA® SUSTENNA® [prescribing information]. Titusville, NJ: Janssen Pharmaceuticals, Inc; November 2014. 2. Samtani M, Gopal S, Gassmann-Mayer C, et al. Dosing and switching strategies for paliperidone palmitate: based on population pharmacokinetic modelling and clinical trial data. CNS Drugs. 2011;25(10):929-845.