Invega

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Invega: instructions for use and reviews

1. Release form and composition
2. Pharmacological properties
3. Indications for use
4. Contraindications
5. Method of application and dosage
6. Side effects
7. Overdose
8. Special instructions
9. Application during pregnancy and lactation
10. Use in childhood
11. In case of impaired renal function
12. For violations of liver function
13. Use in the elderly
14. Drug interactions
15. Analogs
16. Terms and conditions of storage
17. Terms of dispensing from pharmacies
18. Reviews
19. Price in pharmacies

Latin name: Invega

ATX code: N05AX13

Active ingredient: paliperidone (Paliperidone)

Manufacturer: Alza Corporation (USA); Janssen-Cilag Manufacturing LLC (Puerto Rico)

Description and photo update: 2018-27-11

Prices in pharmacies: from 4572 rubles.

Buy

Sustained-release film-coated tablets, Invega

Invega is an antipsychotic drug used in the treatment of schizophrenia and schizoaffective disorders.

Release form and composition

Dosage form - tablets of prolonged action, covered with a shell: capsular, the outlets during visual inspection can be invisible or visible, the inscription is made with water-soluble black ink; dosage 3 mg - white, with the inscription "PAL 3"; dosage 6 mg - light orange (a slight brownish tint is allowed), with the inscription "PAL 6"; dosage 9 mg - pink (let's say a grayish tint), with the inscription "PAL 9"; dosage 12 mg - dark yellow (a grayish tint is acceptable), with the inscription "PAL 12" (30 pcs. in a polyethylene bottle, in a cardboard box 1 bottle; 7 tablets in a blister, in a cardboard box 4 or 8 blisters and instructions for application of Invega).

Composition of 1 tablet:

active substance: paliperidone - 3, 6, 9 or 12 mg;
auxiliary components: macrogol 200K, macrogol 7000K, sodium chloride, povidone (K29-32), hyethylose, stearic acid, butylhydroxytoluene, macrogol 3350, cellulose acetate (398-10), red iron oxide, carnauba wax; for tablets of 3 and 12 mg - iron oxide yellow; for 9 mg tablets - black iron oxide;
ink: propylene glycol, hypromellose, isopropanol, black iron oxide, purified water;
dye: dosage 3 mg - white (titanium dioxide, hypromellose, lactose monohydrate, triacetin); dosage 6 mg - beige (titanium dioxide, hypromellose, polyethylene glycol 400, iron oxide yellow and red); dosage 9 mg - pink (titanium dioxide, hypromellose, polyethylene glycol 400, iron oxide red); dosage 12 mg - dark yellow (titanium dioxide, hypromellose, polyethylene glycol 400, iron oxide yellow).

Pharmacological properties

Pharmacodynamics

Paliperidone, the active ingredient of Invega, is a centrally acting antagonist of dopamine D ₂ receptors. Possesses high antagonism towards serotonin 5-HT _2A -receptors. It also exhibits antagonism to α ₁ - and α ₂ -adrenergic receptors and H ₁ -histamine receptors. The substance does not possess affinity for muscarinic, cholinergic, β ₁ - and β ₂ -adrenergic receptors. Pharmacological activity of (+) and (-) - enantiomers of paliperidone is the same in quantitative and qualitative terms.

The antipsychotic effect of paliperidone is due to the blockade of D ₂ -dopaminergic receptors of the mesocortical and mesolimbic systems. In comparison with classical antipsychotics (neuroleptics), it leads to less suppression of motor activity and induces catalepsy to a lesser extent.

Balanced central antagonism to dopamine and serotonin can reduce the tendency to develop extrapyramidal side effects and expand the therapeutic effect of Invega to cover the productive and negative signs of schizophrenia.

Paliperidone affects the structure of sleep, reducing the number of awakenings after falling asleep and the latency period before falling asleep; increasing overall duration, time and sleep quality index.

