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Invega vs. Clozaril

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Invega (paliperidone) and Clozaril (clozapine) are both atypical antipsychotics used to treat schizophrenia, but they have some key differences. Invega is also approved for schizoaffective disorder, while Clozaril is specifically used for schizophrenia that hasn't responded to other treatments and for reducing suicidal behavior in people with schizophrenia or schizoaffective disorder. Invega is available as an extended-release tablet taken once daily, whereas Clozaril requires multiple doses throughout the day. Clozaril has a higher risk of causing low white blood cell counts, requiring regular blood tests under a special monitoring program called REMS. Invega can cause weight gain and drowsiness, but it generally has fewer severe side effects compared to Clozaril, which can also cause serious heart problems and seizures. Both medications can affect your heart rhythm and should be used cautiously if you have heart issues.

Invega

(paliperidone)

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Clozapine

(Clozaril)

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Summary for Invega

Prescription only

Invega (paliperidone) is taken by mouth and used to improve mood, thoughts, and behaviors in people who have schizophrenia or schizoaffective disorder. It's available as both brand and generic versions in an extended-release pill, which means the medication is released slowly in your body. It only needs to be taken once a day. Some common side effects include drowsiness and uncontrolled muscle movements. There are long-acting injection forms of this medication available given by a trained healthcare provider.

Indications for Invega

  • Schizophrenia
  • Schizoaffective disorder

Pros and Cons for Invega

Pros

  • Available in many different strengths to make it easier to customize your dose
  • Can be used in adolescents
  • Only need to take the medication once a day

Cons

  • You might have to see your provider several times until you find a dose that works best for you
  • Can make you feel sleepy or sedated
  • Can cause weight gain

Common Side Effects for Invega

  • Abnormal muscle movements (up to 40%)
  • Drowsiness (up to 26%)
  • Headache (up to 14%)
  • Irregular heart beat (up to 14%)
  • Vomiting (up to 11%)
  • Anxiety (up to 9%)

Warnings for Invega

  • Higher risk of death in older adults with dementia-related psychosis
  • Neuroleptic malignant syndrome (NMS)
  • High blood sugar, high cholesterol, and weight gain
  • Difficulty controlling muscle movements (tardive dyskinesia)
  • Higher risk of falls
  • High prolactin levels
  • Higher risk of infections
  • Not for people with gut problems
  • Heart rhythm problem (QT prolongation)

Summary for Clozaril

Prescription only

Clozapine (Clozaril) is used to treat schizophrenia. It's an atypical antipsychotic, but it's not a first-choice medication for schizophrenia because it can cause many bothersome side effects, such as drowsiness and dizziness. It can also cause your white blood cell (WBC) count to drop dangerously low and raise your risk for serious infections. As a result, clozapine (Clozaril) is prescribed under a special program called Risk Evaluation and Mitigation Strategies (REMS). In order to pick up your medication at the pharmacy, your provider will ask you to get blood work regularly (weekly to monthly) to make sure your WBC count is at a healthy level.

Indications for Clozaril

  • Schizophrenia that hasn't responded to other treatments
  • Suicidal behavior in people with schizophrenia or schizoaffective disorder

Pros and Cons for Clozaril

Pros

  • Works well to treat schizophrenia when other medications haven't worked well
  • Taken by mouth
  • Comes as both a regular tablet (that you swallow by mouth) and as a dissolvable tablet that you place on the tongue
  • Available as a lower-cost generic

Cons

  • Need to get blood work done every time you get a prescription filled (weekly to monthly)
  • Can cause dizziness and drowsiness
  • Can cause high blood sugar, high cholesterol, and weight gain
  • Not a good option for people with a history of seizures

Common Side Effects for Clozaril

  • Increased salivation (Up to 48%)
  • Drowsiness (up to 46%)
  • Dizziness (up to 27%)
  • Fast heart rate (up to 25%)
  • Constipation (up to 25%)
  • Trouble sleeping (up to 20%)
  • Nausea/vomiting (17%)
  • High or low blood pressure (up to 13%)
  • Fever (up to 13%)
  • Headache (10%)
  • Heartburn (up to 14%)

Warnings for Clozaril

  • Risk of serious infection (from low white blood cells)
  • Low blood pressure, slow heartbeat, and fainting
  • Seizures
  • Heart problems
  • Higher risk of death in older people with dementia-related psychosis
  • High blood sugar, high cholesterol, and weight gain
  • Severe constipation
  • Serious allergic reactions or inflammation problems
  • Life-threatening abnormal heart rhythm (QT prolongation)
  • Neuroleptic malignant syndrome
  • Driving impairment
  • Liver problems
  • Difficulty controlling body movements
  • Not for people with phenylketonuria (dissolvable tablets only)

Prices with our coupons for Invega vs. Clozaril

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Paliperidone ER30 tablets / 6mg
$42.10$419.51
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Clozapine90 tablets / 100mg
$64.59$177.45
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