Invega Sustenna Drug Interactions

Drugs Having Clinically Important Interactions with INVEGA SUSTENNA: Because paliperidone palmitate is hydrolyzed to paliperidone (see Pharmacology: Pharmacokinetics under Actions), results from studies with oral paliperidone should be taken into consideration when assessing drug-drug interaction potential. (See Table 16.)

Click on icon to see table/diagram/image

Drugs Having No Clinically Important Interactions with INVEGA SUSTENNA: Clinically meaningful pharmacokinetic interaction between INVEGA SUSTENNA and valproate (including valproic acid and divalproex sodium) is not expected. Based on pharmacokinetic studies with oral paliperidone, no dosage adjustment of INVEGA SUSTENNA is required when administered with valproate (see Pharmacology: Pharmacokinetics under Actions). Additionally, no dosage adjustment is necessary for valproate when co-administered with INVEGA SUSTENNA (see Pharmacology: Pharmacokinetics under Actions).
Pharmacokinetic interaction between lithium and INVEGA SUSTENNA is also unlikely.
Paliperidone is not expected to cause clinically important pharmacokinetic interactions with drugs that are metabolized by cytochrome P450 isozymes. In vitro studies indicate that CYP2D6 and CYP3A4 may be involved in paliperidone metabolism; however, there is no evidence in vivo that inhibitors of these enzymes significantly affect the metabolism of paliperidone. Paliperidone is not a substrate of CYP1A2, CYP2A6, CYP2C9, and CYP2C19; an interaction with inhibitors or inducers of these isozymes is unlikely. (See Pharmacology: Pharmacokinetics under Actions.)