Invega (Paliperidone) for Schizophrenia

Invega (paliperidone) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat schizophrenia in adults and adolescents ages 12 to 17.

How Invega Works and How It’s Taken

Invega is a type of antipsychotic medicine. It affects dopamine and serotonin activity in the brain. The exact way it works is not fully known, but it may help reduce symptoms linked to schizophrenia.

Doctors prescribe Invega to treat schizophrenia in adults and teens ages 12 to 17.

Invega is given as an extended-release tablet by mouth, usually once daily. It can be taken with or without food. The tablet should be swallowed whole and not chewed, crushed, or split.

There are also long-acting injectable forms of paliperidone for adults with schizophrenia:

Invega Sustenna is given by a healthcare professional once every month
Invega Trinza is given every three months for adults who have already been treated with Invega Sustenna for at least four months
Invega Hafyera is given every six months for adults who have already been treated with either Invega Sustenna or Invega Trinza for a required period of time

Typical Dosing for Schizophrenia

The recommended dose of Invega for schizophrenia in adults is 6 milligrams once daily. Some people may benefit from a lower dose of 3 milligrams per day or a higher dose of up to 12 milligrams per day.

For adolescents ages 12 to 17, the recommended starting dose is 3 milligrams once daily.

For those who weigh less than 51 kilograms, the recommended dose range is 3 milligrams to 6 milligrams per day, with a maximum dose of 6 milligrams per day
For those who weigh 51 kilograms or more, the recommended dose range is 3 milligrams to 12 milligrams per day, with a maximum dose of 12 milligrams per day

If needed, doctors may raise the dose in 3-milligram steps at intervals of more than five days. People with kidney problems may need a lower dose.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Invega Side Effects

In clinical studies of Invega for schizophrenia in adults and adolescents ages 12 to 17, the most common side effects occurred in at least 5 percent to 20 percent of people. These include:

Extrapyramidal symptoms (movement-related symptoms, such as stiffness, shaking, or slowed movements)
Akathisia (restlessness or feeling unable to sit still)
Tachycardia (fast heartbeat)
Somnolence (sleepiness)
Tremor (shaking)
Dystonia (muscle spasms or abnormal muscle contractions)
Cogwheel rigidity (muscle stiffness with a “ratchety” feel)
Anxiety
Weight increased (weight gain)
Nasopharyngitis (sore throat and stuffy nose)

Serious Side Effects and Warnings

Invega can cause serious side effects that may require immediate medical attention. These include:

Increased risk of death in older adults with dementia-related psychosis — Invega is not approved for this use.
Stroke and other blood vessel problems in the brain — These can occur in older adults with dementia-related psychosis.
Neuroleptic malignant syndrome (NMS) — This rare, life-threatening reaction can cause very high fever, severe muscle stiffness, confusion, and unstable blood pressure or heart rate.
QT prolongation — Heart rhythm changes can lead to dangerous irregular heartbeats.
Tardive dyskinesia — Uncontrolled movements, often of the face or tongue, may not go away.
Metabolic changes — High blood sugar, unhealthy cholesterol levels, and weight gain can raise the risk of diabetes and heart disease.
Hyperprolactinemia — High prolactin levels can cause breast milk leakage, missed periods, breast enlargement, and sexual problems, and they may lower bone density over time.
Leukopenia, neutropenia, and agranulocytosis — Low white blood cell problems may increase infection risk.
Seizures — Seizures can occur with Invega.
Orthostatic hypotension and fainting — A sudden drop in blood pressure when standing can occur.
Dysphagia and aspiration — Trouble swallowing and breathing food or liquid into the lungs can occur.
Priapism — Painful or long-lasting erection can occur.
Severe allergic reactions — Hypersensitivity, including anaphylaxis or angioedema, can cause swelling of the face, lips, tongue, or throat.
Gastrointestinal obstruction — Bowel blockage or ileus, a serious slowing or stopping of the intestines, can occur.
Falls — Falls can lead to injuries or fractures.
Problems controlling body temperature — Invega may affect the body’s ability to regulate temperature.
Cognitive and motor impairment — Problems with judgment, thinking, or movement can occur.

Get medical help right away if you think you are having a serious reaction.

How To Save on Invega

The Invega website offers cost and support information for Invega tablets.

What To Know Before Taking Invega

Tell your doctor if you are allergic to paliperidone, risperidone, or any ingredients in Invega. Do not take Invega if you have had a serious allergic reaction to paliperidone, risperidone, or any ingredients in Invega.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Invega may interact with other medicines.

Avoid drinking alcohol while taking Invega.

Invega is also FDA-approved to treat schizoaffective disorder in adults.

There is a pregnancy exposure registry for people who take Invega during pregnancy. To learn more, visit the National Pregnancy Registry for Atypical Antipsychotics or call 866-961-2388.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Invega, talk with your doctor about the risks and benefits.

Breastfed infants exposed to Invega should be monitored for excess sleepiness, poor weight gain, jitteriness, or abnormal muscle movements.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Invega?

In adults with schizophrenia, Invega was studied in three six-week trials at doses from 3 milligrams to 15 milligrams once daily, and it was better than placebo (an inactive treatment) at improving schizophrenia symptoms and personal and social functioning.

In a longer-term maintenance study, people taking Invega had a significantly longer time to relapse than people taking placebo, and the study was stopped early because maintenance of benefit was shown. In adolescents ages 12 to 17, a six-week study showed benefit at doses from 3 milligrams to 12 milligrams per day, but higher doses did not clearly improve effectiveness, and side effects were dose related.

How long does Invega take to work for schizophrenia?

In clinical studies, schizophrenia symptoms were measured over six weeks of treatment with Invega.

After a dose of Invega, paliperidone levels in the body usually reach their highest point in about 24 hours. With daily use, steady levels of the medicine are usually reached within four to five days.

The study results do not say exactly when symptom improvement may begin. Some people may notice changes sooner than others. Always take Invega exactly as prescribed and talk with your doctor about what to expect from treatment.

Can Invega be used with other medicines for schizophrenia?

Invega should be used carefully with certain other medicines. Tell your doctor about all medicines you take, including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements.

Invega may increase dizziness or low blood pressure when taken with medicines that lower blood pressure. It should also be used carefully with other medicines that affect the brain or with alcohol.

Invega may work against levodopa and other dopamine agonists, which are medicines sometimes used for Parkinson’s disease.

Some medicines can change the amount of paliperidone in the body: