20 to 50     : Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution. for IM dosing
10 to 20     : Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution. for IM dosing
<10           : Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution. for IM dosing
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
HD                     :Dialysed. Dose as in GFR
<10           : mL/min
HDF/high flux   :Dialysed. Dose as in GFR
<10           : mL/min
CAV/VVHD      :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Anaesthetics: enhanced hypotensive effect
Analgesics: increased risk of convulsions with tramadol; enhanced hypotensive and sedative effects with opioids
Antidepressants: concentration increased by fluoxetine and possibly paroxetine; concentration of tricyclics possibly increased
Anti-epileptics: antagonism, convulsive threshold may be lowered; metabolism accelerated by carbamazepine
Antimalarials: avoid concomitant use with artemether with lumefantrine
Antipsychotics: avoid concomitant use of depot formulations with clozapine (cannot be withdrawn quickly if neutropenia occurs)
Antivirals: ritonavir may increase concentration of risperidoneAnxiolytics and hypnotics: enhanced sedative effects
Sibutramine: increased risk of CNS toxicity – avoid concomitant use)
ADMINISTRATION
Reconstition
With solvent provided
Route
Oral, deep IM
Rate of Administration
–
Comments
–
OTHER INFORMATION
At a dose of 3 mg twice daily, 1.5 mg (i.e. 25%) of risperidone is removed after a 5 hour dialysis session with a dialysate flow of 500 mL/minIn overdose, rare cases of QT prolongation have been reportedClearance of risperidone and active metabolites decreased by 60% in severe renal impairmentIf a dose of 2 mg daily orally is tolerated then a dose of 25 mg (IM) every 2 weeks can be used initially in renal impairment.