Invega Sustenna® Monthly Long-Acting Injection for Schizophrenia

What Invega Sustenna® Is and How It Works

Invega Sustenna® is the once-monthly long-acting injectable form of paliperidone palmitate. It treats schizophrenia and is also used for schizoaffective disorder as directed by a prescriber. A healthcare professional gives the injection into a shoulder (deltoid) or buttock (gluteal) muscle. Invega Sustenna Injection supports steady medication levels, which helps reduce relapse risk and daily pill burden.

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Paliperidone is the active metabolite of risperidone. After the injection, the palmitate ester slowly releases paliperidone over weeks. It blocks dopamine D2 and serotonin 5-HT2A receptors, which helps control positive and negative symptoms. Treatment often begins with a two-dose initiation, followed by a monthly maintenance dosing schedule. Strengths commonly used include Invega Sustenna 117 mg, Invega Sustenna 156 mg, and 234 mg options. People compare Invega Sustenna Injection price and value because a monthly shot can improve adherence.

Dosage and Usage

• A healthcare professional administers Invega Sustenna by intramuscular injection only. Self-injection is not advised.
• Each prefilled syringe must be shaken vigorously to a uniform, milky suspension before use. The supplied SafetyGlide needle is selected per site and patient build.
• Initiation (typical): Day 1 deltoid 234 mg, then Day 8 deltoid 156 mg. The Invega Sustenna loading dose schedule aims to reach therapeutic levels quickly.
• Maintenance: Given monthly (every 4 weeks) into deltoid or gluteal muscle. The prescriber sets the dose, often between 39 mg and 234 mg, based on response and tolerability.
• Switching from oral risperidone or paliperidone: clinicians generally use the same loading approach and then individualize the maintenance dose.
• Renal impairment: lower initiation and maintenance doses may be used under prescriber supervision.
• Administering Invega Sustenna: inject slowly into the chosen muscle at 90 degrees. Do not give intravenously or subcutaneously.
• Missed dose (general guidance): if a maintenance injection is late, a clinician may resume as soon as possible, or use a brief re-loading plan depending on how much time has passed. If the second initiation dose is missed, re-initiation may be required.
• Invega Sustenna dosing schedule is monthly after the two-starting-dose sequence. Do not change dose or site without medical direction.

• Store at 20–25°C (68–77°F). Short excursions 15–30°C (59–86°F) are acceptable.
• Keep syringes in the original carton to protect from light. Do not freeze.
• Check the expiration date before use. Do not use damaged syringes.
• For travel, pack in your carry-on with the original packaging and a copy of your prescription. Avoid extreme heat (car trunks, heaters, windowsills).
• Keep out of reach of children and pets.

Benefits and Savings

Invega Sustenna for schizophrenia offers consistent blood levels and once-monthly clinic visits. Many patients experience fewer relapses and hospitalizations compared with missed daily tablets. The loading plan helps symptoms stabilize early in treatment, and the monthly cadence supports long-term adherence.

You can order brand-name doses like Invega Sustenna 156 mg or 117 mg at Canadian pricing. Typical customers report 60–80% savings versus common US prices, which helps with ongoing Invega Sustenna cost. Multi-month supplies, when approved on your prescription, can reduce per-month expense. Reorder reminders help you stay on schedule, and you can review the Invega Sustenna injection price by size before checkout. If comparing the invega sustenna 234 mg cost to lower strengths, per-milligram pricing may differ by pack size.

For current offers, see our Invega Sustenna injection coupon page.

Side Effects and Safety

• Common effects: injection-site pain, redness, or swelling.
• Drowsiness, dizziness, restlessness (akathisia), tremor.
• Weight gain, increased appetite.
• Headache, anxiety, insomnia.
• Constipation, dry mouth, nausea.
• Orthostatic hypotension (lightheadedness when standing).
• Elevated prolactin, which may cause menstrual changes or breast symptoms.

Serious but less common risks include neuroleptic malignant syndrome, tardive dyskinesia, seizures, QT prolongation, blood count changes (leukopenia/neutropenia), and severe allergic reactions. There is an increased mortality risk in elderly patients with dementia-related psychosis; this medicine is not approved for that use. Carbamazepine and other inducers can lower paliperidone levels. When used with insulin or sulfonylureas, the overall risk of hypoglycemia may increase and may require dose adjustments of the glucose-lowering drug.

Onset Time

The two-dose start helps many patients feel symptom relief within the first 1–2 weeks. Ongoing improvements often build over several weeks as the monthly injections continue. Steady-state levels are typically reached after a few maintenance doses. Weight, metabolic, or prolactin-related changes may emerge gradually over weeks to months and should be monitored by the care team.

Compare With Alternatives

Risperdal Consta (risperidone long-acting injection) is given every two weeks and usually requires oral overlap. Invega Sustenna does not require chronic oral overlap after the two-dose initiation, which many clinics find simpler for adherence.

Abilify Maintena (aripiprazole monthly injection) is a dopamine partial agonist that may have a different side-effect profile, including a lower tendency for prolactin elevation, but it typically requires an oral supplementation period at start.

Invega Trinza (the 3‑month paliperidone palmitate) may be considered after a patient is stable on Invega Sustenna for at least four months. Some prefer the three-month injection for convenience once dosing is steady and well tolerated.

Combination Therapy

• Monotherapy for schizophrenia maintenance after stabilization on the loading and monthly schedule.
• Adjunct to mood stabilizers (e.g., lithium, valproate) for schizoaffective disorder as directed by a prescriber.
• Short-term use with benzodiazepines for agitation, with monitoring for sedation.
• If used in patients with diabetes, clinicians may lower insulin or sulfonylurea doses to reduce hypoglycemia risk.
• Strong enzyme inducers (e.g., carbamazepine) may require antipsychotic dose adjustments under supervision.

Patient Suitability and Cost-Saving Tips

Invega Sustenna suits adults who benefit from a monthly long-acting shot to support adherence and symptom control. It may be used in schizoaffective disorder under clinician guidance. It is generally not used in elderly patients with dementia-related psychosis because of higher mortality risk in this population. Dose adjustments are often needed in renal impairment. Discuss pregnancy or breastfeeding plans with the prescriber to weigh benefits and risks.

To stretch your pharmacy budget, review the Invega Sustenna price across strengths and pack sizes before checkout. Multi-month fills, when allowed on your prescription, can lower the per-month cost. You can turn on reorder reminders in your account so you do not miss a scheduled clinic visit. Bulk promotions may appear throughout the year, and our Canadian pricing helps keep the overall cost of Invega Sustenna injection manageable. If you are exploring an invega sustenna assisting program or samples, your clinic can advise on local options.

Authoritative Sources

Janssen Prescribing Information and Medication Guide

Health Canada Drug Product Database: Invega Sustenna

FDA Label: Paliperidone Palmitate Extended-Release Injectable Suspension

Order Invega Sustenna® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express shipping.

This page is educational and is not a substitute for professional medical advice. Always consult a qualified healthcare provider about diagnosis, treatment, and dosing decisions.