Invega Sustenna (Paliperidone Palmitate)

Complete patient guide for uses, dosage, side effects, and safety information

Prescription Required

Quick Facts

Generic Name
paliperidone palmitate
Drug Class
antipsychotic agent
Used For
schizophrenia in adults
How Taken
monthly injection into muscle by healthcare professional

What Is Invega Sustenna Used For?

Invega Sustenna is an antipsychotic medication that helps improve symptoms of certain mental health conditions by correcting chemical imbalances in the brain.

Primary Uses

Invega Sustenna is used to treat adults (18 years and older) with schizophrenia, a mental illness that affects thinking, feelings, and behavior. It can also help prevent schizophrenia symptoms from returning. Common symptoms of schizophrenia include seeing, hearing, or sensing things that aren’t there (hallucinations), believing things that aren’t true (delusions), not trusting others and feeling suspicious (paranoia), and avoiding family and friends.

How It Works

Invega Sustenna belongs to a group of medicines called antipsychotic agents. It works by helping to correct a chemical imbalance in the brain that is associated with schizophrenia.

Good to know: It may take some time before your schizophrenia symptoms start to improve. Invega Sustenna is one part of your overall treatment plan, so it’s important to keep all appointments.

How to Take Invega Sustenna

Invega Sustenna is given as an injection by your doctor or healthcare professional in a medical office or clinic. It’s designed to gradually release into your body so you don’t need daily medication.

Dosage Instructions

Your doctor will decide the right strength for you. The usual first dose is 150 mg, followed by a second dose of 100 mg one week later. After that, the usual monthly dose is 75 mg, but your doctor may prescribe anywhere from 25 mg to 150 mg based on your condition and kidney function. The injection is given into the muscle of your upper arm or buttocks. Treatment will only start after you’ve already tolerated oral paliperidone or oral/injectable risperidone.

What If You Miss a Dose?

Contact your doctor as soon as possible if you think you’re going to miss or have missed your appointment. Your doctor will decide what to do next. It’s very important to keep all your appointments and get your medicine on time.

Important: Do not miss any injections or appointments with your doctor. After the first two doses, you’ll need injections once every month.

Available Tablet Strengths

25 mg
25 mg Tablet White to off-white, Pre-filled syringe • paliperidone palmitate 39 mg equivalent
50 mg
50 mg Tablet White to off-white, Pre-filled syringe • paliperidone palmitate 78 mg equivalent
75 mg
75 mg Tablet White to off-white, Pre-filled syringe • paliperidone palmitate 117 mg equivalent
100 mg
100 mg Tablet White to off-white, Pre-filled syringe • paliperidone palmitate 156 mg equivalent
150 mg
150 mg Tablet White to off-white, Pre-filled syringe • paliperidone palmitate 234 mg equivalent

Side Effects

Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.

Common Side Effects

These side effects occur relatively frequently and usually don’t require emergency care:

  • Difficulty falling or staying asleep
  • Headache
  • Nausea
  • Trembling, muscle weakness, unsteadiness
  • Drowsiness, tiredness, difficulty concentrating
  • Pain at injection site
  • Irritability or agitation
  • Anxiety or depression
  • Muscle or joint stiffness or pain
  • Unusual restlessness
  • Weight gain or loss
  • Common cold symptoms
  • Dry mouth
  • Constipation or diarrhea
  • Menstrual irregularities
  • Sexual dysfunction

Seek immediate medical attention if you experience:

  • Serious allergic reactions (rash, difficulty breathing, swelling)
  • Heart or blood pressure problems (fast/slow heart rate, dizziness when standing)
  • High blood sugar or diabetes symptoms (unusual thirst, tiredness, frequent urination)
  • Severe skin reactions (Stevens-Johnson syndrome or toxic epidermal necrolysis)
  • Mini-strokes (sudden weakness, numbness, slurred speech)
  • Tardive dyskinesia (involuntary movements of tongue, mouth, face, arms, or legs)
  • Neuroleptic malignant syndrome (fever, muscle stiffness, sweating, confusion)

Important Warnings

There are several important warnings and precautions to be aware of before starting Invega Sustenna.

Who Should Not Take Invega Sustenna

Do not use Invega Sustenna if you are allergic to paliperidone, risperidone (another similar antipsychotic medicine), or any of the ingredients listed in the medication guide.

