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This drug carries several important safety considerations and warnings. It is crucial to understand these potential risks and consult your healthcare provider with any questions or concerns you may have:

• Increased Risk in Older Adults with Dementia: There is a heightened risk of serious, potentially fatal side effects such as stroke, heart failure, and irregular heartbeat in older adults with dementia using this medication. It is not approved for managing dementia-related behavior problems. Always discuss the risks and benefits with your doctor before use.

• Dementia-Related Psychosis: For individuals over 65 with dementia-related psychosis, using this medication can increase the risk of death, often linked to stroke or vascular issues. Notify your healthcare provider if dementia is present before starting treatment.

• Neuroleptic Malignant Syndrome: This rare but life-threatening condition can occur with antipsychotic drugs. Watch for symptoms like fever, muscle stiffness, confusion, or irregular heartbeat. Immediate medical attention is necessary if these occur, and your doctor may advise discontinuing the medication.

• Tardive Dyskinesia: This medication can cause uncontrolled, possibly permanent muscle movements. To minimize risk, use the lowest effective dose for the shortest time needed. Contact your healthcare provider immediately if you notice uncontrollable movements.

• Metabolic Changes: Weight gain, elevated blood sugar, and cholesterol levels are possible. Regular blood tests may be recommended to monitor these levels. A healthy diet and exercise are advised during treatment.

• High Prolactin Levels: Symptoms such as nipple discharge, breast enlargement, and menstrual irregularities may indicate elevated prolactin levels. Discuss any concerns with your healthcare provider.

• Blood Pressure Changes and Falls: This medication can cause dizziness and increase the risk of falls, particularly when standing up quickly. Report any falls to your healthcare provider, especially if you have low blood pressure or are taking blood pressure-lowering medications.

• Risk of Infection: A decrease in white blood cells can increase infection risk. Regular blood tests may be necessary. Contact your provider if you experience signs of infection like fever or persistent cough.

• Drowsiness and Concentration Issues: May cause extreme drowsiness and impair concentration. Avoid activities requiring alertness until you know how the medication affects you. Alcohol and certain other medications can increase this risk.

• Seizures: If you have a history of seizures or conditions that increase seizure risk, inform your healthcare provider before starting this medication.

• Prolonged Erection: Rarely, it can cause prolonged and painful erections. Seek medical help if an erection lasts more than four hours.

Contraindications: Do not use this medication if you have allergies to risperidone or paliperidone. Always consult your healthcare provider for personalized advice before starting this treatment.

When taking this medication, you might experience common side effects such as drowsiness, dizziness, lightheadedness, constipation, tiredness, drooling, and weight gain. Some people also report muscle stiffness, difficulty with movement, extreme sleepiness, restlessness, nausea, and tremors. These effects are generally mild and often do not require medical intervention. However, if they persist or worsen, consulting your healthcare provider is advisable.

There are also more serious side effects that, although rare, require immediate medical attention. These include neuroleptic malignant syndrome, characterized by symptoms such as fever, stiff muscles, confusion, and irregular heartbeat. The medication might also cause high blood sugar, leading to increased thirst, frequent urination, and tiredness. Serious infections, seizures, and difficulty swallowing are also potential risks that need urgent care if they occur.

Additionally, the drug may impact hormone levels, leading to changes such as unwanted breast milk production in females, or changes in sexual function in males. In rare cases, it can cause a painful or prolonged erection, which requires prompt medical attention to prevent long-term issues. Should you experience any signs of an allergic reaction, such as rash, swelling, or trouble breathing, seek immediate medical help. Always discuss any concerns or side effects with your healthcare provider to ensure safe and effective use of the medication.