Dosing Tips - Oral

Tablet should not be divided or chewed, but rather should only be swallowed whole Tablet does not change shape in the GI tract and generally should not be used in patients with gastrointestinal narrowing because of the risk of intestinal obstruction Some patients may benefit from doses above 6 mg/day; alternatively, for some patients 3 mg/day may be sufficient A common dosage error is to assume the paliperidone ER oral dose is the same as the risperidone oral dose in mg, and that paliperidone should be titrated. However, many patients do well initiating a dose of 6 mg orally of paliperidone ER without titration

There is a dose-dependent increase in some side effects, including extrapyramidal symptoms and weight gain, above 6 mg/ day

Rather than raise the dose above these levels in acutely agitated patients requiring acute antipsychotic actions, consider

Augmentation with a benzodiazepine or conventional antipsychotic, either orally or intramuscularly

•  Rather than raise the dose above these levels in partial responders, consider augmentation with a mood-stabilizing anticonvulsant, such as valproate or lamotrigine

•  Children and elderly should generally be dosed at the lower end of the dosage spectrum

•  Treatment should be suspended if absolute neutrophil count falls below 1,000/mm3

•  Oral doses correspond to injection doses as follows: 3 mg oral to 39-78 mg injection, 6 mg oral to 117 mg injection,

12 mg oral to 234 mg injection

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  • Category: Nervous diseases