Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
Paliperidone
Atypical Antipsychotic · Antipsychotic
Atypical AntipsychoticAntipsychotic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
B
FDA category + note
Top interactionssee all 12 →
- AlfentanilSevereDatabaseDDInter
- AmiodaroneSevereDatabaseDDInter
- AmisulprideSevereDatabaseDDInter
- AnagrelideSevereDatabaseDDInter
Mechanism
Paliperidone is a metabolite of risperidone.
Indications
SchizophreniaPsychotic or manic symptoms of schizoaffective disorderMaintenance of schizophrenia in patients who are clinically stable on once-monthly intramuscular paliperidoneMaintenance in schizophrenia in patients previously responsive to paliperidone or risperidone
Dosing
- Adult
- By mouth: Initially 6 mg once daily in the morning, adjusted in steps of 3 mg if required, over at least 5 days; usual dose 3–12 mg daily.…
- Pediatric
- Schizophrenia (ages 13–17): approved.
- Max dose
- Oral: 12 mg daily. Intramuscular (Xeplion): 150 mg once a month. Intramuscular (Trevicta): 525 mg every 3 months.
Pharmacokinetics
Peak effect
24 h
Bioavailability
28%
Protein binding
74%
Excretion
59% excreted unchanged, 32% appears as metabolites (primarily phase 2 via UGT1A4). 80% of elimination is renal, related to active excretion by the efflux transporter Pgp.
Contraindications
- Cataract surgery (risk of intraoperative floppy iris syndrome)
- Dementia with Lewy bodies
- Elderly patients with dementia
- Use in elderly dementia patients (increased mortality risk)
Side effects
Common
Moderate risk of metabolic adverse effectshigh rates of hyperprolactinemia
Serious
- Intraoperative floppy iris syndrome
- Neuroleptic malignant syndrome
- increased mortality in elderly dementia patients
Pregnancy & lactation
Pregnancy
B
Lactation
Not specified
Drug interactions
Amiodarone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amisulpride
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Arsenic Trioxide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bedaquiline
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bepridil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Buprenorphine
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Bupropion
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cabozantinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Other Atypical Antipsychotic drugs
Ask House about Paliperidone
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Katzung, BNF, Nelson·Verified: 2026-05-13 · House clinical team