Paliperidone Teva (Paliperidone Palmitate)

Paliperidone palmitate is a long‑acting formulation that acts on dopamine and serotonin pathways to manage chronic psychotic disorders.

• Schizophrenia: Reduces the frequency of psychotic relapses and stabilises mood in adult patients.
• Schizoaffective disorder: Helps maintain symptom control when oral therapy is insufficient.
• Maintenance therapy for schizophrenia: Provides consistent plasma levels to minimise breakthrough symptoms between oral dosing intervals.

• Paliperidone palmitate is a pro‑drug of paliperidone that, after intramuscular administration, is slowly hydrolysed to release paliperidone. The active moiety antagonises dopamine D2 and serotonin 5‑HT2A receptors, modulating neurotransmission in mesolimbic and mesocortical pathways 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
• Drowsiness or somnolence
• Weight gain
• Restlessness (akathisia)
• Dry mouth

Serious or Rare Side Effects

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

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

• Cardiovascular assessment: Evaluate for history of arrhythmias or QT prolongation.
• Metabolic monitoring: Check blood glucose and lipid profiles regularly.
• Movement disorders: Observe for signs of tardive dyskinesia or akathisia.
• Pregnancy and lactation: Use only if the potential benefit justifies the risk.
• Elderly patients: Start at the lowest recommended dose and monitor closely for sedation.
• Store at ambient temperature: Keep in original packaging, protect from moisture and direct sunlight.

Paliperidone palmitate can interact with other medicines that affect its metabolism or cardiac conduction.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): May increase paliperidone exposure.
• QT‑prolonging agents (e.g., quinidine, sotalol): Heighten risk of cardiac arrhythmias.

Moderate Interactions (Monitor Closely)

• CNS depressants (e.g., benzodiazepines, opioids): May enhance sedation.
• Antihypertensives: May potentiate orthostatic hypotension.
• Antidiabetic drugs: May require dose adjustment if hyperglycaemia develops.