Invega Trinza
Invega Trinza (paliperidone) is an atypical antipsychotic. It's a long-acting injection that's given every 3 months to treat schizophrenia in adults. But it's only for people who've already been receiving the monthly Invega Sustenna (paliperidone) injection for at least 4 months. Invega Trinza (paliperidone) is injected into the muscles by a trained healthcare provider. The most common side effects include injection site reactions, weight gain, and headache.
What is Invega Trinza (paliperidone)?
What is Invega Trinza (paliperidone) used for?
How Invega Trinza (paliperidone) works
Invega Trinza (paliperidone) is an atypical antipsychotic. It can affect dopamine and serotonin levels in your brain, which helps control your thoughts, mood, and behaviors.
Drug facts
Side effects of Invega Trinza (paliperidone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Upper respiratory tract infection (e.g., common cold; 10%)
- Weight gain (9%)
- Headache (9%)
- Not able to stay still (5%)
Less Common Side Effects
- Rigid movements, tremors
- Urinary tract infection
- Injection site reaction
Invega Trinza (paliperidone) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Seizures
- Difficulty swallowing
- Neuroleptic malignant syndrome: high fever, muscle stiffness, confusion, sweating, changes in pulse, heart rate, changes in blood pressure
- Tardive dyskinesia: uncontrolled muscle movements, such as facial grimacing, lip-smacking, blinking
- Extremely high blood sugar levels: feeling very hungry or thirsty, urinating more often, stomach pain, weakness, fruity-smelling breath
- Serious infections: fever, chills, body aches, tiredness, cough
- Priapism: painful erection that that lasts longer than 4 hours
The following Invega Trinza (paliperidone) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
More common
bladder pain
bloody or cloudy urine
body aches or pain
chills
deep or fast breathing with dizziness
difficult, burning, or painful urination
difficulty with breathing
difficulty with swallowing
ear congestion
frequent urge to urinate
headache
inability to sit still
irregular heartbeat
irritability
loss of balance control
loss of voice
lower back or side pain
mask-like face
need to keep moving
nervousness
numbness of the feet, hands, and around the mouth
restlessness
runny or stuffy nose
shaking
shuffling walk
slowed movements
slurred speech
stiffness of the arms and legs
tic-like (jerky) movements of the head, face, mouth, and neck
trembling and shaking of the fingers and hands
trouble with sleeping
twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
unusual tiredness or weakness
Less common
Blurred vision
difficulty with speaking
dizziness
inability to move the eyes
increase in body movements
increased blinking or spasms of the eyelid
loss of balance control
muscle trembling, jerking, or stiffness
pounding in the ears
slow or fast heartbeat
sticking out of the tongue
uncontrolled movements, especially of the face, neck, and back
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual facial expressions
Incidence not known
Change in mental status
decrease in the amount and frequency of urination
difficulty speaking
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
loss of bladder control
pale color of the skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
seizures
severe constipation
severe vomiting
stomach pain
swollen tongue
tightness in the chest
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
Less common
Back pain
difficulty with moving
increased weight
lack or loss of strength
muscle pains, cramps, or stiffness
nightmares
pain and swelling in the joints
pain in the arms or legs
tearing of the skin
toothache
upper abdominal or stomach pain
vomiting
Incidence not known
Sleepwalking
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Invega Trinza (paliperidone)
Pros
- Only need to take once every 3 months
- Good option if you have trouble swallowing pills
- Less side effects compared to typical antipsychotics
Cons
- No lower-cost generic available
- Can only be given by a trained healthcare provider
- Not recommended for people with moderate to severe kidney problems
Pharmacist tips for Invega Trinza (paliperidone)
- Mark your calendar to help you remember when your appointments are to get your dose of Invega Trinza (paliperidone). If you miss a dose, contact your provider right away to reschedule your appointment. You can still continue with your regular Invega Trinza (paliperidone) dose, even if you missed your appointment by up to (but less than) a month.
- If you missed your Invega Trinza (paliperidone) appointment by longer than a month (but less than 8 months), your provider will ask you to "catch-up" on treatment by receiving two doses of Invega Sustenna (paliperidone) one week apart before you can take Invega Trinza (paliperidone) again.