May lead to an increase in the plasma concentration of prolactin. Has an antiemetic effect.

Pharmacokinetics

The pharmacokinetic data presented below are based on the results of studies in adult patients (unless otherwise indicated).

Pharmacokinetic characteristics of the substance after oral administration are dose-dependent in the recommended therapeutic range (1 time per day, 3–12 mg).

Plasma concentration of paliperidone after taking one dose increases steadily, C _max (maximum concentration) is reached within 24 hours. Equilibrium concentrations of paliperidone in most cases are reached within 4–5 days.

Paliperidone is an active metabolite of risperidone. The peculiarities of the release of the active substance from Invega provide less fluctuations in the maximum and minimum concentrations of the substance than those observed with the use of conventional dosage forms (the concentration fluctuation index is 38%, for conventional dosage forms - 125%).

After oral administration of paliperidone, there is a mutual transformation of (+) and (-) enantiomers, the ratio AUC (+) / AUC (-) (area under the concentration-time curve) in the equilibrium state is about 1.6. Absolute bioavailability - 28% (ranges from 23 to 33% with a confidence interval of 90%).

After a single dose of 15 mg of paliperidone simultaneously with high-calorie fatty foods, the C _max and AUC values increase relative to fasting intake by 42 and 46%, respectively. According to the results of another study, the increase was 60% and 54% (when taking 12 mg of paliperidone). Thus, it was found that the presence / absence of food in the stomach affects the plasma concentration of the substance.

Paliperidone is rapidly distributed in body fluids and tissues. The apparent volume of distribution is 487 liters. The substance binds to plasma proteins at a level of 74%. Binding occurs primarily with albumin and α ₁ -acid glycoprotein.

7 days after taking 1 mg of paliperidone, 59% of the dose of the unchanged substance was excreted in the urine, which indicates the absence of intensive metabolism of paliperidone in the liver. Approximately 80% of the drug is found in urine, in feces - about 11%.

Metabolism can be carried out in four ways - dealkylation, hydroxylation, dehydrogenation and cleavage of benzisoxazole. None of them cover more than 6.5% of the dose. The isoenzymes CYP2D6 and CYP3A4 of cytochrome P450 play a role in the metabolism of paliperidone, however, reliable evidence of their significant participation has not been obtained. CYP2C9, CYP2A6, CYP1A2, CYP3A5 and CYP2C19 isoenzymes are not involved in paliperidone metabolism.

The final T _1/2 (half-life) of paliperidone is ~ 23 hours.

Paliperidone belongs to the substrates of P-glycoprotein and weakly inhibits it when used in high concentrations. The clinical significance of this has not been established.

The use of Invega in severe liver dysfunction has not been studied.

It has been established that the elimination of the substance decreases with the decrease in CC (creatinine clearance). Decrease in the total clearance of paliperidone and the value of the mean final T _1/2, depending on CC:

50–80 ml / min (mild renal impairment): 32%; 24 hours;
30-50 ml / min (moderate renal impairment): 64%; 40 hours;
10-30 ml / min (severe renal impairment): 71%; 51 hours

In patients with moderate / severe renal impairment, the dose of paliperidone should be reduced.

Indications for use

schizophrenia in adults, including in the acute phase: treatment;
schizophrenia in adults: prevention of exacerbations;
schizophrenia in adolescents 12–17 years old: treatment;
schizoaffective disorders in adults: treatment as monotherapy or in combination with normotimics and / or antidepressants.

Contraindications

Absolute:

lactation period;
age under 12 (for the treatment of schizophrenia) or 18 years (for the treatment of schizoaffective disorders);
individual intolerance to the components of the drug, as well as risperidone.

Relative (Invega tablets are used under medical supervision):

diseases that reduce the threshold of convulsive readiness, aggravated history of convulsive conditions;
narrowing of the lumen of the gastrointestinal tract, dysphagia (associated with the possibility of obstruction);
dementia with Lewy bodies, Parkinson's disease (associated with the risk of developing neuroleptic malignant syndrome or hypersensitivity to antipsychotics);
old age (in the treatment of dementia);
pregnancy.

