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Invega Sustenna is a long-acting intramuscular antipsychotic containing paliperidone palmitate. It is indicated for schizophrenia in adults and for schizoaffective disorder in adults as monotherapy or with mood stabilizers or antidepressants.
read more about invega sustenna ...Paliperidone palmitate is converted to paliperidone after injection. The exact therapeutic mechanism is not established, but paliperidone activity is thought to involve antagonism at dopamine D2 and serotonin 5-HT2A receptors.
Invega Sustenna is used in adults with schizophrenia or schizoaffective disorder. Tolerability with oral paliperidone or oral risperidone is established before the first injection in patients who have not previously taken either medicine. It is not recommended when creatinine clearance is below 50 mL per minute.
The standard initiation regimen uses 234 mg in the deltoid muscle on day 1 and 156 mg in the deltoid muscle one week later. Monthly maintenance begins five weeks after the first injection and can be given in the deltoid or gluteal muscle. The recommended schizophrenia maintenance dose is 117 mg monthly, with adjustments based on response and tolerability.
Invega Sustenna carries a boxed warning for increased mortality in older adults with dementia-related psychosis and is not approved for that use. Other serious concerns include neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, QT prolongation, high prolactin, orthostatic hypotension, low white blood cell counts, and seizures.
It treats schizophrenia and schizoaffective disorder in adults.
The standard initiation regimen starts with 234 mg in the deltoid muscle on day 1.
The second dose is 156 mg in the deltoid muscle one week after the first dose.
No. Current labeling does not recommend it when creatinine clearance is below 50 mL per minute.
INVEGA SUSTENNA (Paliperidone Palmitate) Prescribing Information. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1af14e42-951d-414d-8564-5d5fce138554. Date Accessed October 5, 2026.
INVEGA SUSTENNA Prescribing Information. https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVEGA%2BSUSTENNA-pi.pdf. Date Accessed October 5, 2026.
Paliperidone Injection: MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a615032.html. Date Accessed October 5, 2026.
Paliperidone Palmitate, a Potential Long-Acting Treatment for Patients With Schizophrenia: Results of a Randomized, Double-Blind, Placebo-Controlled Efficacy and Safety Study. https://pubmed.ncbi.nlm.nih.gov/19941696/. Date Accessed October 5, 2026.
Paliperidone Palmitate Once-Monthly Reduces Risk of Relapse of Psychotic, Depressive, and Manic Symptoms and Maintains Functioning in a Double-Blind, Randomized Study of Schizoaffective Disorder. https://pubmed.ncbi.nlm.nih.gov/25562685/. Date Accessed October 5, 2026.