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The use of Invega (paliperidone) requires careful consideration due to several potential risks and side effects. It is important to discuss these with your healthcare provider to ensure safe and effective treatment. Below are key safety warnings and precautions associated with this medication:

• Increased Risk of Death in Elderly with Dementia: Older adults with dementia-related psychosis should not use Invega (paliperidone) as it may lead to severe side effects or death due to heart issues, stroke, or infections. Discuss alternative treatments with your healthcare provider.

• Neuroleptic Malignant Syndrome (NMS): This medication may cause NMS, a serious condition that can be fatal. Symptoms include high fever, stiff muscles, confusion, rapid or irregular heartbeat, and sweating. If these occur, stop using the medication and seek medical help immediately.

• Metabolic Concerns: Invega (paliperidone) may increase blood sugar, cholesterol levels, and body weight. Individuals with a history of diabetes or high cholesterol should monitor symptoms like excessive hunger, thirst, frequent urination, abdominal pain, weakness, or fruity breath and report them to a healthcare provider.

• Tardive Dyskinesia: Uncontrolled muscle movements, potentially permanent, may occur with this medication. If you notice unusual movements, particularly in the face or limbs, seek medical advice promptly.

• Risk of Falls: Paliperidone can cause dizziness, sleepiness, or sudden drops in blood pressure, increasing the risk of falls. Stand up slowly and stay hydrated. Inform your healthcare provider if dizziness persists.

• Elevated Prolactin Levels: This medication may increase prolactin levels, potentially impacting fertility, causing breast enlargement in males, sexual dysfunction, menstrual irregularities, or weak bones. Regular monitoring through blood tests may be recommended.

• Increased Infection Risk: Paliperidone can decrease white blood cell counts, heightening infection risk. Watch for signs like fever or sore throat and consult your doctor if these develop. Regular lab work may be necessary.

• Gastrointestinal Concerns: If you have conditions like inflammatory bowel disease, inform your provider, as the medication's outer shell may cause blockages.

• Heart Rhythm Issues (QT Prolongation): Individuals with low potassium or magnesium levels, certain heart conditions, or those on other medications affecting heart rhythm should use this medication cautiously.

• Contraindications: Do not use if you have a known allergy to risperidone (Risperdal).

Before starting Invega (paliperidone), ensure thorough discussion with your healthcare provider, particularly if you are taking other medications or have pre-existing health conditions. In case of overdose, seek immediate medical attention.

Common side effects:

• drowsiness
• dizziness
• lightheadedness
• drooling
• weight gain
• stomach discomfort
• tiredness
• headache
• anxiety
• increased saliva production
• dry mouth
• cough
• upset stomach
• constipation

Less common but important to monitor:

• changes in muscle movements
• increased blood prolactin levels

Serious side effects:

• neuroleptic malignant syndrome
• tardive dyskinesia
• extremely high blood sugar levels
• priapism
• difficulty swallowing
• severe dizziness
• fainting
• seizures
• serious allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Metoclopramide
• Bepridil
• Bromopride
• Cisapride
• Dronedarone
• Mesoridazine
• Pimozide
• Piperaquine
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Amiodarone
• Chlorpromazine
• Moxifloxacin
• Quinidine
• Sotalol
• Procainamide
• Opioid pain or cough relievers
• Alcohol
• Drugs for sleep or anxiety
• Muscle relaxants
• Antihistamines
• Paroxetine