Invega, instructions for use: method and dosage

Inweg is taken orally, swallowed whole and washed down with a liquid. The tablets must not be crushed or chewed.

The drug should be taken in the morning, regardless of the meal. There is no need to gradually increase the dose.

For adults, Invega is prescribed 6 mg once a day.

Some patients may require dose adjustment:

schizophrenia: the recommended range is 3–12 mg per day; when using large doses of Invega, there is a general tendency to increase the effect; an increase in the dose, if necessary, is carried out in 3 mg increments with intervals of more than 5 days;
schizoaffective disorders: the recommended range is 6–12 mg per day; an increase in the dose is carried out only after assessing the patient's clinical condition in 3 mg increments with intervals of more than 4 days; supportive care has not been studied.

For adolescents 12-17 years old, Invega is prescribed 3 mg 1 time per day. If necessary, the dose is adjusted in the range of 6–12 mg, the dose should be increased in 3 mg increments with interruptions of more than 5 days.

The use of Invega in severe hepatic impairment has not been studied.

Features of therapy in patients with impaired renal function, depending on CC:

50–80 ml / min: initial daily dose - 3 mg; after assessing the patient's condition and the tolerability of the drug, the dose can be doubled;
10-50 ml / min: daily dose - 3 mg;
more than 10 ml / min: it is not recommended to use the drug, since the safety profile has not been studied.

The dose of Invega for elderly patients is selected in accordance with renal function. Due to the increased risk of stroke, caution is required when prescribing the drug to elderly patients with dementia. The safety profile in patients over 65 years of age with schizoaffective disorders has not been studied.

When transferring to Invega from other antipsychotics, the doctor must carefully assess the patient's condition.

Side effects

Possible adverse reactions [> 10% - very common; (> 1% and 0.1% and 0.01% and <0.1%) - rarely; <0.01% - extremely rare]:

nervous system: very often - headache; often - salivation, parkinsonism, akathisia, dysarthria, dystonia, increased muscle tone, sedation, drowsiness, tremor; infrequently - impaired attention, hypesthesia, loss of consciousness, hypokinesia, psychomotor hyperactivity, paresthesia, opisthotonus, tardive dyskinesia, dyskinesia, fainting, convulsions, cerebrovascular disorders, postural dizziness;
hematopoietic / lymphatic system: infrequently - anemia, decreased hematocrit and leukocyte count, neutropenia; rarely, thrombocytopenia; extremely rare - agranulocytosis;
immune system: infrequently - hypersensitivity, anaphylactic reaction;
endocrine system: infrequently - hyperprolactinemia; extremely rare - inadequate secretion of antidiuretic hormone;
metabolism and nutrition: infrequently - anorexia, hyperglycemia, increased activity of creatine phosphokinase; rarely - hypoglycemia, diabetes mellitus, water intoxication; extremely rare - diabetic ketoacidosis;
digestive system: often - dyspepsia, nausea, constipation, diarrhea, discomfort in the upper abdomen, increased appetite; infrequently - fecal incontinence, small bowel obstruction, gastroenteritis, decreased appetite, lip inflammation, dysphagia, flatulence, tongue edema, toothache, dysgeusia; extremely rare - intestinal obstruction, pancreatitis;
respiratory system: infrequently - wheezing, hyperventilation of the lungs, nasal congestion, pain in the pharyngeal-laryngeal region, shortness of breath, cough; rarely - sleep apnea syndrome;
cardiovascular system: infrequently - an increase in the QT interval, conduction disturbances, palpitations, bradycardia, atrioventricular block, changes in the electrocardiogram (ECG), ischemia, decrease / increase in blood pressure, flushing; rarely - atrial fibrillation; extremely rare - pulmonary embolism, deep vein thrombosis;
infections: often - nasopharyngitis, upper respiratory tract infections; infrequently - cystitis, tonsillitis, urinary tract and respiratory tract infections, bronchitis, acarodermatitis, inflammation of the subcutaneous fat, ear infections, sinusitis, influenza, pneumonia, onychomycosis;
psyche: often - insomnia (including initial and secondary insomnia), mania; infrequently - sleep disturbances, nightmares, depression;
sensory organs: infrequently - vertigo, ear pain, ringing in the ears, dry eyes, conjunctivitis, photophobia, lacrimation; with an unspecified frequency - ISDR (intraoperative flabby iris syndrome);
liver and biliary tract: extremely rare - jaundice;
skin and subcutaneous tissues: infrequently - seborrheic dermatitis, skin discoloration, acne, rash, itching, dry skin, erythema, eczema; rarely - alopecia, Quincke's edema;
musculoskeletal system: often - musculoskeletal pain, myalgia; infrequently - joint stiffness, muscle cramps / weakness, neck and back pain, arthralgia, joint swelling;
genitals and mammary gland: infrequently - erectile / sexual dysfunction, anorgasmia, decreased libido, nipple discharge, gynecomastia, chest discomfort, menstrual changes, vaginal discharge, breast engorgement, ejaculation disorder; extremely rare - priapism;
kidneys and urinary tract: infrequently - urinary incontinence, dysuria, urinary retention, pollakiuria;
laboratory data: infrequently - an increase in the activity of gamma-glutamyl transferase, liver enzymes, transaminases, an increase in the concentration of triglycerides and cholesterol in the blood;
others: often - weight gain; infrequently - weight loss, facial edema, chills, gait disturbance, edema (including peripheral and generalized edema, mild edema), chest discomfort, increased body temperature, thirst, fever; extremely rare - withdrawal syndrome in newborns, hypothermia.

