Sounds like 'PAL-ee-PER-i-done'

Easy-to-read medicine information about paliperidone – what is it, how to take paliperidone safely and possible side effects.

Type of medicine Also called
  • Antipsychotic
  • Belongs to a group of medicines known as atypical antipsychotics 
  • Invega®
  • Invega Sustenna®

What is paliperidone?

  • Paliperidone is used to treat some types of mental illness such as schizophrenia.
  • It does not cure this condition, but will help to ease the symptoms, and to support your recovery. It works by restoring the balance of certain natural chemicals in the brain (neurotransmitters).
  • Paliperidone belongs to a group of medicines called antipsychotics.
  • Paliperidone is available as tablets, or as a long-acting (depot) injection. The injection is an option when your symptoms have settled by taking tablets.    


  • The usual dose of paliperidone tablets is 6 milligrams a day.
  • Some people may require higher doses or lower doses depending on their response to the medication.  
  • Always take your paliperidone exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much paliperidone to take, how often to take it, and any special instructions.
  • When you first start paliperidone injection, you will initially be given a dose of 150 milligrams and then a dose of 100 milligrams a week later. From then on, you will need to have one injection every 4 weeks. Your doctor will adjust the amount of paliperidone given to suit what is right for you.

How to take paliperidone

Paliperidone tablets

  • Take paliperidone tablets once a day, in the morning. 
  • You can take paliperidone with breakfast or before breakfast, on an empty stomach.
    It is important that you take each of your doses in the same way each day – do not change between taking the tablets with breakfast one day, and without breakfast another.
  • Limit or avoid drinking alcohol while you are taking paliperidone. Alcohol may increase your chance of side effects such as drowsiness.
  • If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
  • Keep taking paliperidone every day. It usually takes a few weeks to start working and it can take several months before you feel the full benefits.
  • Do not stop taking paliperidone suddenly as your symptoms may return if stopped too early; speak to your doctor or nurse before stopping.

Paliperidone long-acting (depot) injection

  • This injection is given by a nurse or other trained health professional, in a clinic, community health centre, or hospital.
  • The first two doses will be injected into a muscle in your upper arm. After this, the injections can either be given into a muscle in your arm, or if preferred, the buttocks.


Paliperidone may cause changes in your blood sugar level, your cholesterol level and in your heart function. To keep an eye out for these effects, your doctor will monitor your physical health. You will have your weight measured regularly. You may be sent for tests such as blood tests to monitor your blood, kidneys, liver, cholesterol and glucose levels. You may also have your blood pressure measured and be required to undergo an ECG test to assess your heart rate.       

Possible side effects

Like all medicines, paliperidone can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Feeling dizzy
  • This usually only happens when you start your medication. It should wear off in a few weeks.
  • Try not to stand up too quickly. You are at risk of falls.
  • If you feel dizzy, don't drive.
  • Feeling sleepy, drowsy, or tired
  • It can last a few hours after the dose.  
  • Don’t drive or operate machinery.  
  • Ask your doctor if you can take you medicine at a different time.
  • Avoid drinking alcohol.
  • Feeling shaky and restless (cannot sit still)
  • Eyes or tongue may move on their own
  •  It is not dangerous but a well known side effect.
  • If it is troublesome, tell your doctor.
  • Pain where the injection is given 
  • A warm bath can help, as can exercise.
  • Make sure you have the injection in a different site to the last time.
  •  Weight gain by eating more
  • A diet full of vegetables and fibre may help prevent weight gain.
  • Limit sugary or fatty foods.
  • Speak with your doctor if your weight becomes troublesome.
  • Signs of changes in hormones such as, in women, it can affect breasts (including milk being leaked) and irregular or no periods.
  • In men it can cause impotence (trouble maintaining an erect penis) and chest changes.
  • These changes are due to raised levels of a hormone called prolactin, and it can be very distressing.
  • Discuss with your doctor.


When certain medications are taken together, an unintended reaction may occur – this is known as an interaction. Paliperidone interacts with a number of important medications and herbal supplements so check with your doctor or pharmacist.

Learn more

The following links provide further information on paliperidone. Be aware that websites from other countries may contain information that differs from New Zealand recommendations: 

Medsafe Consumer Information (NZ)

Patient Info, UK