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This medication carries important safety information for users, which should be carefully reviewed. Please discuss any concerns with your healthcare provider.

• Increased Risk in Older Adults with Dementia: There is a slightly higher risk of severe, potentially fatal side effects, such as heart problems, stroke, or infections, in older adults with dementia-related psychosis who use this medication. It is not approved for treating dementia-related behavior issues. Consult your doctor to weigh the risks and benefits and explore alternative treatments.

• Neuroleptic Malignant Syndrome: This medication may lead to a rare but life-threatening condition known as neuroleptic malignant syndrome. Symptoms include fever, sweating, muscle stiffness, confusion, and an irregular heartbeat. Seek immediate medical attention if these symptoms occur, as it may be necessary to discontinue the medication.

• Tardive Dyskinesia: The medication can cause involuntary muscle movements, which may become permanent. To minimize this risk, the lowest effective dose should be used for the shortest time possible. Notify your provider immediately if you notice unusual, uncontrollable movements.

• Metabolic Changes: Usage can result in increased blood sugar and cholesterol levels, as well as weight gain. Regular blood tests are advised, and a healthy diet and regular exercise are recommended. Those with diabetes, high cholesterol, or obesity should be particularly cautious.

• High Prolactin Levels: The drug may elevate prolactin levels, leading to symptoms like nipple discharge, breast enlargement, and menstrual irregularities. Discuss these symptoms with your healthcare provider if they arise.

• Blood Pressure and Fall Risk: The medication can cause drowsiness and lower blood pressure, raising the risk of falls. Stand up slowly and use support when transitioning from sitting or lying down. Contact your provider if you experience any falls.

• Infection Risk: Low white blood cell counts may occur, increasing infection risk. Regular blood tests may be needed initially. Notify your provider if you develop signs of infection such as fever or trouble breathing.

• Cognitive Effects and Drowsiness: This medication may cause significant drowsiness and impair concentration. Avoid driving or operating machinery until you understand how it affects you. Increased risk with alcohol or other drowsiness-inducing drugs.

• Seizure Risk: Although rare, seizures have been reported. Inform your provider of any personal or familial seizure history or conditions that increase seizure risk beforehand.

• Prolonged and Painful Erection: Rare cases of prolonged and painful erections have been reported. Seek medical help immediately if an erection lasts more than 4 hours.

• Contraindications: Do not use if allergic to risperidone or paliperidone. Always consult your healthcare provider to ensure safe use of this medication.

When using this medication, you might experience mild and common side effects such as drowsiness, dizziness, lightheadedness, tiredness, drooling, and weight gain. These are usually manageable, but it's important to contact your healthcare provider if they persist or worsen. Constipation and dry mouth are also possible, so staying hydrated and maintaining a balanced diet may help alleviate these symptoms. You may also notice redness, swelling, or pain at the injection site, and if you have any concerns, discuss them with your healthcare provider.

More serious side effects, although less common, require prompt medical attention. These include difficulty swallowing, muscle spasms, tremors, mood changes such as anxiety or restlessness, and interrupted breathing during sleep. Rarely, this medication may elevate blood sugar levels, potentially worsening diabetes, and cause significant weight gain and increased cholesterol levels. Monitoring your health regularly and communicating with your healthcare provider is crucial to manage these risks.

In rare cases, the medication can lead to a serious condition called neuroleptic malignant syndrome, characterized by symptoms like fever, muscle stiffness, confusion, and an irregular heartbeat. Immediate medical help is necessary if these symptoms occur. Additionally, an increase in prolactin levels may result in symptoms such as unwanted breast milk, menstrual irregularities, or changes in sexual ability. Rare side effects like prolonged erections in males, seizures, or severe allergic reactions also demand urgent attention.

Always stay vigilant about your body’s reactions and keep an open line of communication with your healthcare provider to address any concerns or unusual symptoms promptly.