It has been established that paliperidone can cause NMS (neuroleptic malignant syndrome). It is characterized by the following symptoms: increased activity of creatine phosphokinase, rhabdomyolysis, myoglobinuria, muscle rigidity, hyperthermia, instability of the autonomic nervous system function, depression of consciousness, acute renal failure.

Dose-related side effects reported in clinical trials in ≥ 2% of adult patients with schizophrenia:

nervous system: headache, dizziness;
cardiovascular system: 1st degree atrioventricular block, sinus arrhythmia / tachycardia, tachycardia, bundle branch block, orthostatic hypotension;
digestive system: pain in the upper abdomen, dry mouth, vomiting, hypersalivation;
organ of vision: oculogyric crises;
extrapyramidal disorders: sedation, drowsiness, akathisia, tremor, dystonia, hypertension, parkinsonism;
general disorders: fatigue, asthenia.

Dose-related side effects reported in clinical trials in ≥ 2% of adolescents 12 to 17 years of age with schizophrenia:

respiratory system: nosebleeds;
cardiovascular system: tachycardia;
digestive system: hypersalivation, dry mouth, vomiting, swelling of the tongue;
nervous system: dizziness, akathisia;
organ of vision: blurred vision;
genitals and mammary gland: amenorrhea, edema of the mammary glands, galactorrhea;
infections: nasopharyngitis;
psyche: anxiety;
laboratory data: weight gain;
extrapyramidal disorders: tongue paralysis, headache, drowsiness, lethargy;
general disorders: asthenia, fatigue.

Paliperidone is an active metabolite of risperidone; however, in terms of pharmacokinetic characteristics and release profile, Inweg differs significantly from oral forms of risperidone with immediate release. The development of side effects, which there is information about when using risperidone, can also be noted when using paliperidone.

In elderly patients with dementia, the risk of stroke is increased (the safety profile for this group of patients has not been studied).

Dose-dependent extrapyramidal symptoms have been reported in clinical trials of therapy with high doses (9 and 12 mg).

