risperidone
Risperdal Consta (risperidone) is an atypical antipsychotic that's used to treat schizophrenia and bipolar type 1 disorder in adults. It's a long-acting injection that's given into the muscle by a healthcare provider every 2 weeks. Possible side effects include headache and movement problems.
What is Risperdal Consta (risperidone)?
What is Risperdal Consta (risperidone) used for?
Schizophrenia in adults
Bipolar 1 disorder in adults
How Risperdal Consta (risperidone) works
Risperdal Consta (risperidone) is an atypical antipsychotic. It's not completely known how Risperdal Consta (risperidone) works. But it's thought to work by balancing out the levels of chemicals (dopamine and serotonin) in your brain to help control your thoughts, mood, and behaviors.
Drug Facts
What are the side effects of Risperdal Consta (risperidone)?
Common Side Effects
- Headache (15-21%)
- Movement problems (parkinsonism) (8-15%)
- Dizziness (7-11%)
- Restlessness (4-11%)
- Tiredness (3-9%)
- Dry mouth (up to 7%)
- Constipation (5-7%)
- Indigestion (6%)
- Sleepiness (5-6%)
- Pain in arms or legs (2-6%)
- Weight gain (4-5%)
Other Side Effects
- Nausea
- Swelling of the legs or ankles
- Blurry vision
- Pain
- Fever
- Cough
- Stuffy nose
- Dry skin
- Weight loss
Serious Side Effects
- Neuroleptic malignant syndrome: fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
- Dangerously high blood sugar: feeling thirsty often, needing to urinate often, tiredness, nausea, vomiting, difficulty breathing, having fruity breath, dry mouth
- Serious infections: fever, headache, chills, body aches, cough, weakness
- Seizures
- Difficulty swallowing
Source: DailyMed
More on Risperdal Consta (risperidone) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
- High prolactin level—unexpected breast tissue growth, discharge from the nipple, change in sex drive or performance, irregular menstrual cycle
- Infection—fever, chills, cough, or sore throat
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Pain or trouble swallowing
- Prolonged or painful erection
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Constipation
- Drowsiness
- Muscle pain or cramps
- Weight gain
Pros and cons of Risperdal Consta (risperidone)
Pros
Good choice for treating schizophrenia or bipolar disorder
Given every 2 weeks
Cons
Must be injected into the muscle by a healthcare provider
Takes 3 weeks to start working
More likely to cause weight gain, high cholesterol, and high blood sugar than some other atypical antipsychotics
Pharmacist tips for Risperdal Consta (risperidone)
Tell your provider and pharmacist about all the medications you're taking before you start Risperdal Consta (risperidone). Risperdal Consta (risperidone) interacts with a lot of common medications, like certain SSRIs (selective serotonin reuptake inhibitors) and blood pressure medications. Your providers can make sure your medications are safe to take together and adjust any doses if needed.
Mark your appointments in your calendar to get your Risperdal Consta (risperidone) injections on time. This helps make sure you don't miss any doses.
Risperdal Consta (risperidone) can make you sleepy and dizzy. Don't drive or operate any heavy machinery until you know how this medication affects you.
It's recommended that you avoid alcohol while you're taking Risperdal Consta (risperidone). Alcohol can worsen side effects like drowsiness and dizziness. It can also worsen symptoms of your condition. If needed, speak with your provider for suggestions on how to lower the amount you drink and stop drinking during treatment.
Risperdal Consta (risperidone) can cause a sudden drop in blood pressure when you're changing positions, such as from sitting to standing, and make you feel dizzy. This can commonly happen when you start treatment and when your dose changes. Get up slowly and try to hold onto something to help keep you stable. Get medical help right away if you end up falling or hitting your head.
Risperdal Consta (risperidone) can make it harder for your body to cool down when your body temperature gets too high. You might be more likely to get dehydrated and overheated. Drink plenty of fluids during the day to stay hydrated. Tell your provider if you feel very hot or thirsty, notice a change in the amount of sweat you have or urine you make, or if you notice very dark-colored urine.
It's important to regularly exercise and eat a balanced diet with fruits, vegetables, and low-fat and low-sugar foods to help manage your cholesterol (fat) levels and weight while you're taking this medication. This is because Risperdal Consta (risperidone) can raise cholesterol (fat) levels in your blood and can cause weight gain.
Risperdal Consta (risperidone) might raise your blood sugar levels. If you have diabetes, ask your provider whether you need to check your blood sugar more often while you're taking this medication.
Although rare, some people taking Risperdal Consta (risperidone) have had difficulty swallowing, which raises the risk for choking. Take small bites of food and eat slowly to lower your risk for choking.
Frequently asked questions about Risperdal Consta (risperidone)
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What are the risks and warnings for Risperdal Consta (risperidone)?
Risperdal Consta (risperidone) 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
People over the age of 65 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 Risperdal Consta (risperidone). Clinical studies found that older adults with dementia-related psychosis who take antipsychotic medications like Risperdal Consta (risperidone) have a higher risk of death. In studies, the causes of death were often linked to heart problems, stroke, or infections. Let your provider know if you or your loved one has dementia before treatment starts.
