November 30, 2015
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Invega Sustenna

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Invega Sustenna


(In-VEY-guh Suss-TEN-uh)
(paliperidone palmitate) Extended-Release Injectable Suspension

Read this Patient Information carefully before you receive INVEGA SUSTENNA and each time you receive it. There may be new information. This information does not take the place of talking to your healthcare provider about your medical condition or your treatment.

What is the most important information I should know about INVEGA SUSTENNA?

INVEGA SUSTENNA can cause serious side effects, including:

  • Increased risk of death in elderly people who are confused, have memory loss and have lost touch with reality (dementia-related psychosis). INVEGA SUSTENNA is not for treating dementia-related psychosis.


INVEGA SUSTENNA is a prescription medicine given by injection by a health care professional and used to treat:

It is not known if INVEGA SUSTENNA is safe and effective in children under 18 years of age.

Who should not receive INVEGA SUSTENNA?

Do not receive INVEGA SUSTENNA if you:

  • are allergic to paliperidone, risperidone, or any of the ingredients in INVEGA SUSTENNA. See the end of this Patient Information leaflet for a complete list of ingredients in INVEGA SUSTENNA.

What should I tell my healthcare provider before receiving INVEGA SUSTENNA?

Before you receive INVEGA SUSTENNA, tell your healthcare provider about all your medical conditions, including if you:

  • have had Neuroleptic Malignant Syndrome (NMS)
  • have or have had heart problems, including a heart attack, heart failure, abnormal heart rhythm, or long QT syndrome
  • have or have had low levels of potassium or magnesium in your blood
  • have or have had uncontrolled movements of your tongue, face, mouth, or jaw (tardive dyskinesia)
  • have or have had kidney or liver problems
  • have diabetes or have a family history of diabetes
  • have had a low white blood cell count
  • have had problems with dizziness or fainting or are being treated for high blood pressure
  • have or have had seizures or epilepsy
  • have any other medical conditions
  • are pregnant or plan to become pregnant. It is not known if INVEGA SUSTENNA will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. INVEGA SUSTENNA can pass into your breast milk and may harm your baby. You and your healthcare provider should decide if you will receive INVEGA SUSTENNA or breastfeed. You should not do both.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Know the medicines you take. Keep a list of them to show to your healthcare provider or pharmacist when you get a new medicine.

How will I receive INVEGA SUSTENNA?

  • Take INVEGA SUSTENNA exactly as your healthcare provider tells you to.
  • Your healthcare provider will tell you how much INVEGA SUSTENNA you will receive and when you will receive it.
  • INVEGA SUSTENNA is given as an injection by your healthcare provider into the muscle (intramuscularly) of your arm or your buttocks.
  • When you receive your first dose of INVEGA SUSTENNA you will need to get a second dose 1 week later. After that you will only need to get a dose 1 time a month.

What should I avoid while receiving INVEGA SUSTENNA?

  • INVEGA SUSTENNA may affect your ability to make decisions, think clearly, or react quickly. Do not drive, operate heavy machinery, or do other dangerous activities until you know how INVEGA SUSTENNA affects you.
  • Avoid getting overheated or dehydrated.

What are the possible side effects of INVEGA SUSTENNA?

INVEGA SUSTENNA may cause serious side effects, including:

  • See “What is the most important information I should know about INVEGA SUSTENNA?”
  • stroke in elderly people (cerebrovascular problems) that can lead to death
  • Neuroleptic Malignant Syndrome (NMS). NMS is a rare but very serious problem that can happen in people who receive INVEGA SUSTENNA. NMS can cause death and must be treated in a hospital. Call your healthcare provider right away if you become severely ill and have any of these symptoms:
    • high fever
    • severe muscle stiffness
    • confusion
    • loss of consciousness
    • changes in your breathing, heartbeat and blood pressure
  • problems with your heartbeat. These heart problems can cause death. Call your healthcare provider right away if you have any of these symptoms:
    • passing out or feeling like you will pass out
    • dizziness
    • feeling as if your heart is pounding or missing beats
  • uncontrolled movements of your tongue, face, mouth, or jaw (tardive dyskinesia)
  • metabolic changes. Metabolic changes may include high blood sugar (hyperglycemia), diabetes mellitus and changes in the fat levels in your blood (dyslipidemia), and weight gain.
  • low blood pressure and fainting
  • changes in your blood cell counts
  • high level of prolactin in your blood (hyperprolactemia). INVEGA SUSTENNA may cause a rise in the blood levels of a hormone called prolactin (hyperprolactemia) that may cause side effects including missed menstrual periods, leakage of milk from the breasts, development of breasts in men, or problems with erection
  • problems thinking clearly and moving your body
  • seizures
  • difficulty swallowing that can cause food or liquid to get into your lungs
  • prolonged or painful erection lasting more than 4 hours. Call your healthcare provider or go to your nearest emergency room right away if you have an erection that lasts more than 4 hours.
  • problems with control of your body temperature especially when you exercise a lot or spend time doing things that make you warm. It is important for you to drink water to avoid dehydration.

The most common side effects of INVEGA SUSTENNA include:

  • injection site reactions
  • sleepiness or drowsiness
  • dizziness
  • feeling of inner restlessness or needing to be constantly moving
  • abnormal muscle movements, including tremor (shaking), shuffling, uncontrolled involuntary movements, and abnormal movements of your eyes

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all the possible side effects of INVEGA SUSTENNA. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

General information about the safe and effective use of INVEGA SUSTENNA.

This Patient Information leaflet summarizes the most important information about INVEGA SUSTENNA. If you would like more information, talk with your healthcare provider.

You can ask your healthcare provider or pharmacist for more information that is written for healthcare professionals. For more information, go to or call 1-800-526-7736.

What are the ingredients in INVEGA SUSTENNA?

Active ingredient: paliperidone palmitate

Inactive ingredients: polysorbate 20, polyethylene glycol 4000, citric acid monohydrate, disodium hydrogen phosphate anhydrous, sodium dihydrogen phosphate monohydrate, sodium hydroxide, and water for injection

Last reviewed on RxList: 7/1/2015
This monograph has been modified to include the generic and brand name in many instances.

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Report Problems to the Food and Drug Administration


You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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