Cases of extrapyramidal syndrome in clinical trials of schizoaffective disorders were detected with higher doses of Invega than with placebo, in all patients without an obvious relationship with the dose received. Extrapyramidal disorders included dyskinesia, dystonia, hyperkinesia, tremors, and parkinsonism.

The greatest likelihood of weight gain in the treatment of schizophrenia and schizoaffective disorders is observed with the use of Invega in doses of 9 and 12 mg.

The maximum value of the increase in serum prolactin concentration was observed on the fifteenth day of the drug administration; before the end of treatment, they exceeded the usual level.

While taking Invega, the following disorders may occur: pirouette-type ventricular tachycardia, cardiac arrest, increased QT interval, ventricular arrhythmia (ventricular tachycardia, atrial fibrillation), unexplained and unexpected death. There is also information about cases of venous thromboembolism, including episodes of deep vein thrombosis and pulmonary embolism.

Overdose

The main symptoms: enhanced pharmacological effects of paliperidone, including drowsiness, sedation, tachycardia, arterial hypotension, extrapyramidal disorders, prolongation of the QT interval. It is also possible to develop bidirectional tachycardia and ventricular fibrillation.

In the event of an acute overdose of paliperidone, the likelihood of the toxic effects of several drugs must be taken into account.

When assessing the therapeutic need and the effectiveness of overdose relief, one should remember about the prolonged release of paliperidone.

Therapy: Generally accepted supportive measures, including ensuring and maintaining a good airway, as well as adequate ventilation and oxygenation. Monitoring of cardiovascular activity should be immediately organized (to detect possible arrhythmias - ECG monitoring). Collaptoid conditions and arterial hypotension are stopped by intravenous administration of sympathomimetic agents and / or plasma-substituting solutions. Some patients are prescribed gastric lavage (including after intubation, if the patient is unconscious), the introduction of laxatives and activated charcoal. With severe extrapyramidal symptoms, m-anticholinergics are indicated. Control of the patient's condition and monitoring of the main physiological functions should be carried out until the consequences of an overdose are completely eliminated.

The specific antidote for paliperidone is unknown.

special instructions

During the period of application of Invega, like other antipsychotic drugs, the development of ZNS is possible. It is characterized by an increase in serum creatine phosphokinase concentrations, depression of consciousness, muscle rigidity, hyperthermia, instability of the autonomic nervous system function. Disorders such as acute renal failure and rhabdomyolysis may also occur. In cases where the patient has objective or subjective symptoms of NNS, Invega is canceled.

Therapy can cause tardive dyskinesia, which is characterized by rhythmic involuntary movements, mainly of the facial muscles and / or tongue. If there are objective / subjective suspicions of the development of this disorder, it is necessary to assess the feasibility of further application of Invega.

When prescribing Invega to patients with a history of cardiac arrhythmias, congenital lengthening of the QT interval, and also when used in combination with drugs that prolong the QT interval, caution is required.

During the period of therapy, there were cases of hyperglycemia, diabetes mellitus and exacerbation of existing diabetes mellitus. It is difficult to establish a reliable connection between Invega and these violations. If the patient has a confirmed diagnosis of diabetes mellitus, regular monitoring of glucose levels is indicated. In the case of risk factors (including obesity, family history of diabetes mellitus) at the beginning of therapy and periodically during it, patients should be monitored for fasting blood glucose. All patients are shown clinical control for the presence of symptoms of diabetes mellitus and hyperglycemia. Sometimes the signs of hyperglycemia after discontinuation of Invega disappeared on their own, but some patients require antidiabetic therapy even if paliperidone is discontinued.

All patients need weight control, since during the period of application of Invega there is a significant increase in body weight.

Invega, along with other D ₂ -dopamine receptor antagonists, increases prolactin levels. This increase persists throughout the entire period of therapy. Paliperidone can be compared to risperidone, the drug that has the greatest effect on prolactin levels among other antipsychotics.

