Paliperidon Teva (Paliperidone Palmitate)

Paliperidon Teva is an atypical antipsychotic used in the management of schizophrenia and related psychotic disorders. It helps reduce relapse risk and maintain stability in patients diagnosed with:

• Schizophrenia: Improves overall symptom control and reduces the frequency of relapse.
• Schizoaffective disorder: Assists in stabilising mood and psychotic symptoms.
• Maintenance therapy for schizophrenia: Provides long‑term symptom management after acute episodes.
• Relapse prevention in chronic psychosis: Extends the interval between dosing compared with daily oral agents.

• Paliperidone palmitate is a long‑acting pro‑drug of paliperidone that, after intramuscular administration, is slowly hydrolysed to release paliperidone. The active molecule antagonises dopamine D2 and serotonin 5‑HT2A receptors, modulating neurotransmission implicated in psychosis and helping to stabilise mood and thought processes.

Adverse reactions to paliperidone palmitate can vary in frequency and severity.

Common Side Effects

• Injection site pain or erythema: Local discomfort at the administration site.
• Weight gain: Modest increase in body weight over time.
• Akathisia: Restlessness or an urge to move.
• Somnolence: Drowsiness or fatigue.
• Constipation: Reduced bowel motility.
• Dry mouth: Decreased salivation.

Serious or Rare Side Effects

• Neuroleptic malignant syndrome: Potentially life‑threatening reaction with fever and muscle rigidity.
• Tardive dyskinesia: Involuntary, repetitive movements that may be irreversible.
• Hyperglycaemia: Elevated blood glucose levels, especially in diabetic patients.
• Orthostatic hypotension: Sudden drop in blood pressure upon standing.
• Seizures: Rare occurrence of convulsive episodes.
• Elevated prolactin: May cause galactorrhoea or menstrual disturbances.

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

• Cardiovascular assessment: Evaluate for history of arrhythmias or QT prolongation before initiating therapy.
• Metabolic monitoring: Regularly check blood glucose, lipid profile and weight.
• Pregnancy and lactation: Use only if the potential benefit outweighs risk; discuss with a specialist.
• Elderly patients: Start at the lowest effective dose and monitor for orthostatic effects.
• Concomitant CNS depressants: Use caution as additive sedation may occur.
• Store at room temperature: Keep in the original packaging, protect from light and moisture.

Paliperidone palmitate may interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): May increase paliperidone levels and risk of toxicity.
• CNS depressants (e.g., benzodiazepines, opioids): Heightened sedation and respiratory depression risk.
• Antihistamines with anticholinergic properties: May exacerbate anticholinergic side effects.

Moderate Interactions (Monitor Closely)

• CYP2D6 substrates (e.g., metoprolol, codeine): Potential for altered plasma concentrations.
• Antidiabetic agents: May require dose adjustments due to hyperglycaemic effect.",