Paliperidon Krka (Paliperidone)

Paliperidone is an atypical antipsychotic that modulates dopamine and serotonin pathways in psychotic disorders.

• Schizophrenia: helps reduce hallucinations, delusions and thought disorder.
• Schizoaffective disorder: improves mood symptoms and psychotic features.
• Maintenance therapy: helps prevent relapse of psychotic episodes after stabilization.

• Paliperidone acts primarily as a dopamine D2‑receptor antagonist and also blocks serotonin 5‑HT2A receptors. By inhibiting dopamine transmission in mesolimbic pathways and modulating serotonergic activity, it reduces positive psychotic symptoms while exerting a lower risk of motor side effects compared with typical antipsychotics.

Paliperidone may cause a range of adverse reactions that vary in frequency and severity.

Common Side Effects

• Akathisia: feeling of inner restlessness.
• Drowsiness or somnolence.
• Weight gain.
• Dry mouth.
• Constipation.
• Increased prolactin levels.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: high fever, muscle rigidity, autonomic instability.
• Tardive dyskinesia: involuntary, repetitive movements.
• Seizures: especially in patients with a history of epilepsy.
• Orthostatic hypotension: marked drop in blood pressure upon standing.
• Hyperglycaemia: elevated blood glucose levels, may worsen diabetes.

When prescribing Paliperidone, clinicians should consider several safety aspects.

• Cardiovascular assessment: evaluate baseline ECG and monitor for QT prolongation.
• Metabolic monitoring: check weight, fasting glucose, and lipid profile regularly.
• Prolactin monitoring: assess for galactorrhea, menstrual changes, or sexual dysfunction.
• CNS effects: advise patients about drowsiness and avoid operating heavy machinery.
• Pregnancy and lactation: use only if benefits outweigh risks; discuss with obstetric specialist.
• Store at ambient temperature: keep below 25°C, in the original container, protected from moisture and light.

Paliperidone can interact with other medicines, altering its effectiveness or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole) – may increase paliperidone levels.
• Strong CYP3A4 inducers: (e.g., rifampicin) – may reduce the  ...