Paliperidon Teva (Paliperidone Palmitate)

Paliperidone palmitate is an atypical antipsychotic indicated for the treatment of schizophrenia and related psychotic disorders.

• Schizophrenia: Reduces the frequency and severity of psychotic episodes and helps maintain long‑term stability.
• Schizoaffective disorder: Controls mood‑related symptoms while addressing core psychotic features.
• Maintenance therapy after acute stabilization: Provides sustained drug exposure to prevent relapse without daily oral dosing.

• Paliperidone palmitate is a long‑acting pro‑drug of paliperidone that, after intramuscular administration, is slowly hydrolysed to release paliperidone. Paliperidone antagonises dopamine D2 and serotonin 5‑HT2A receptors, modulating neurotransmission in pathways implicated in psychosis and thereby reducing psychotic symptoms.

Paliperidone palmitate may cause a range of adverse reactions, most of which are dose‑dependent and reversible.

Common Side Effects

• Injection site pain or erythema.
• Headache.
• Weight gain.
• Restlessness or akathisia.
• Fatigue.
• Nausea.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome.
• Tardive dyskinesia.
• Severe orthostatic hypotension.
• Seizures.
• Hyperglycaemia or new‑onset diabetes.
• Elevated prolactin with associated endocrine effects.

When prescribing Paliperidone palmitate, clinicians should consider several safety aspects.

• Cardiovascular assessment: Evaluate for history of arrhythmias or QT prolongation.
• Metabolic monitoring: Check weight, glucose and lipid profiles regularly.
• Pregnancy and lactation: Use only if the potential benefit outweighs risk.
• Elderly patients: Start at the lowest recommended dose and monitor closely for sedation and falls.
• Drug‑interaction review: Assess concomitant medications that may affect cardiac or metabolic status.
• Store at room temperature: Keep in original packaging, protect from moisture and direct sunlight.

Paliperidone palmitate can interact with other medicines; careful review is required.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): May increase paliperidone exposure and risk of toxicity.
• CNS depressants (e.g., benzodiazepines, opioids): May enhance sedation and respiratory depression.

Moderate Interactions (Monitor Closely)

• Antihypertensives: May potentiate orthostatic hypotension.
• Antidiabetic agents: May require dose adjustment due to altered glucose control.
• Anticholinergic drugs: May increase risk of constipation and urinary retention.
• QT‑prolonging agents: May modestly increase QT interval when combined.