- It's possible to experience a relapse while taking Invega Trinza (paliperidone) (when your symptoms become worse or reappear after you've been feeling and acting better for a period of time). Some signs include reappearance of hallucinations, confusion, difficulty concentrating, lack of energy, or feeling tense or agitated. Let your healthcare provider know right away if your symptoms return or get worse.
- Carefully monitor your weight while you're taking Invega Trinza (paliperidone) because this medication can cause weight gain. Let your provider know if you notice a lot of weight gain because this might lead to other health problems, such as heart problems.
- Invega Trinza (paliperidone) can cause your blood pressure to drop when changing positions, which could lead to dizziness and falls. This is more likely to happen when you start the medication for the first time or raise your dose. Make sure to stand up slowly from a seated or lying position.
- Invega Trinza (paliperidone) can sometimes cause a painful or long-lasting erection (priapism). If you experience an erection that lasts more than 4 hours, get medical help right away.
- Invega Trinza (paliperidone) can cause unusual, uncontrolled, or repetitive movements of your eyes, tongue, face, arm, or legs. Contact your healthcare provider right away because these might be signs of tardive dyskinesia, which can become permanent.
- Drink water to stay hydrated, especially if you're out in the sun or exercising. Be careful if you're traveling to a place that is very hot. This is because Invega Trinza (paliperidone) might make it hard for your body to maintain a normal body temperature.
- Taking Invega Trinza (paliperidone) during pregnancy, especially during the third trimester, might raise the risk of your baby developing movement disorders or withdrawal symptoms at birth. At the same time, it's important for you to continue mental health treatment during pregnancy. If you're pregnant or thinking of becoming pregnant, talk with your provider about options to treat your condition.
- Talk to your provider if you wish to become pregnant. Invega Trinza (paliperidone) might make it harder for females to get pregnant while they're taking this medication.
Common questions about Invega Trinza (paliperidone)
Invega Sustenna (paliperidone) and Invega Trinza (paliperidone) are both long-acting injections that contain the same active ingredient. But Invega Sustenna is given once every month, and Invega Trinza is given once every 3 months. Invega Sustenna is FDA-approved to treat schizophrenia and schizoaffective disorder, while Invega Trinza is only approved to treat schizophrenia. If you've been taking Invega Sustenna for at least 4 months and your condition has been stable, you can ask your provider if Invega Trinza is a good option for you.
It can. Weight gain is a common side effect of antipsychotics, including Invega Trinza (paliperidone). In a clinical study, about 10% of people taking Invega Trinza (paliperidone) gained at least 7% of their starting body weight, compared to 1% of the people who received placebo. While weight gain might not be completely avoidable, you can minimize it by eating healthy and sticking to a regular exercise routine. If you're concerned about your weight, work with your healthcare provider to make a treatment plan that works for you.
Yes. You can get Invega Trinza (paliperidone) up to 2 weeks before your next scheduled 3-month injection. If you need to get your dose early to avoid missing your dose, contact your provider so they can help you schedule your appointment.
Invega Trinza (paliperidone) can be injected into the muscle in your upper arm (deltoid muscle) or your buttocks. Keep track of the location you got your last injection so that your provider can give your next injection in a different site. For example, if you got your last injection in your right upper arm, you can get your next one in your left upper arm or either buttock muscle. Switching between sites will allow each injection site to heal fully before future injections.
If you're starting Invega Trinza (paliperidone) for the first time, your provider will want to make sure your condition is well-controlled with monthly Invega Sustenna (paliperidone) first. After you've received Invega Sustenna (paliperidone) for at least 4 months and didn't experience any major side effects, your provider will consider transitioning you over to Invega Trinza (paliperidone). Talk with your provider if you've any questions about starting Invega Trinza (paliperidone).
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Risks and warnings for Invega Trinza (paliperidone)
Invega Trinza (paliperidone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk of death in older adults with dementia-related psychosis
- Risk factors: Older adults with dementia-related psychosis
Older adults who also have dementia sometimes have some of the symptoms of schizophrenia, like hallucinations and delusions. This is called dementia-related psychosis, and it shouldn't be treated with Invega Trinza (paliperidone). If Invega Trinza (paliperidone) is used for dementia-related psychosis, it can cause death. The cause of death is typically from heart problems, stroke, or infections. Let your provider know if you or your loved one has dementia before starting Invega Trinza (paliperidone).