Medical Conditions to Discuss

Tell your doctor if you have: heart problems, irregular heart rhythm, high or low blood pressure, history of heart attack or stroke; epilepsy, seizures, or involuntary movements; dementia or Lewy body dementia; Parkinson’s disease; low white blood cell counts; diabetes or high blood sugar risk; kidney or liver problems; blood clot history; lung inflammation; swallowing problems or stomach/intestinal disorders; confusion or unsteadiness; suicidal thoughts; or if you’re planning eye surgery.

Pregnancy and Breastfeeding

Check with your doctor if you are pregnant or planning to become pregnant. Newborn babies of mothers taking Invega Sustenna in their last trimester may have difficulty feeding or breathing, shaking, muscle stiffness, weakness, sleepiness, or agitation. It’s recommended not to breastfeed while using Invega Sustenna as it passes into breast milk.

Elderly Patients With Dementia: Elderly patients with dementia who are treated with similar medicines may have an increased risk of stroke or death. Invega Sustenna has not been studied in elderly patients with dementia.

Drug Interactions

Some medicines may interfere with Invega Sustenna and affect how it works. Always tell your doctor about all medications you’re taking.

  • Sleeping tablets, tranquillizers, painkillers, or allergy medications (antihistamines) – may increase drowsiness
  • Medicines for epilepsy or Parkinson’s disease – Invega Sustenna may reduce their effectiveness
  • Blood pressure medications including water tablets (diuretics) – may lower blood pressure further
  • Medicines for irregular heart rhythms or heart failure
  • Medicines for depression, panic disorder, anxiety, or obsessive-compulsive disorder
  • Other medicines for mental illnesses or psychotic conditions
  • Central nervous system stimulants (like methylphenidate)
  • Medicines for nausea, vomiting, indigestion, or stomach problems
  • Some malaria medications

Alcohol & Driving

Invega Sustenna can affect your ability to drive safely and can increase the effects of alcohol.

Alcohol

Do not drink alcohol while using Invega Sustenna. The medication can increase the effects of alcohol.

Driving and Operating Machinery

Be careful before driving or using machines until you know how Invega Sustenna affects you. The medication may cause dizziness, drowsiness, or light-headedness. If you feel dizzy or faint, be careful when getting up from sitting or lying down – getting up slowly may help.

Temperature Regulation

Tell your doctor if you have problems with body temperature regulation, unusual excessive sweating, or diarrhea, as these can affect how your body handles the medication.

Storage

Invega Sustenna will typically be stored by your doctor or pharmacist. If you need to store it at home, keep it in a cool, dry place protected from light where the temperature stays below 25°C. Do not use it beyond the expiry date printed on the pack.

Overdose Information

Because Invega Sustenna is given by healthcare professionals, the risk of overdose is low. However, overdose symptoms may include reduced consciousness, drowsiness, excessive trembling, muscle stiffness, fast heartbeat, low blood pressure, abnormal heart rhythm, and seizures. If you experience these symptoms, immediately call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital emergency department.

Frequently Asked Questions

It may take some time before your schizophrenia symptoms start to improve. The medication is designed to gradually release into your body over the month between injections.

The source material does not indicate that Invega Sustenna is addictive. However, it’s important not to miss appointments or stop treatment without consulting your doctor.

Do not miss any injections or appointments with your doctor. Invega Sustenna helps control your condition but will not cure it, so you will need regular injections. Contact your doctor if you’re considering stopping treatment.

No, you should avoid drinking alcohol while using Invega Sustenna. The medication can increase the effects of alcohol.

Yes, there is a possibility of weight gain when taking Invega Sustenna. Your doctor may monitor your body weight or recommend strategies to help with weight management. Avoid excessive eating.

Invega Sustenna has not been studied in elderly patients with dementia. Elderly patients with dementia who are treated with similar medicines may have an increased risk of stroke or death.

Contact your doctor as soon as possible if you think you’re going to miss or have missed your appointment. Your doctor will decide what you should do next. It’s very important to keep all appointments and get your medicine on time.

Important Disclaimer

This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.

If you think you may have a medical emergency, call your doctor or emergency services immediately.