Invega Sustenna (paliperidone palmitate)

Invega Sustenna (paliperidone palmitate, monthly injection)

Brand name: Invega® Sustenna®

Active ingredient: Paliperidone palmitate

Type: Atypical antipsychotic

Available from: Janssen Inc.

Form: Long‑acting injection

Generic: No

Listed on Ontario formulary: Yes (with suggested criteria*)

OHIP+ coverage: Yes (with suggested criteria*)

*Suggested for individuals with non‑adherence AND inadequate control/side effects on:

≥2 oral antipsychotics or

≥1 typical depot antipsychotic

What is Invega Sustenna used for?

Monthly long‑acting injection for schizophrenia and related psychotic illnesses in adults.

How should I take Invega Sustenna?

Administered by a healthcare provider.
Available in 50 mg, 75 mg, 100 mg, and 150 mg prefilled syringes.
Starter dosing:

  • 1st injection →
  • 2nd injection after 1 week
  • Then monthly

Your doctor adjusts the dosage based on your response.

Common side effects

  • Headache
  • Insomnia
  • Constipation
  • Nausea/vomiting
  • Injection‑site pain
  • Weight gain
  • Restlessness (akathisia)
  • Dizziness
  • Abnormal movements (EPS)

Rare but serious side effects

Same as oral Invega:

  • Agranulocytosis
  • Stroke
  • Severe allergic reaction
  • DKA
  • NMS

Warnings/Precautions

Not approved for dementia-related psychosis due to increased mortality risk in this population.

Medication interactions

Same interaction profile as oral Invega.