Regardless of the etiology, hyperprolactinemia can suppress the expression of GnRH (gonadotropin-releasing hormone) of the hypothalamus, this causes a decrease in the secretion of gonadotropins by the pituitary gland and, as a consequence, suppression of reproductive function and weakening of sexual steroidogenesis in men and women. During the period of therapy, the development of galactorrhea, amenorrhea, gynecomastia and impotence is possible. Prolonged hypogonadism-associated hyperprolactinemia in men and women can cause a decrease in bone density.

Studies have shown that approximately 1/3 of breast cancer cases are prolactin-dependent. This should be taken into account when prescribing Invegi to patients who have previously been diagnosed with breast cancer. Epidemiological and clinical studies have not proven the relationship between the intake of atypical antipsychotics and the formation of tumors. However, it is believed that the available information is too limited for final conclusions.

Paliperidone has an α-blocking activity, therefore, Invega can cause orthostatic hypotension in some patients. In this connection, therapy should be carried out with caution in patients with cardiovascular diseases (for example, with heart failure, myocardial infarction or ischemia, conduction disorders of the heart muscle), cerebrovascular diseases, as well as in the presence of conditions that contribute to arterial hypotension (for example, with dehydration, hypovolemia, and antihypertensive therapy).

It is believed that neuroleptics are characterized by such undesirable effects as a violation of the ability to regulate temperature. When prescribing Invega to patients with conditions that can lead to an increase in internal body temperature (with intense physical activity, dehydration, exposure to high external temperatures, or when used in combination with drugs with anticholinergic activity), care must be taken.

The antiemetic effect of paliperidone, revealed in preclinical studies, can mask objective / subjective signs of overdose of certain drugs, as well as diseases, for example, brain tumors, intestinal obstruction and Reye's syndrome.

There is information about the development of priapism during the use of drugs with α-adrenergic blocking effects. During post-marketing studies of paliperidone, priapism has also been reported.

Mental illness is characterized by the possibility of suicidal attempts, in this regard, when using Invega, control should be established for the condition of patients at high risk. In order to reduce the risk of overdose, the drug is prescribed to such patients in the minimum dose.

During the use of Invega, cases of leukopenia, neutropenia and agranulocytosis were observed. During post-marketing observations, agranulocytosis was observed in very rare cases. If there is a clinically significant decrease in the number of leukocytes in the history or drug-dependent leukopenia / neutropenia during the first months of therapy, a complete blood count is recommended. At the first clinically significant decrease in the number of leukocytes, if all possible causes are excluded, the possibility of canceling Invega should be considered.

Patients with clinically significant neutropenia need to be monitored for fever or symptoms of infection. If such symptoms occur, treatment should be started immediately. In cases of severe neutropenia (in patients with an absolute neutrophil count of less than 1 × 10 ⁹ / l), Invega is canceled until the leukocyte count is normalized.

There is information about the development of venous thromboembolism. Since patients taking Invega often have a high risk of venous thromboembolism, it is necessary to identify all possible risk factors and take preventive measures before and during therapy.

ISDR can occur during cataract surgery in patients who take drugs of the α1-adrenergic receptor antagonist group. Because of ISDR, the likelihood of ocular complications both during surgery and after surgery increases. It is necessary to warn the doctor performing such an operation in advance that the patient has taken / is taking Invega. The potential benefit of discontinuing the drug before surgery has not been established, and the physician should assess it against the risks associated with such discontinuation.

In case of pregnancy or planning it during the period of using Invega, you must notify the doctor about it.

It is recommended to refrain from drinking alcohol during therapy.

Conditions / diseases in which conditions are created to reduce the presence of the drug in the gastrointestinal tract, in particular those associated with chronic diarrhea, can lead to a decrease in paliperidone absorption.

