Invega Sustenna® (paliperidone palmitate) Extended-Release IM Injection

What Invega Sustenna® Is and How It Works

Invega Sustenna® is a long-acting injectable form of paliperidone palmitate. It is an atypical antipsychotic used for schizophrenia. Each prefilled syringe is for intramuscular injection. Dosing is monthly after a two-dose start. Many patients and prescribers choose the loading plan known as Invega Sustenna® initiation for steady levels. This page covers Invega Sustenna Injection details, including dosing, safety, and savings.

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Paliperidone blocks dopamine D2 and serotonin 5-HT2A receptors. This helps reduce positive and negative symptoms in schizophrenia. The palmitate ester is slowly released from muscle tissue. This supports once-monthly maintenance after the loading schedule. Invega Sustenna® for schizophrenia may improve adherence compared with daily tablets.

Dosage and Usage

Invega Sustenna® administration is by deep intramuscular injection in the deltoid or gluteal muscle. A healthcare professional must perform administering Invega Sustenna. The product is supplied as a prefilled syringe with a needle kit. Do not self-inject unless your prescriber has trained and approved you.

• Initiation: Day 1: 234 mg in the deltoid. Day 8: 156 mg in the deltoid. This is the typical Invega Sustenna® starting dose sequence.
• Maintenance: Inject once monthly into the deltoid or gluteal muscle. Usual doses are 39 mg, 78 mg, 117 mg, 156 mg, or 234 mg based on response.
• Common maintenance dose: Many patients remain on 117 mg monthly, but dosing is individualized.
• Dosing adjustments: Renal impairment and tolerability may require changes. Follow your prescriber’s plan.
• Missed dose: If an Invega Sustenna® missed dose occurs, contact the clinic promptly. The catch-up plan depends on how much time has passed since the last injection.
• Administration details: The syringe must be shaken by the clinician and injected immediately. Do not massage the site. Report any painful or hard injection site lump.

Storage and travel tips for patients and caregivers:

• Store your supply at room temperature, generally 15–30 °C. Do not freeze.
• Keep syringes in the original carton until your appointment.
• Protect from light and excessive vibration.
• If you travel, carry your medication in a hand bag, not checked luggage.
• Use an insulated pouch if temperatures may be extreme.
• Bring your prescription and clinic details when you fly.

Ask the clinic about Invega Sustenna® dosing specifics, including needle selection and rotation of injection sites. Invega Sustenna® injection dosage options range from 39 mg to 234 mg. The labeled schedule supports once-monthly injections after loading.

Benefits and Savings

Invega Sustenna® offers reliable monthly dosing, which can reduce daily pill burden. The two-dose start quickly achieves therapeutic levels. Many patients experience stable symptom control and improved adherence. Compared with biweekly depot options, monthly dosing may be more convenient. This antipsychotic is also available in several strengths, including 78 mg, 117 mg, 156 mg, and 234 mg.

Ordering from a Canadian pharmacy can lower the cost of care. You can save an estimated 60–80% versus typical US prices. This can make the cost of Invega Sustenna injection more manageable over time. Patients often ask about Invega Sustenna injection price by strength. We list the available presentations so you can compare per-dose costs.

Side Effects and Safety

All antipsychotics can cause side effects. Discuss risks and benefits with the prescriber and read the monograph. Watch for side effects of Invega Sustenna injection after each dose, especially during the first months.

• Common: Injection site pain, redness, or an injection site lump; dizziness; drowsiness; insomnia; anxiety; headache; restlessness or akathisia; extrapyramidal symptoms (mild); constipation; nausea; weight gain; increased prolactin with related symptoms.
• Metabolic effects: Increased blood sugar, lipids, and weight can occur.
• Cardiovascular: Orthostatic hypotension and possible QT prolongation in susceptible patients.
• Serious but rare: Severe extrapyramidal symptoms, tardive dyskinesia, neuroleptic malignant syndrome, seizures, severe allergic reactions, dangerously high blood sugar, stroke in elderly patients with dementia-related psychosis.

Patients with kidney impairment may need dose changes. Paliperidone can raise prolactin and cause menstrual changes, sexual dysfunction, or breast symptoms. Avoid combining with strong dopamine agonists unless directed by the prescriber. Alcohol and CNS depressants can increase sedation. This medicine is not approved for elderly patients with dementia-related psychosis due to increased mortality risk.

If you notice severe reactions, seek medical help right away. Report any persistent injection site issues to the clinic. Keep all follow-up visits so your prescriber can monitor response and safety.

Onset Time

The loading regimen reaches therapeutic levels fast. Many patients notice early changes within the first one to two weeks. Symptom improvement varies by individual and dose selection. Steady state usually develops after several monthly injections. Continue follow-up, as the full effect can build over time.

Compare With Alternatives

Several long-acting antipsychotic injections are available. Risperidone LAIs, such as biweekly formulations, require more frequent clinic visits. Aripiprazole options, like aripiprazole once-monthly or extended-interval products, have different side-effect patterns and monitoring needs. Each product has unique needle kits and injection schedules.

Invega Sustenna® antipsychotic dosing uses a two-dose start, then monthly injections. Some patients later switch to longer intervals after stability. Your prescriber may consider a three-month paliperidone option for stable patients who respond well to monthly dosing. The choice depends on prior response, adherence goals, and tolerability.

Oral antipsychotics, including paliperidone ER tablets, are alternatives when injections are not preferred. Daily tablets allow fine dose adjustments but require strict adherence. Long-acting injections help many patients maintain steady levels with less daily planning.

Combination Therapy

Some patients receive adjunctive therapies alongside Invega Sustenna®. Options can include structured psychotherapy, psychosocial support, or substance use counseling. In selected cases, prescribers may use mood stabilizers or antidepressants. Treatment is individualized. Coordination between the clinic, therapist, and caregivers supports the plan.

Patient Suitability and Cost-Saving Tips

Invega Sustenna® for schizophrenia is for adults who benefit from long-acting treatment. It is not for everyone. Patients with known allergy to paliperidone or risperidone should avoid it. Dose changes may be needed with renal impairment. Discuss pregnancy, plans to conceive, and breastfeeding with the prescriber. Review possible drug interactions and QT risk. Clinic staff will guide Invega Sustenna® administration and monitoring.

Budget planning helps with ongoing monthly injections. Ask your clinic which strength you will use long term, such as 78 mg, 117 mg, 156 mg, or 234 mg. Patients often compare Invega Sustenna 117 mg and Invega Sustenna 156 mg pricing before maintenance begins. Many also request an estimate for Invega Sustenna 234 mg cost if dose increases are likely. We offer fair Invega Sustenna cost at Canadian pricing.

You can lower per-month spend when you order multiple months together. Multi-month supplies and bulk promotions can reduce shipping fees and unit pricing. We also offer reorder reminders so you stay on schedule. For current offers and bulk options, see our invega sustenna coupon page.

Authoritative Sources

Janssen Invega Sustenna prescribing information

Health Canada Drug Product Database: Invega Sustenna

FDA label for paliperidone palmitate LAI

Ready to get started? You can place an order with YouDrugstore today. Our team ships with prompt, express, cold-chain shipping to protect temperature-sensitive medicines. Our service team is here during posted office hours if you have order questions.

Disclaimer: This content is for general information. It does not replace medical advice from your prescriber or pharmacist. Review the official product monograph and follow clinic guidance on dosing and monitoring.