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Drugs Having No Clinically Important Interactions with INVEGA TRINZA: Based on pharmacokinetic studies with oral paliperidone, no dosage adjustment of INVEGA TRINZA is required when administered concomitantly with valproate (see Pharmacology: Pharmacokinetics under Actions). Additionally, no dosage adjustment is necessary for valproate when co-administered with INVEGA TRINZA (see Pharmacology: Pharmacokinetics under Actions).
Pharmacokinetic interaction between lithium and INVEGA TRINZA is 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.)