Paliperidone
CLINICAL USE
Atypical antipsychotic for schizophrenia
DOSE IN NORMAL RENAL FUNCTION
3–12 mg once daily
PHARMACOKINETICS
Molecular weight :426.5 %Protein binding :74 %Excreted unchanged in urine : 59 Volume of distribution (L/kg) :487 litreshalf-life – normal/ESRD (hrs) :23/51 DOSE IN RENAL IMPAIRMENT
GFR (mL/MIN)
50–80 3 mg once daily and increase according to response30–50 3 mg once daily and increase according to response10–30 3 mg alternate days, increasing to 3 mg daily according to response <10 : 3 mg alternate days, increasing to 3 mg daily according to response. Use with caution DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD :Unknown dialysability. Dose as in GFR <10 mL/min HD :Unknown dialysability. Dose as in GFR <10 mL/minHDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/minCAV/VVHD :Unknown dialysability. Dose as in GFR=10–30 mL/min IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs Anaesthetics: enhanced hypotensive effect Anti-arrhythmics: increased risk of ventricular arrhythmias when given with anti-arrhythmics that prolong the QT intervalAntidepressants: increases concentration of tricyclics (possibly increased risk of ventricular arrhythmias)Antimalarials: avoidance of antipsychotics advised by manufacturer of artemether/lumefantrineAtomoxetine: increased risk of ventricular arrhythmias with atomoxetineAnti-epileptics: antagonise anticonvulsant effect (convulsive threshold lowered)Antivirals: concentration possibly increased by ritonavirSibutramine: increased risk of CNS toxicity – manufacturer of sibutramine advises avoid concomitant use ADMINISTRATION
Reconstition
– Route
Oral Rate of Administration
–Comments
– OTHER INFORMATION
Clearance is reduced by 71% in ERF Contraindicated (by manufacturer) in patients with GFR <10 mL/min, due to lack of experience.
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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