Paliperidone
Rx Only
Generic NamePaliperidone
Therapeutic ClassAtypical Antipsychotic
Common Dose6–12 mg once daily
Max / 24h12 mg
PregnancyCategory C
Indications ▼
Schizophrenia in adults and adolescents (13–17 years)
Schizoaffective disorder (as monotherapy or adjunct to mood stabilizers)
Mechanism & Pharmacokinetics ▼
Mechanism: Paliperidone is a dopamine D2 and serotonin 5-HT2A receptor antagonist; it modulates neurotransmission to reduce psychotic symptoms.
Pharmacokinetics: Oral bioavailability ~28%; peak plasma levels 24 hours post-dose. Primarily excreted unchanged in urine; half-life ~23 hours. Extended-release and long-acting injection forms available for sustained effect.
Dosage & Administration ▼
| Patient Category | Recommended Dose | Max / 24h |
|---|---|---|
| Adults (Schizophrenia) | 6 mg orally once daily; adjust based on response | 12 mg |
| Elderly | Start 3 mg once daily; titrate slowly | 6 mg |
| Adolescents (13–17 yrs) | 3–6 mg once daily; monitor closely | 6 mg |
| Schizoaffective Disorder (IM long-acting) | Start with 234 mg IM day 1, 156 mg day 8; maintain 117 mg every 4 weeks | 117 mg per 4 weeks |
Note: Can be taken with or without food. Swallow tablets whole. Monitor for extrapyramidal symptoms, orthostatic hypotension, and metabolic changes.
Side Effects ▼
Common: Insomnia, headache, anxiety, weight gain
Occasional: Extrapyramidal symptoms, orthostatic hypotension, hyperprolactinemia
Rare: Tardive dyskinesia, neuroleptic malignant syndrome, QT prolongation
Contraindications ▼
Hypersensitivity to paliperidone or risperidone
Severe CNS depression
History of QT prolongation or cardiac arrhythmias
Drug Interaction ▼
CYP2D6 and P-gp substrates: monitor for altered plasma levels
Other antipsychotics: additive CNS or cardiac effects
Drugs prolonging QT interval: increased risk of arrhythmia
Pregnancy & Lactation ▼
Category C; use only if benefits outweigh risks
Excreted in breast milk; avoid breastfeeding during therapy
Clinical / Research Summary ▼
Effective for controlling positive and negative symptoms of schizophrenia.
Long-acting IM formulation improves adherence in chronic cases.
Generally well-tolerated; monitor metabolic and cardiac parameters.
Patient Counseling Points ▼
Take at the same time daily; do not stop abruptly.
Monitor weight, blood sugar, and blood pressure regularly.
Report unusual movements, palpitations, or severe dizziness.
Avoid alcohol and CNS depressants while taking this drug.
Storage & Handling ▼
Store at 20–25°C
Protect from moisture and light
Keep out of reach of children
Brand Names (Bangladesh & Global) ▼
Modesto XR® 3 mg
Medical Disclaimer: This clinical summary is for informational purposes only. Always consult a qualified healthcare professional for dosage, interactions, and use.
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