In the production of Invega tablets, technologies for the osmotic release of the active component are used, while the release of paliperidone at a controlled rate provides osmotic pressure. The system, which looks like a capsule tablet, consists of a three-layer osmotically active core. It is surrounded by an intermediate shell and a semipermeable membrane. The composition of the tablet core: two medicinal layers, which contain a medicinal substance and auxiliary components + a push layer with osmotically active substances.

On the side of the medicinal layers on the dome, there are two outlets that are made with a laser. The colored membrane in the gastrointestinal tract dissolves rapidly, water gradually enters the tablet through a semi-permeable control membrane. The water intake is controlled by a membrane, which in turn controls the release of paliperidone.

The hydrophilic polymers contained in the tablet core swell by absorbing water and turn into a gel containing paliperidone, which is then pushed out through the holes in the dome. Insoluble substances are excreted in the feces. If you find something like a pill in your stool, don't worry.

Influence on the ability to drive vehicles and complex mechanisms

Before establishing the individual sensitivity of the action of Invega, patients are advised to refuse to drive vehicles.

Application during pregnancy and lactation

During pregnancy, Invega can only be used in cases where the expected benefit is greater than the possible harm.

There is no data confirming the safety of paliperidone for women during pregnancy and intrauterine development of the fetus. The influence of Invega on labor is unknown.

When taking paliperidone in the third trimester of pregnancy, newborns are likely to develop withdrawal symptoms and / or extrapyramidal disorders of varying severity. The main symptoms are: feeding disorders, hypertension, agitation, hypotension, tremors, drowsiness, respiratory disorders. Thus, the condition of the newborn should be monitored. If it is necessary to interrupt treatment during pregnancy, the dose is gradually reduced.

During lactation, therapy is contraindicated, since paliperidone passes into breast milk in clinically significant doses.

Pediatric use

Age restrictions in pediatrics when using Invega tablets:

schizophrenia: up to 12 years old;
schizoaffective disorders: up to 18 years.

With impaired renal function

For moderate / severe impairment of renal function (in patients with CC <50 ml / min), Invega is prescribed in a reduced dose (3 mg per day).

For violations of liver function

Dose reduction is not required for patients with liver functional impairment.

Use in the elderly

The dose of Invega in elderly patients is selected in accordance with renal function.

When prescribing the drug in elderly patients with dementia, caution is required.

Drug interactions

drugs that prolong the QT interval: the combination requires caution;
centrally acting drugs, alcohol: the combination requires caution, since paliperidone affects mainly the central nervous system;
levodopa and other dopamine agonists: paliperidone helps to neutralize their action;
drugs that cause orthostatic hypotension: an additive effect is possible;
carbamazepine: C _max and AUC of paliperidone decreases, which may require dose adjustment of Invega;
divalproex sodium prolonged action: C _max and AUC of paliperidone increases, which may require a dose adjustment;
risperidone: blood levels of paliperidone may increase.

Analogs

Invega's analogs are Trevikta, Xeplion, Torendo, Rispolept, Rileptid, Risset, etc.

Terms and conditions of storage

Store at 15-30 ° C. Keep out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Inweg

Reviews about Inweg are mostly positive. The drug effectively relieves the productive symptoms of schizophrenia (hallucinations, delusions). They note that apathy passes, social communication increases and a desire to act appears. Most often, the disadvantages indicate an increase in prolactin, an increase in body weight, hormonal disorders.

Price for Inwegu in pharmacies

The approximate price for Invega (28 tablets) is:

dosage 3 mg - 6900-7149 rubles;
dosage 6 mg - 4700-7185 rubles;
dosage of 9 mg - 4700–9716 rubles.

Invega: prices in online pharmacies

Drug name

Price

Pharmacy

Invega 9 mg film-coated tablets of prolonged action 28 pcs.

RUB 4572

Buy

Invega 3 mg film-coated tablets of prolonged action 28 pcs.

RUB 5,999

Buy

Invega 6 mg film-coated tablets of prolonged action 28 pcs.

RUB 6377

Buy

Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!