Take paliperidone once a day at breakfast time. Even if you don't eat breakfast, you should still take paliperidone first thing each morning. Always take your doses in the same way - either with food or without food.
Keep your regular appointment with your doctor so your progress can be checked.
The most common side-effects include feeling restless, feeling sleepy, difficulties falling or staying asleep, and headache.
|Type of medicine||An antipsychotic medicine|
|Used for||Easing the symptoms of schizophrenia and schizoaffective disorder|
Paliperidone belongs to a group of medicines called antipsychotics. These medicines work on the balance of chemical substances in the brain.
You will have been prescribed paliperidone to relieve the symptoms of schizophrenia, or a similar mental health problem which affects your thoughts, feelings or behaviours. Symptoms of schizophrenia include hearing, seeing, or sensing things that are not real, having mistaken beliefs, and feeling unusually suspicious. Paliperidone will help to ease these symptoms.
Maintenance doses of paliperidone can also be given to people with schizophrenia by depot injection. There is a separate medicine leaflet providing more information about this, called Paliperidone long-acting injection.
Before taking paliperidone
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking paliperidone it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have a heart condition or blood vessel disease.
- If you have liver, kidney, or prostate problems.
- If you have any problems with your breathing.
- If you have any of the following: epilepsy, depression, Parkinson's disease, raised pressure in your eye (glaucoma) or a condition which causes muscle weakness, called myasthenia gravis.
- If you have ever had yellowing of your skin or the whites of your eyes (jaundice) or a blood disorder.
- If you have any difficulties swallowing, or if you have a disorder which could cause a blockage in your intestines.
- If you are scheduled to have cataract eye surgery.
- If you have a tumour on your adrenal gland (a condition called phaeochromocytoma), or if you have been told you have 'a prolactin-dependent tumour'.
- If you have had an allergic reaction to a medicine.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take paliperidone
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about paliperidone and it will also provide you with a full list of the side-effects which you may experience from taking it.
- The recommended starting dose for adults is 6 mg once daily, with breakfast. Your dose, however, may be adjusted to suit your condition, so take paliperidone exactly as your doctor tells you to. The directions for taking your doses will be printed on the label of the pack to remind you about what the doctor said to you.
- Try to get into the habit of taking your dose at the same time of day each day, as this will help you to remember to take it. If you do not eat breakfast, you should still take paliperidone first thing each morning. It is important that you take each of your doses in the same way each day - do not change between taking the tablets with breakfast one day, and without breakfast another.
- If you forget to take a dose, you must remember to take your next dose when it is due on the following day. Do not take two doses at the same time to make up for the missed dose.
- Swallow the tablet whole with a drink of water. Do not chew, crush or break the tablets because they are made so that they release the medicine they contain slowly during the day. Also, do not worry if you notice something that looks like a tablet in your stools when you go to the toilet - this is just the coating of the tablet being passed out of your system.
Getting the most from your treatment
- Your treatment will require careful monitoring to make sure that you get the best possible benefit from paliperidone. Keep your regular doctor's appointments so that your progress can be checked. You will need to have some tests from time to time.
- Paliperidone tablets come in different strengths and colours. If your dose is changed, your tablets may look different. If you are unsure about your tablets at any time, please ask your pharmacist for advice.
- Treatment with paliperidone is usually long-term unless you experience an adverse effect. Keep taking the tablets unless your doctor tells you otherwise. Stopping paliperidone suddenly can cause problems so your doctor may want you to reduce your dose gradually if this becomes necessary.
- If you drink alcohol, ask your doctor for advice. Alcohol increases the risk of side-effects from paliperidone so it is best avoided.
- If you have diabetes you may need to check your blood glucose more frequently, as paliperidone may affect the levels of sugar in your blood. Your doctor will advise you about this.
- Some medicines similar to paliperidone can cause the skin to become more sensitive to sunlight than normal. It may be advisable to use a sunscreen in bright sunlight until you know how your skin reacts.
- If you are due to have any medical or dental treatment, tell the person carrying out the treatment which medicines you are taking. This is important because paliperidone may interfere with any anaesthetic you receive. If you are having cataract surgery, it is particularly important that you tell your surgeon that you are on paliperidone. This is because an eye problem known as 'floppy iris syndrome' has developed in some people and your doctor will want to advise you about the risks of this.
- If you buy or take any 'over-the-counter' medicines or herbal remedies, please check with a pharmacist that they are suitable for you to take with paliperidone.
Can paliperidone cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with paliperidone. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common paliperidone side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Feeling sleepy or restless||Do not drive or use tools or machines|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Sleeping difficulties||Speak with your doctor if troublesome|
|Common paliperidone side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy, blurred vision||Do not drive or use tools or machines. Do not drink alcohol|
|Diarrhoea or constipation||Drink plenty of water|
|Feeling sick, indigestion||Stick to simple meals - avoid rich or spicy foods|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Feeling shaky, unusual or uncontrollable muscle movements||Speak with your doctor about these|
|Increased number of infections such as coughs and colds, feeling anxious or agitated, changes in appetite or weight, rash, menstrual problems, aches and pains||Speak with your doctor about any of these. Your treatment may need adjusting|
Important: if you experience symptoms such as muscle stiffness, a very high temperature, feeling confused, a fast heartbeat and sweating, you should contact your doctor immediately. These can be signs of a rare but serious condition known as neuroleptic malignant syndrome.
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store paliperidone
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Invega® 1.5 mg, 3 mg, 6 mg, 9 mg, 12 mg prolonged-release tablets; Janssen-Cilag Ltd, The electronic medicines Compendium. Dated May 2015.
- British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Adrian Bonsall