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Paliperidone palmitate 1-month long-acting injectable (Invega Sustenna®): Basic Information

Paliperidone palmitate 1-month (PP1M) long-acting injectable (Invega Sustenna®) is an extended-release injectable second-generation (“atypical”) antipsychotic. Here is basic information about this medication.


FDA-approved indications

1. Treatment of schizophrenia in adults

2. Treatment of schizoaffective disorder in adults as monotherapy and as an adjunct to mood stabilizers or antidepressants


Dosage

A. Schizophrenia

Initiation (IM deltoid): Administer 234 mg on day 1; 156 mg on day 8

Monthly maintenance dose (IM deltoid or gluteal): 39–234 mg (administered 5 weeks after first injection)

Maximum monthly dose: 234 mg

(Recommended maintenance dose for schizophrenia is 117 mg, though some patients may benefit from higher or lower doses within available strengths)


B. Schizoaffective disorder

Initiation (IM deltoid): 234 mg on day 1; 156 mg on day 8

Monthly maintenance dose (IM deltoid or gluteal): 78–234 mg (based upon tolerability and efficacy)

Maximum monthly dose: 234 mg


C) Use in specific population: patients with renal impairment

Mild renal impairment (creatinine clearance 50-80 mL/min): Administer 156 mg on treatment day 1 and 117 mg one week later, both on deltoid muscle. Follow with monthly injections of 78 mg in either the deltoid or gluteal muscle.

Moderate to severe renal impairment (creatinine clearance<50 mL/min): Invega  Sustenna® is not recommended


Dosage forms and strengths

Extended-release injectable suspension: 39 mg, 78 mg, 117 mg, 156 mg, and 234 mg


Important! Please refer to the full Prescribing Information before prescribing this medication.


Related Pages

Dose equivalents of long-acting injectable second-generation antipsychotics

Equivalence of risperidone oral and long-acting injection (RLAI; Risperdal Consta®)

CPT billing code for administration of injections

Aripiprazole lauroxil (Aristada®) versus Aripiprazole (Abilify Maintena®)

Be careful in converting from Abilify Maintena® to Aristada®

Long-acting injectable antipsychotics: Overview

Aripiprazole (Abilify Maintena®): Basic information

Aripiprazole lauroxil (Aristada®): Basic information

Olanzapine (Zyprexa Relprevv®): Basic information

Paliperidone palmitate (Invega Sustenna®): Basic information

Paliperidone palmitate 3-month (Invega Trinza®): Basic information

Risperidone long-acting injection (Risperdal Consta®): Basic Information


References

Paliperidone palmitate (Invega Sustenna®) Prescribing Information


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Disclaimer: The material on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified healthcare professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.

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Comments

  1. vnmakhija says

    March 31, 2025 at 1:37 pm

    Dear Dr. Mago
    I have a 55 years old patient with schizoaffective disorder who is stable on risperidone 3mgs/d. I want to give her LAI. Unfortunately, Uzedy is not covered by her insurance but Invega Sustenna and Risperdal Consta are covered. What is a reliable conversion from oral risperidone to Sustenna? For someone who is stable risperidone 3mg/d, do I still give the dose of 234mg initially and 156mg on day 8 before putting her on monthly maintenance per the conversion guideline?
    Thank you.

    Reply

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Copyright 2016 to 2025: Simple and Practical Medical Education, LLC. All rights reserved.