Invega Sustenna is a medication containing the active ingredient paliperidone palmitate, an atypical antipsychotic from the benzisoxazole derivative class. It is formulated as a sterile aqueous extended-release suspension for intramuscular injection, available in doses of 39 mg, 78 mg, 117 mg, 156 mg, and 234 mg. Key inactive ingredients include polysorbate 20, polyethylene glycol 4000, and citric acid monohydrate.

How should I use this medication?

This medication is for injection into a muscle. It is given in a hospital or clinic setting. Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

It is important not to miss your dose. Call your care team if you are unable to keep an appointment.

Where should I keep my medication?

This medication is given in a hospital or clinic and will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

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 -Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing -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): -Dizziness -Drowsiness -Pain, redness, or irritation at injection site -Restlessness -Weight gain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions: -Dementia -Diabetes -Difficulty swallowing -Have trouble controlling your muscles -Heart disease -High cholesterol -History of breast cancer -History of irregular heartbeat -History of stroke -Kidney disease -Liver disease -Low blood counts, like low white cell, platelet, or red cell counts -Low blood pressure -Parkinson's disease -Seizures -An unusual or allergic reaction to paliperidone, risperidone, other medications, foods, dyes, or preservatives -Pregnant or trying to get pregnant -Breast-feeding

What may interact with this medication?

Do not take this medication with any of the following: -Cisapride -Dronedarone -Metoclopramide -Pimozide -Thioridazine This medication may also interact with the following: -Alcohol -Antihistamines for allergy, cough, and cold -Carbamazepine -Certain medications for anxiety or sleep -Certain medications for depression like amitriptyline, fluoxetine, paroxetine, sertraline -Certain medications for fungal infections like fluconazole, posaconazole -General anesthetics like halothane, isoflurane, methoxyflurane, propofol -Levodopa or other medications for Parkinson's disease -Medications for blood pressure -Medications for seizures -Medications that relax muscles for surgery -Narcotic medications for pain -Other medications that prolong the QT interval (cause an abnormal heart rhythm) -Phenothiazines like chlorpromazine, prochlorperazine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication. Tell your care team if your symptoms do not start to get better or if they get worse. You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medication. Avoid alcoholic drinks. This medication may increase blood sugar. Ask your care team if changes in diet or medications are needed if you have diabetes. This medication can cause problems with controlling your body temperature. It can lower the response of your body to cold temperatures. If possible, stay indoors during cold weather. If you must go outdoors, wear warm clothes. It can also lower the response of your body to heat. Do not overheat. Do not over-exercise. Stay out of the sun when possible. If you must be in the sun, wear cool clothing. Drink plenty of water. If you have trouble controlling your body temperature, call your care team right away.

What are the most serious risks of this medication?

This medication should not be used to treat mood and behavior changes caused by dementia. It may increase the risk of death in older adults with dementia.