RISPERIDONE

Indications & Dose:

Schizophrenia and other psychoses in patients tolerant to risperidone by mouth and taking oral risperidone up to 4 mg daily

•  BY DEEP INTRAMUSCULAR INJECTION

Adult: Initially 25 mg every 2 weeks, to be administered into the deltoid or gluteal muscle, adjusted in steps of 12.5 mg (max. per dose 50 mg every 2 weeks) at intervals of at least 4 weeks, during initiation risperidone by mouth may need to be continued for 4–6 weeks; risperidone by mouth may also be used during dose adjustment of depot injection

Schizophrenia and other psychoses in patients tolerant to risperidone by mouth and taking oral risperidone over 4 mg daily

• BY DEEP INTRAMUSCULAR INJECTION

Adult: Initially 37.5 mg every 2 weeks, adjusted in steps of 12.5 mg (max. per dose 50 mg every 2 weeks) at intervals of at least 4 weeks, during initiation risperidone by mouth may need to be continued for 4–6 weeks; risperidone by mouth may also be used during dose adjustment of depot injection

Acute and chronic psychosis

•  BY MOUTH

Adult: 2 mg daily in 1–2 divided doses for day 1, then 4 mg daily in 1–2 divided doses for day 2, slower titration is appropriate in some patients, usual dose 4–6 mg daily, doses above 10 mg daily only if benefit considered to outweigh risk; maximum 16 mg per day

Elderly: Initially 500 micrograms twice daily, then increased in steps of 500 micrograms twice daily, increased to 1–2 mg twice daily

Mania

•  BY MOUTH

Adult: Initially 2 mg once daily, then increased in steps of 1 mg daily if required; usual dose 1–6 mg daily

Elderly: Initially 500 micrograms twice daily, then increased in steps of 500 micrograms twice daily, increased to 1–2 mg twice daily

Short-term treatment (up to 6 weeks) of persistent aggression in patients with moderate to severe Alzheimer’s dementia unresponsive to nonpharmacological interventions and when there is a risk of harm to self or others

•  BY MOUTH

Adult: Initially 250 micrograms twice daily, then increased in steps of 250 micrograms twice a day on alternate days, adjusted according to response; usual dose 500 micrograms twice daily (max. per dose 1 mg twice daily) 

Contraindications:

Side Effects:

Cautions:

Precautions:

 Neuroleptic malignant syndrome, tardive dyskinesia, prolonged QT interval, seizures 

Interaction:

Drugs

Levodopa, dopamine agonists: Risperidone may antagonize effect. 

Warnings:

Adverse Effects:

Lactations:

Pregnancy ; excreted in breast milk 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Aggressive reaction, anxiety, decreased libido, dizziness, EPS frequency is dose related), increased dream activity, insomnia, somnolence

CV: arthostatic hypotension, tachycardia

EENT: Abnormal vision (accommodation), dry mouth

GI: Abdominal pain, constipation, dyspepsia, nausea, vomiting

GU: Menorthagia, polyuria, sexual (erectile and orgasmic) dysfunction, urinary retention, vaginal dryness

HEME: Anemia

METAB: Amenorrhea, galactorrhea, gynecomastia, hyponatremia

MS: Arthralgia, back pain, chest pain

RESP: Cough, dyspnea, pharyngitis, rhinitis, sinusitis

SKIN: Dry skin, increased pigmentation, photosensitivity, rash, seborrhea

MISC: Fatigue, feve

Patient And Carer Advice: