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Invega Sustenna (paliperidone) is a medication that carries several important safety considerations. It is crucial to be aware of these risks and to discuss them with your healthcare provider to ensure safe use. Below are key warnings and precautions associated with Invega Sustenna (paliperidone):

• Increased Risk of Death in Older Adults with Dementia-related Psychosis: This medication is not recommended for treating dementia-related psychosis as it may lead to fatal outcomes due to heart issues, stroke, or infections. Inform your healthcare provider if dementia is a concern before starting treatment.

• Neuroleptic Malignant Syndrome (NMS): A rare but potentially life-threatening condition that could occur, characterized by high fever, muscle stiffness, confusion, and irregular heartbeat. Immediate medical attention is required if these symptoms appear.

• Heart Rhythm Issues (QT Prolongation): Invega Sustenna (paliperidone) can cause QT prolongation, which affects heart rhythm and can be dangerous. People with existing heart conditions, low potassium or magnesium levels, or those taking other medications affecting heart rhythm should exercise caution.

• Muscle Movement Disorders (Tardive Dyskinesia): This medication may cause involuntary, persistent muscle movements. Consult a healthcare provider promptly if unusual movements are noticed.

• Metabolic Changes: There is a risk of increased blood sugar, cholesterol levels, and weight gain. Be vigilant for symptoms of high blood sugar, such as excessive hunger or thirst, and report them to your provider.

• Risk of Falls: Dizziness and drops in blood pressure may occur, increasing the risk of falls, particularly in older adults or those with heart issues. Rising slowly from sitting or lying positions can help mitigate this risk.

• Infection Risk: The medication might lower white blood cell counts, raising infection risk. Regular blood tests may be necessary, and any signs of infection should be reported immediately.

• Elevated Prolactin Levels: High levels of prolactin can lead to fertility issues, breast changes, and bone weakness. Regular monitoring through blood tests may be recommended.

• Drowsiness and Concentration Difficulties: Extreme sleepiness and impaired focus are possible side effects. Avoid driving or operating machinery until you know how the medication affects you.

• Seizure Risk: Individuals with a history of seizures or conditions predisposing them to seizures should inform their healthcare provider before starting this medication.

• Swallowing Difficulties: Be cautious if you experience trouble swallowing, as it might lead to respiratory issues.

Contraindications: Avoid using Invega Sustenna (paliperidone) if you have allergies to paliperidone or risperidone. Always consult your healthcare provider for personal medical advice and before starting any new medication.

When using this medication, some individuals may experience mild side effects such as headache, agitation, injection site reactions, anxiety, drowsiness, dizziness, and difficulty staying still. These are generally mild, but if they persist or worsen, consult your healthcare provider for guidance. Other side effects may include abnormal muscle movements, stomach pain, nausea, vomiting, dry mouth, diarrhea, weight gain, and cough. Again, these are typically not severe, but it's important to monitor them.

On the more serious end, certain side effects require immediate medical attention. These include seizures, difficulty swallowing, and symptoms of neuroleptic malignant syndrome, which can manifest as high fever, muscle stiffness, confusion, sweating, and changes in heart rate or blood pressure. Tardive dyskinesia is another rare yet serious condition characterized by uncontrolled muscle movements, particularly in the face. High blood sugar levels are also a concern, marked by increased hunger or thirst, frequent urination, stomach pain, weakness, and a fruity-smelling breath.

In rare cases, the medication may cause a condition called priapism, a painful erection lasting more than four hours, or serious infections with symptoms like fever, chills, body aches, and tiredness. If you experience any of these severe side effects, seek medical help promptly. Additionally, the medication may affect hormone levels, leading to symptoms such as unwanted breast milk production, menstrual issues in females, and decreased sexual ability or enlarged breasts in males. It's important to report these symptoms to your healthcare provider. While serious allergic reactions are rare, symptoms such as fever, swollen lymph nodes, rash, severe dizziness, and trouble breathing require immediate medical attention.

When using Invega Sustenna (paliperidone), it's important to be aware of potential interactions with other medications and substances. Let your doctor and pharmacist know about all the medications and supplements you are currently taking, including vitamins and herbal products.

Some medications should not be used with Invega Sustenna, as they could cause harmful effects. These include drugs like Bepridil, Bromopride, Cisapride, Dronedarone, Mesoridazine, Metoclopramide, Pimozide, Piperaquine, Saquinavir, Sparfloxacin, Terfenadine, Thioridazine, and Ziprasidone.

Additionally, many drugs can affect heart rhythm (QT prolongation) and their use with Invega Sustenna is generally not recommended. However, if necessary, your doctor might adjust the dosage or frequency. These medications include Amiodarone, Chlorpromazine, Moxifloxacin, Quinidine, Sotalol, Procainamide, as well as others like Acecainide, Ajmaline, and Alfuzosin.

Certain medications might increase the risk of side effects when combined with Invega Sustenna, but sometimes the combination is necessary for optimal treatment. In such cases, your doctor may alter the dosing schedule to mitigate risks. Paroxetine is one such drug.

Moreover, drugs that cause drowsiness, like opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana, sleep or anxiety medications (such as Alprazolam, Lorazepam, Zolpidem), muscle relaxants (such as Carisoprodol, Cyclobenzaprine), and antihistamines (such as Cetirizine, diphenhydramine), can interact with Invega Sustenna. It's crucial to check all your medicines, including over-the-counter products like allergy or cough-and-cold remedies, for ingredients that cause drowsiness. Consult your pharmacist to ensure safe usage.