Indications for: INVEGA TRINZA
Schizophrenia after adequately treated with Invega Sustenna (1-month paliperidone palmitate ext-rel inj susp) for ≥4 months.
Establish tolerability with Invega Sustenna prior to initiating. Give by deep deltoid or gluteal IM inj when next Invega Sustenna dose is scheduled using 3.5-fold higher dose equivalent (see full labeling). Maintenance: give once every 3 months; may adjust dose every 3 months in increments of 273–819mg based on tolerability and/or efficacy. Renal impairment: CrCl ≥50–<80mL/min: adjust dose and stabilize patient using Invega Sustenna, then transition to Invega Trinza; CrCl<50mL/min: not recommended. Missed doses or switching from other antipsychotics: see full labeling.
<18yrs: not established.
INVEGA TRINZA Contraindications:
Increased mortality in elderly patients with dementia-related psychosis.
INVEGA TRINZA Warnings/Precautions:
Elderly with dementia-related psychosis (not approved use): increased risk of death. Discontinue immediately if neuroleptic malignant syndrome (NMS) is suspected. Avoid in congenital long QT syndrome, history of cardiac arrhythmias. Consider discontinuation if tardive dyskinesia occurs. Cardio- or cerebrovascular disease; risks may be increased due to metabolic changes (eg, hyperglycemia, dyslipidemia, weight gain); monitor. Conditions that predispose to hypotension (eg, dehydration, hypovolemia). Diabetes risk factors (obtain baseline fasting blood sugar and periodically thereafter). Perform fall risk assessments when initiating and recurrently on long-term therapy (esp. in elderly). History of significant low WBC/ANC or drug-induced leukopenia/neutropenia; obtain CBCs frequently during 1st few months of treatment; consider discontinuation if significant decline in WBC. Monitor for signs/symptoms of infection in those with neutropenia; discontinue if severe (ANC <1000mm3) and follow WBC until recovery. History of seizures. Conditions that lower the seizure threshold. Patients at risk for aspiration pneumonia. Exposure to extreme temperatures. Write ℞ for smallest practical amount. Reevaluate periodically. Parkinson's disease. Dementia with Lewy bodies. Renal impairment. Severe hepatic impairment. Neonates: risk of extrapyramidal and/or withdrawal symptoms post delivery (due to exposure during 3rd-trimester pregnancy). Pregnancy. Nursing mothers: monitor infants.
INVEGA TRINZA Classification:
INVEGA TRINZA Interactions:
Avoid drugs that prolong QT interval (eg, Class 1A and Class III antiarrhythmics, chlorpromazine, thioridazine, gatifloxacin, moxifloxacin). Avoid concomitant strong CYP3A4 and/or P-gp inducers (eg, carbamazepine, rifampin, St. John's Wort); if coadmin necessary, consider oral paliperidone ext-rel tabs. Caution with other CNS drugs, alcohol, drugs that may cause orthostatic hypotension (monitor). Caution with anticholinergic drugs that may elevate body temperature. May antagonize levodopa, other dopamine agonists. Additive effects with concomitant risperidone or oral paliperidone for long-term use; caution.
Inj site reactions, somnolence/sedation, dizziness, akathisia, extrapyramidal disorder; may cause NMS, tardive dyskinesia, QT prolongation, metabolic changes, hyperprolactinemia, orthostatic hypotension, syncope, agranulocytosis, priapism.
Generic Drug Availability:
Kit—1 (prefilled syringe + needles)