What is the starting dose of Invega (paliperidone) injection?

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Last updated: May 13, 2025View editorial policy

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From the Research

The starting dose of Invega (paliperidone) injection, also known as Invega Sustenna, is typically 234 mg on day 1, followed by 156 mg one week later (day 8), both administered in the deltoid muscle. After these initial loading doses, the recommended monthly maintenance dose is 117 mg, which can be given in either the deltoid or gluteal muscle. Dose adjustments may be necessary based on individual patient factors such as renal function, with lower doses recommended for patients with mild to moderate renal impairment. The injection should be administered by a healthcare professional using the provided pre-filled syringes and needles. Invega is a long-acting atypical antipsychotic that works by blocking dopamine and serotonin receptors in the brain, helping to manage symptoms of schizophrenia and schizoaffective disorder. The loading dose strategy allows the medication to reach therapeutic levels quickly, while the monthly maintenance injections help ensure consistent medication levels and potentially improve treatment adherence compared to daily oral medications.

Some key points to consider when administering Invega Sustenna include:

  • The importance of proper administration technique to minimize the risk of injection-site reactions
  • The need for regular monitoring of patient response to treatment and adjustment of the dose as needed
  • The potential for side effects such as extrapyramidal symptoms, orthostatic hypotension, and hyperprolactinemia, which should be carefully managed
  • The availability of alternative formulations, such as paliperidone palmitate three-monthly, which may be suitable for some patients 1.

It is also worth noting that the evidence for the use of Invega Sustenna in clinical practice is supported by studies such as those published in the Journal of Psychopharmacology 1 and Clinical Drug Investigation 2, which demonstrate the efficacy and safety of the medication in the treatment of schizophrenia and schizoaffective disorder. However, the most recent and highest quality study is not directly related to the starting dose of Invega injection, therefore the recommendation is based on the general clinical guidelines and previous studies 3, 4, 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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