Neuroleptic malignant syndrome (NMS)
- Risk factors: Taking antipsychotic medications
Invega Trinza (paliperidone) can cause neuroleptic malignant syndrome (NMS), which is a rare but serious condition that can be life-threatening. Be careful using Invega Trinza (paliperidone) if you're also taking other medications that might cause NMS. Symptoms include a very high fever, stiff muscles, problems thinking clearly, a very fast or uneven heartbeat, and sweating. Stop taking Invega Trinza (paliperidone) and get medical attention right away if you experience these symptoms.
Heart rhythm problem (QT prolongation)
- Risk factors: Low potassium or magnesium blood levels | Using other medications that cause QT prolongation | Born with QT prolongation | History of heart problems or abnormal heart rhythms (arrhythmias) | Slow heart rate
Although rare, Invega Trinza (paliperidone) can affect your heart rhythm by lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation and it can be life-threatening. Your risk for QT prolongation is higher if you have any of the risk factors listed above. Make sure to tell your provider about all the medications you're taking and don't start any new medications while taking Invega Trinza (paliperidone) without talking to your provider or pharmacist first. People who were born with QT prolongation or have a history of arrhythmias should avoid taking Invega Trinza (paliperidone). If you feel your chest pounding, have trouble breathing, chest pain, or feel faint or lightheaded while taking Invega Trinza (paliperidone), call 911 right away.
Difficulty controlling muscle movements (tardive dyskinesia)
- Risk factors: Older adults | Female and 65 years or older
Invega Trinza (paliperidone) can cause uncontrolled and possibly permanent muscle movements in the tongue, face, mouth, lips, neck, hands, arms, legs, and feet (tardive dyskinesia). To lower your risk of tardive dyskinesia, your provider will have you take the lowest dose that treats your symptoms. Get medical help right away if you notice any unusual movements you can't control. This side effect can sometimes occur even after you stop the medication.
High blood sugar, high cholesterol, and weight gain
- Risk factors: History of diabetes | History of high cholesterol
Invega Trinza (paliperidone) can raise your blood sugar levels. Rarely, it can reach dangerous levels resulting in coma or death. Let your provider know if you have symptoms of high blood sugar, such as feeling very hungry or thirsty, urinating more often, stomach pain, weakness, or fruity-smelling breath.
Invega Trinza (paliperidone) can also cause high cholesterol levels and weight gain. Your provider might check your weight and order blood tests regularly to make sure your blood sugar, cholesterol, and weight aren't too high.
Higher risk of falls
- Risk factors: Starting Invega Trinza (paliperidone) for the first time | Recent rise in Invega Trinza (paliperidone) dose | Older adults | Not enough fluids in your body | History of heart problems | History of low blood pressure | Taking medications that lower blood pressure
Invega Trinza (paliperidone) can cause sleepiness, dizziness, difficulties keeping your balance, and drops in blood pressure when you sit up or stand too quickly. This can result in fainting and falling. Sit up or stand up slowly, especially during the first few days after you start Invega Trinza (paliperidone) or when your provider raises your dose. Your risk of falls is higher if you have heart problems or if you don't have enough fluids in your body. Talk to your healthcare provider if you continue to experience dizziness while taking Invega Trinza (paliperidone).
Higher risk of infections
- Risk factors: History of low white blood cell counts | Taking other medications that lower white blood cell counts
Invega Trinza (paliperidone) can lower the amount of white blood cells in your body and put you at higher risk for serious infection. You might need to get lab work done regularly to make sure your white blood cell count is healthy. If the levels are too low, your provider might stop your medication. Talk to your provider right away if you experience symptoms of an infection, including fever, weakness, or sore throat, while taking Invega Trinza (paliperidone).
High prolactin levels
Invega Trinza (paliperidone) can cause prolactin levels in the blood to go up. High prolactin levels can lead to fertility problems, enlarged male breasts, sexual dysfunction, absent or irregular menstrual periods, and weak bones. Your provider might recommend regular blood tests for you to make sure your prolactin levels are within normal range.
