What are the common side effects of Invega (Paliperidone)?

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Last updated: March 13, 2025View editorial policy

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From the Guidelines

Invega (paliperidone) is associated with a range of common side effects, including extrapyramidal symptoms (EPS) such as dyskinesia, akathisia, hypokinesia, tremor, and extrapyramidal disorder, as reported in 34% of patients in the acute and continuation treatment phases 1. These side effects can be distressing and impact the patient's quality of life.

  • The most common EPS-related side effects include:
    • Dyskinesia
    • Akathisia
    • Hypokinesia
    • Tremor
    • Extrapyramidal disorder
  • Other potential side effects of Invega (paliperidone) may include:
    • Drowsiness
    • Dizziness
    • Weight gain
    • Increased appetite
    • Restlessness
    • Headaches
    • Insomnia
    • Anxiety
    • Constipation
    • Sexual side effects such as decreased libido, erectile dysfunction, and menstrual irregularities It is essential to monitor patients taking Invega (paliperidone) for these side effects and adjust the treatment plan as needed to minimize their impact on the patient's quality of life.
  • Healthcare providers should be aware of the potential for serious side effects, such as neuroleptic malignant syndrome, tardive dyskinesia, and increased prolactin levels, which can lead to breast enlargement or milk production 1. Patients experiencing severe side effects should contact their healthcare provider immediately, rather than stopping the medication abruptly, to avoid withdrawal symptoms and ensure proper management of their condition 1.

From the FDA Drug Label

The most common adverse reactions in clinical trials in adult subjects with schizophrenia (reported in 5% or more of subjects treated with paliperidone and at least twice the placebo rate in any of the dose groups) were extrapyramidal symptoms, tachycardia, and akathisia The most common adverse reactions in clinical trials in adult patients with schizoaffective disorder (reported in 5% or more of subjects treated with paliperidone and at least twice the placebo rate) were extrapyramidal symptoms, somnolence, dyspepsia, constipation, weight increased, and nasopharyngitis

The common side effects of Invega (Paliperidone) are:

  • Extrapyramidal symptoms
  • Tachycardia
  • Akathisia
  • Somnolence
  • Dyspepsia
  • Constipation
  • Weight increased
  • Nasopharyngitis 2

From the Research

Common Side Effects of Invega (Paliperidone)

The common side effects of Invega (Paliperidone) include:

  • Extrapyramidal symptoms, such as Parkinsonism, akathisia, and use of anticholinergic medications, which increased in a dose-related manner 3
  • Tachycardia and somnolence, which were among the most common clinically relevant adverse events associated with paliperidone ER 3
  • Modest QTc interval prolongation, which did not produce clinical symptoms 3
  • Increases in serum prolactin levels, similar to risperidone 3, 4
  • Weight gain, with clinically significant gains in bodyweight seen in 15% of patients treated with paliperidone ER during the extension phase of placebo-controlled trials 4
  • Extrapyramidal symptoms, which occurred in approximately a quarter of the patients treated with higher doses of paliperidone ER (9 and 12 mg/day) in 6-week trials, and in 25% of paliperidone ER (mean dosage 10 mg/day) recipients during the 52-week extension phases 4

Rare but Severe Side Effects

Rare but severe side effects of Invega (Paliperidone) include:

  • Acute dystonia with rhabdomyolysis, which has been reported in a patient treated with long-acting injectable paliperidone palmitate 5
  • Rebound catatonia, which has been associated with injectable paliperidone in a patient with schizophrenia 6
  • Catatonia, which is a rare but severe side effect that can occur in patients treated with antipsychotics, including paliperidone 6

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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