Neuroleptic malignant syndrome
Taking antipsychotic medications like Risperdal Consta (risperidone) can cause a rare, but life-threatening condition called neuroleptic malignant syndrome. Symptoms include fever, sweating, stiff muscles, confusion, not aware of your surroundings, and fast or irregular heartbeat. Get medical attention as soon as possible if you have any of these symptoms while you're taking Risperdal Consta (risperidone). You might need to stop taking Risperdal Consta (risperidone) and switch to a different medication.
Difficulty controlling muscle movements (tardive dyskinesia)
Risk factors: Older adults | Female and 65 years or older | Higher than recommended doses of Risperdal Consta (risperidone) | Taking Risperdal Consta (risperidone) for a long time
Risperdal Consta (risperidone) 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 give you the lowest dose possible for the shortest period of time for your symptoms. Stop taking Risperdal Consta (risperidone) and talk to your provider right away if you notice any unusual movements that you can't control.
Weight gain, higher blood sugar, and higher cholesterol levels
Risk factors: Diabetes | High cholesterol | Considered obese
Risperdal Consta (risperidone) can raise your blood sugar and cholesterol levels. This medication can also lead to weight gain. Your provider will regularly order blood tests throughout treatment with Risperdal Consta (risperidone) to make sure your blood sugar and cholesterol aren't too high. Make sure to follow a balanced diet that's low in fat and sugar and keep a regular exercise routine while you're taking Risperdal Consta (risperidone).
High prolactin levels
Risperdal Consta (risperidone) can cause prolactin hormone levels in your blood to go up. High prolactin levels can lead to symptoms such as milky discharge from the nipple, enlarged breasts, and absent or irregular menstrual periods. Talk to your healthcare provider if you experience or have any concerns about these symptoms.
Changes in blood pressure and risk of falls
Risk factors: Low blood pressure | Taking medications that lower blood pressure | History of medical conditions that can lower blood pressure | Liver or kidney problems | 65 years or older
Risperdal Consta (risperidone) can make you tired, lower your blood pressure when you stand up, or cause you to lose your balance. This can lead to falls and accidental injuries. Make sure to get up slowly and hold onto something when you stand from a sitting or lying position. Contact your provider if you experience a fall while you're taking Risperdal Consta (risperidone).
Risk of infection (from low white blood cell count)
Risk factors: Poor immune system
Though rare, Risperdal Consta (risperidone) can lower your white blood cell counts (WBCs) and put you at risk for developing infections. You might need to get blood tests done regularly during the first few months of taking Risperdal Consta (risperidone) so your provider can make sure your WBCs are in a safe range. If your WBC count drops too low, you'll probably need to stop taking Risperdal Consta (risperidone). Contact your provider right away if you have any signs of infection, such as fever, tiredness, chills, cough, or trouble breathing, and they don't go away.
Difficulty concentrating and extreme sleepiness
Risk factors: Taking high doses of Risperdal Consta (risperidone) | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Risperdal Consta (risperidone) 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, anxiety medications, 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 Risperdal Consta (risperidone).
Seizures
Risk factors: History of seizures | Health conditions that make it easier to have seizures
Though rare, some people who took Risperdal Consta (risperidone) had seizures. Before starting this medication, tell your provider if you've had seizures in the past or have a medical condition that raises your risk for seizures.
Prolonged and painful erection
Although rare, some people who took Risperdal Consta (risperidone) reported having prolonged and painful erections, which sometimes required surgery to treat. Get medical attention right away if you develop a prolonged erection that lasts longer than 4 hours.
Risperdal Consta (risperidone) dosage forms
Typical dosing for Risperdal Consta (risperidone)
You'll take Risperdal Consta (risperidone) with oral risperidone (Risperdal) for the first 3 weeks of treatment as you wait for Risperdal Consta (risperidone) to kick in.
The typical dose for Risperdal Consta (risperidone) is 25 mg injected into the muscle of the upper arm or buttocks every 2 weeks. The maximum dose is 50 mg every 2 weeks.
Your dose might differ if you have kidney or liver problems or if you're taking a medication that interacts with Risperdal Consta (risperidone).
Risperdal Consta (risperidone) contraindications
Allergy to risperidone or paliperidone
What are alternatives to Risperdal Consta (risperidone)?
Schizophrenia in adults
Bipolar 1 disorder in adults
Schizophrenia in adults
Bipolar 1 disorder in adults
What is the latest news about Risperdal Consta (risperidone)?
Risperdal Consta (risperidone) images
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References
Best studies we foundJanssen Pharmaceuticals, Inc. (2021). Risperdal Consta- risperdone [package insert]. DailyMed.
MGH Center for Women’s Mental Health. (n.d.). National Pregnancy Registry for Psychiatric Medications©.
Muench, J., et al. (2010). Adverse effects of antipsychotic medications. American Family Physician.
You and Your Hormones. (2023). Prolactin.
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