paliperidone
Brand names: Invega
Paliperidone extended-release tablets, also known as Invega, are a type of antipsychotic medicine. It helps manage symptoms of certain mental disorders.
Drug Pricing (NADAC)
Generic Price
$1.17/unit
Generic Available
Yes (11 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine is used to treat schizophrenia in adults and teens (12-17 years old).
Common side effects
Extrapyramidal symptoms (movement problems), Fast heart rate, Feeling restless and unable to sit still
Key warnings
This medicine has a boxed warning.
How It Works
Paliperidone affects certain chemicals in the brain. These chemicals, like dopamine, can become unbalanced in people with schizophrenia and schizoaffective disorder. By acting on these chemicals, paliperidone helps to reduce symptoms.
How to Take It
Take this medicine once a day, exactly as your doctor tells you. Swallow the tablet whole with a drink of water. Do not chew, crush, or break the tablet. You can take it with or without food, but be consistent each day.
Pregnancy & Breastfeeding
If you are pregnant or plan to become pregnant, talk to your doctor. Babies born to mothers who use this medicine in the last 3 months of pregnancy may have withdrawal symptoms or movement problems after birth. There is a pregnancy registry to monitor outcomes in women exposed to atypical antipsychotics during pregnancy. You can contact the registry at 1-866-961-2388.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store this medicine at room temperature (68° to 77°F) away from moisture and heat. Keep out of reach of children.
Side Effects (from patient reports)
Based on 17,980 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 22,775 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2007–2025.
Total Reports
22,775
Death-Related Reports
801
Hospitalization Reports
4,563
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | INJURY | 4,331 |
| 2 | GYNAECOMASTIA | 3,664 |
| 3 | DRUG INEFFECTIVE | 1,729 |
| 4 | ABNORMAL WEIGHT GAIN | 1,660 |
| 5 | OFF LABEL USE | 1,502 |
| 6 | WEIGHT INCREASED | 1,361 |
| 7 | HYPERPROLACTINAEMIA | 1,255 |
| 8 | GALACTORRHOEA | 1,051 |
| 9 | SEDATION | 735 |
| 10 | DYSTONIA | 695 |
| 11 | DYSKINESIA | 686 |
| 12 | SUICIDE ATTEMPT | 662 |
| 13 | TREATMENT NONCOMPLIANCE | 651 |
| 14 | SCHIZOPHRENIA | 645 |
| 15 | PRODUCT USE IN UNAPPROVED INDICATION | 619 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
This medicine has a boxed warning. It may increase the risk of death in elderly patients with dementia-related psychosis. Paliperidone is not approved to treat this condition.
Known Drug Interactions
In an interaction study in healthy subjects in which a single 3 mg dose of paliperidone was administered concomitantly with 20 mg per day of paroxetine (a potent CYP2D6 inhibitor), paliperidone exposures were on average 16% (90% CI: 4, 30) higher in CYP2D6 extensive metabolizers. Higher doses of paroxetine have not been studied. In an interaction study in healthy subjects in which a single 3 mg dose of paliperidone was administered concomitantly with 20 mg per day of paroxetine (a potent CYP2D6 inhibitor), paliperidone exposures were on average 16% (90% CI: 4, 30) higher in CYP2D6 extensive...
Mechanism: Paroxetine slows down the liver's ability to clear paliperidone from your body. This can cause the levels of paliperidone in your blood to rise slightly.
What to do: Your doctor may monitor you for increased side effects, but a dose adjustment is typically not required for this small change.
In a drug interaction study, co-administration of paliperidone (12 mg once daily for 5 days) with divalproex sodium extended-release tablets (500 mg to 2000 mg once daily) did not affect the steady-state pharmacokinetics (AUC 24h and C max,ss ) of valproate in 13 patients stabilized on valproate. In a clinical study, subjects on stable doses of valproate had comparable valproate average plasma concentrations when paliperidone 3 to 15 mg/day was added to their existing valproate treatment. Dosage reduction for paliperidone should be considered when paliperidone is co-administered with valpro...
Mechanism: Taking these drugs together can increase the amount of paliperidone that stays in your blood. It does not seem to change the levels of valproate.
What to do: Your doctor may need to lower your dose of paliperidone when you are taking it with valproate.
Pharmacokinetic interaction between lithium and paliperidone is unlikely. Pharmacokinetic interaction between lithium and paliperidone is unlikely. Pharmacokinetic interaction between lithium and paliperidone is unlikely.
Mechanism: These two drugs do not interfere with how the body absorbs or breaks down each other. An interaction between them is not expected.
What to do: No specific dose changes are needed, but continue to follow your regular blood test schedule as directed by your doctor.
Paliperidone may antagonize the effect of levodopa and other dopamine agonists. Paliperidone may antagonize the effect of levodopa and other dopamine agonists.
Mechanism: Paliperidone blocks the same spots in the body that dopamine tries to reach, which stops dopamine from working correctly.
What to do: Your doctor may need to monitor you closely or adjust your doses since these drugs work against each other.
In addition, carbamazepine causes, or would be expected to cause, decreased levels of the following drugs, for which monitoring of concentrations or dosage adjustment may be necessary: acetaminophen, albendazole, alprazolam, aprepitant, buprenorphone, bupropion, citalopram, clonazepam, clozapine, corticosteroids (e.g., prednisolone, dexamethasone), cyclosporine, dicumarol, dihydropyridine calcium channel blockers (e.g., felodipine), doxycycline, ethosuximide, everolimus, haloperidol, imatinib, itraconazole, lamotrigine, levothyroxine, methadone, methsuximide, mianserin, midazolam, olanzapin...
Mechanism: Carbamazepine speeds up the removal of paliperidone from your body, which can make the treatment less effective.
What to do: Your doctor may need to change your dose or monitor your symptoms more frequently.
Common Questions
Can I cut the tablet in half?
What should I do if I feel dizzy?
Can I drink alcohol while taking this medicine?
How long will it take for this medicine to work?
Will I gain weight while taking this medicine?
Can I stop taking this medicine suddenly?
What if I have trouble swallowing the tablet?
Does this medicine interact with other medications?
What should I do if I experience side effects?
How often will I see my doctor while taking this medicine?
What are the common side effects of paliperidone?
Does paliperidone interact with other medications?
What drug class is paliperidone?
Is paliperidone safe during pregnancy?
Related Medications in Atypical Antipsychotic
Other drugs grouped near paliperidone — same-class peers and common alternatives.
acamprosate
Campral
Acamprosate is a medicine that can help you stay away from alcohol if you are alcohol-dependent and have already stopped drinking.
Compare with paliperidone →
alprazolam
Xanax
Alprazolam (Xanax) is a medication that can help you with anxiety and panic disorders.
Compare with paliperidone →
amitriptyline
Elavil
Amitriptyline is a medicine used to treat depression.
Compare with paliperidone →
amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
Compare with paliperidone →
aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
Compare with paliperidone →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for paliperidone
The FDA label for paliperidone (sold under brand names such as Invega) classifies it as a prescription-only medication in the Atypical Antipsychotic class. This medicine is used to treat schizophrenia in adults and teens (12-17 years old). Official labeling lists 11 commonly reported side effects, including Extrapyramidal symptoms (movement problems), Fast heart rate, Feeling restless and unable to sit still.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 17,980 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $1.17.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: January 19, 2026
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages