Paliperidone long-acting injection (Xeplion)

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Paliperidone long-acting injection will be given to you by your doctor or nurse every four weeks.

If you miss an appointment for an injection, please make another appointment as soon as possible.

The most common side-effects are headache and difficulties sleeping.

Type of medicineAn antipsychotic medicine
Used forSchizophrenia in adults
Also calledXeplion®
Available asLong-acting intramuscular depot injection

Schizophrenia is a mental health condition that causes disordered ideas, beliefs and experiences. You will have been prescribed paliperidone to relieve the symptoms of schizophrenia. Such symptoms include hearing, seeing, or sensing things that are not real, having mistaken beliefs and feeling unusually suspicious. Paliperidone works on the balance of chemical substances in your brain to help control these types of symptoms.

Long-acting or 'depot' injections are used for maintenance once your symptoms have been eased by taking tablets. The injection slowly releases paliperidone into your body. You will need to receive the injection regularly, once every month. The main advantage of a depot injection is that you do not have to remember to take tablets every day.

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 having paliperidone injections, 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 are scheduled to have eye cataract 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.
  • Before you start the treatment, ask to 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 having it.
  • Paliperidone injection will be given to you by your doctor or nurse. The first two doses will be injected into a muscle in your upper arm. After this, the injections can either be given into a muscle in your arm, or if preferred, the buttocks.
  • If you haven't received paliperidone injection before, you will initially be given a dose of 150 mg and then a dose of 100 mg a week later. From then on, you will need to have one injection each month. Your doctor will adjust the amount of paliperidone given to suit what is right for you.
  • 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 you get your injections on time and your progress can be checked. If you miss an appointment for an injection, contact your doctor to arrange for another appointment as soon as possible. This is so that you can be given the injection without any further delay.
  • If you are due to have any dental treatment or an operation, please tell the person carrying out the treatment that you have had a paliperidone injection. This is important because it 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, check with a pharmacist that they are suitable for you to take with paliperidone.
  • 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.
  • If you drink alcohol, please ask your doctor for advice. Alcohol increases the risk of side-effects from paliperidone, so it is best avoided.

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 long-acting injection. 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 injection side-effects (these affect more than 1 in 10 people)What can I do if I experience this?
Difficulties sleepingDiscuss this with your doctor if it becomes troublesome
HeadacheAsk your pharmacist to recommend a suitable painkiller
Common paliperidone injection side-effects (these affect less than 1 in 10 people)What can I do if I experience this?
Pain at the site of the injectionThis should quickly pass. If the area becomes red, swollen or 'lumpy', let your doctor know
Feeling dizzy, tired or sleepyDo not drive or use tools or machines. Do not drink alcohol
Feeling shaky or restless, unusual or uncontrollable movementsSpeak with your doctor
Feeling or being sick, indigestion, tummy (abdominal) discomfortStick to simple meals - avoid rich or spicy food
DiarrhoeaDrink plenty of water to replace lost fluids
ConstipationDrink plenty of water and eat a well-balanced diet
Increased infections, weight increase or loss, mood changes, high blood pressure, toothache, rash, aches and painsDiscuss these with your doctor if any become troublesome
Changes to the results of some medical testsYour doctor will check for these

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 medicine, please speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

If you suspect that you have had an overdose of this medicine, contact your doctor or go to the accident and emergency department of your local hospital.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

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.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Hannah Gronow
Document ID:
13910 (v2)
Last Checked:
Next Review:
The Information Standard - certified member

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