Difficulty concentrating and extreme sleepiness
- Risk factors: Taking high doses of Invega Trinza (paliperidone) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Invega Trinza (paliperidone) can cause extreme sleepiness and lower your ability to think, react, and focus. Your risk is higher if you're also taking other medications that can cause drowsiness, such as benzodiazepines, muscle relaxants, and sleep medications. Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from Invega Trinza (paliperidone).
Seizures
- Risk factors: History of seizures | Age 65 or older | Health conditions that make it easier to get seizures
Invega Trinza (paliperidone) can potentially cause seizures. Before starting this medication, let your provider know if you have a history of seizures or have a medical condition that puts you at risk for getting seizures.
Difficulty swallowing
Invega Trinza (paliperidone) can sometimes make it hard for you to swallow food or liquids. This can be dangerous if food or liquids get into your lungs, because it can cause issues with your breathing and potentially pneumonia (lung infection). Make sure to chew your food completely and swallow carefully if you notice tightening of your throat or neck area.
Invega Trinza (paliperidone) dosage
Syringe| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1.315ml of 410mg | 1 syringe | $4,995.28 | $4,995.28 |
| 0.875ml of 273mg | 1 syringe | $3,344.20 | $3,344.20 |
| 1.75ml of 546mg | 1 syringe | $6,719.49 | $6,719.49 |
| 2.625ml of 819mg | 1 syringe | $9,988.96 | $9,988.96 |
Typical dosage for Invega Trinza (paliperidone)
Invega Trinza (paliperidone) is given as an injection into the muscle by a healthcare provider. It should only be used after you've taken Invega Sustenna (paliperidone) for at least 4 months. Your provider will determine your dose based on what dose of Invega Sustenna (paliperidone) you were taking.
- You'll receive your first dose of Invega Trinza (paliperidone) when your next 1-month Invega Sustenna (paliperidone) dose is due. After that, Invega Trinza (paliperidone) is injected once every 3 months. The typical dose ranges from 273 mg to 819 mg.
Interactions between Invega Trinza (paliperidone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Bromopride
- Cisapride
- Dronedarone
- Mesoridazine
- Metoclopramide
- Pimozide
- Piperaquine
- Saquinavir
- Sparfloxacin
- Terfenadine
- Thioridazine
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acecainide
- Ajmaline
- Alfuzosin
- Amiodarone
- Amisulpride
- Amitriptyline
- Amoxapine
- Anagrelide
- Apomorphine
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Artemether
- Asenapine
- Azimilide
- Azithromycin
- Bedaquiline
- Bretylium
- Buprenorphine
- Buserelin
- Carbamazepine
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Dasatinib
- Degarelix
- Delamanid
- Desipramine
- Deslorelin
- Deutetrabenazine
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Droperidol
- Efavirenz
- Encorafenib
- Entrectinib
- Enzalutamide
- Erythromycin
- Escitalopram
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Formoterol
- Foscarnet
- Fosphenytoin
- Fostemsavir
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Histrelin
- Hydroquinidine
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Inotuzumab Ozogamicin
- Ivabradine
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Levofloxacin
- Lofexidine
- Lopinavir
- Lumacaftor
- Lumefantrine
- Macimorelin
- Mefloquine
- Methadone
- Metronidazole
- Mifepristone
- Mirtazapine
- Mitotane
- Moxifloxacin
- Nafarelin
- Nilotinib
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Ondansetron
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxymorphone
- Ozanimod
- Panobinostat
- Pasireotide
- Pazopanib
- Phenytoin
- Pimavanserin
- Pitolisant
- Ponesimod
- Posaconazole
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Remifentanil
- Ribociclib
- Rifampin
- Selpercatinib
- Sematilide
- Sertraline
- Sevoflurane
- Simeprevir
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Solifenacin
- Sorafenib
- Sotalol
- St John's Wort
- Sulpiride
- Sunitinib
- Tacrolimus
- Tedisamil
- Telavancin
- Telithromycin
- Tetrabenazine
- Tipranavir
- Toremifene
- Trazodone
- Triclabendazole
- Trifluoperazine
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Vinflunine
- Voclosporin
- Voriconazole
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
How much does Invega Trinza (paliperidone) cost?
$3,344.20
Invega Trinza (paliperidone) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Invega Trinza (paliperidone) will not be safe for you to take.
- Allergy to paliperidone or risperidone
