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Schizophrenia Clinical criteria: Patient must have previously received and be stabilised on PBS-subsidised paliperidone once-monthly injection for at least 4 consecutive months; OR Patient must have previously received and be stabilised on PBS-subsidised paliperidone six-monthly injection for at least one cycle.
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“Paliperidone is a centrally active dopamine Type 2 (D2) receptor antagonist and a serotonin Type 2 (5HT2A) receptor antagonist.”
“The median apparent half-life of paliperidone following a single INVEGA HAFYERA of either 700 or 1000 mg was 148 and 159 days respectively.”
“In vitro studies in human liver microsomes showed that paliperidone does not substantially inhibit the metabolism of medicines metabolised by cytochrome P450 isozymes, including CYP1A2, CYP2A6, CYP2C8/9/10, CYP2D6, CYP2E1, CYP3A4, and CYP3A5.”
A plain-language summary of the cited sources below. Informational only — not medical advice.
Paliperidone is an antipsychotic medication approved in Australia for the treatment of schizophrenia. It works by blocking specific receptors in the brain—dopamine Type 2 receptors and serotonin Type 2A receptors—which helps reduce symptoms such as hallucinations, delusions, and disorganised thinking. The medication is available both as a tablet taken by mouth and as a long-acting injection. When taken by mouth, it stays in the body for around 23 hours before half of it is cleared. The injectable form lasts much longer, with a median half-life of 148 to 159 days depending on the dose, meaning it provides symptom control for weeks or months after a single injection.
Common side effects include upper respiratory tract infections, nasopharyngitis (cold-like symptoms), headache, weight gain, and pain at the injection site if your family member receives the injectable form. These effects are generally mild but worth monitoring, especially weight changes over time.
There are also serious side effects that occur less often but require immediate medical attention. Neuroleptic malignant syndrome is a rare but life-threatening reaction causing high fever, muscle stiffness, confusion, and changes in heart rate or blood pressure. Tardive dyskinesia involves involuntary movements, often of the face or tongue, which can become permanent if not caught early. Other serious risks include suicidal thoughts, a severe drop in white blood cells (agranulocytosis) that increases infection risk, and severe skin reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis. If you notice any of these symptoms, seek urgent medical care.
Paliperidone should not be used in people who have had an allergic reaction to paliperidone itself, to any ingredient in the formulation, or to risperidone, a closely related medication. Laboratory studies show that paliperidone does not significantly interfere with enzymes that break down other medications, which means it is less likely than some other drugs to cause problematic interactions through that pathway.
A plain-language summary of the cited sources below. Informational only — not medical advice.
Paliperidone is a centrally active dopamine D2 and serotonin 5HT2A receptor antagonist indicated for the treatment of schizophrenia and, in long-acting injectable formulations, for maintenance treatment of schizophrenia in adult patients stabilised on prior monthly or quarterly paliperidone palmitate regimens. It is the active metabolite of risperidone and is contraindicated in patients with known hypersensitivity to paliperidone, risperidone, or formulation excipients.
The oral formulation has an apparent half-life of approximately 23 hours, while long-acting injectable depot formulations exhibit median apparent half-lives of 148 to 159 days depending on dose. In vitro studies in human liver microsomes indicate that paliperidone does not substantially inhibit metabolism via CYP1A2, CYP2A6, CYP2C8/9/10, CYP2D6, CYP2E1, CYP3A4, or CYP3A5. Common adverse effects include upper respiratory tract infection, nasopharyngitis, headache, weight gain, and injection-site pain. Serious adverse effects include neuroleptic malignant syndrome, tardive dyskinesia, suicidal ideation, agranulocytosis, and Stevens-Johnson syndrome/toxic epidermal necrolysis.
Curated subset. The full adverse-effect list is in the TGA Product Information; click any citation above to open it.