risperidone
Risperdal, Risperdal Consta
Class and Category of Drug
Chemical class: Benzisoxazole derivative
Therapeutic class: Antipsychotic
Pregnancy category: C
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Drug Indications and Dosages
Oral Solution, Orally Disintegrating Tablets, Tablets
Adults. 1 mg b.i.d. on day 1; 2 mg b.i.d. on day 2; 3 mg b.i.d. on day 3. Or, 2 mg daily on day one; 4 mg daily on day two; 6 mg daily on day 3. Then increased by 1 to 2 mg daily at 1- to 2-wk intervals, as needed. Maximum: 16 mg daily. Adolescents ages 13 to 17. Initial: 0.5 mg once daily, increased as needed every 24 hr in 0.5- to 1-mg increments. Maximum: 3 mg once daily.
Intramuscular Injection (Risperdal Consta)
Adults. Initial: 25 mg every 2 wk, increased as needed every 4 wk to 37.5 or 50 mg. Maximum: 50 mg every 2 wk.
To treat bipolar mania
Oral Solution, Orally Disintegrating Tablets,Tablets
Adults. Initial: 2 or 3 mg daily, increased as needed by 1 mg daily up to 6 mg. Maximum: 6 mg daily for no more than 3 wk.
Children and adolescents ages 10 to 17. Initial: 0.5 mg once daily, increased as needed every 24 hr in 0.5- to 1-mg increments. Maximum: 2.5 mg once daily.
To treat bipolar mania as monotherapy or as adjunct to lithium or valproate therapy intramuscular
Injection (Risperdal Consta)
Adults. 25 mg every 2 wk., increased, as needed to 37.5 mg or 50 mg. Maximum: 50 mg every 2 wk.
Dosage AdjustmentInitially 0.5 mg b.i.d. for elderly or debilitated patients, those with renal or hepatic impairment, and those at risk for hypotension. Increased by 0.5 mg b.i.d. every wk, as needed. Given daily after target dosage maintained for 2 or 3 days. Maximum for patients with severe hepatic dysfunction, 4 mg daily; for elderly patients, 3 mg daily. Initially 12.5 mg for patients receiving drug intramuscular who have renal or hepatic impairment, take other drugs that increase risperidone blood level, or have a history of tolerating psychotropic drugs poorly. For adolescents and children with persistent somnolence, dose may be split and given twice daily.
To treat irritability associated with autistic disorder
Oral Solution, Orally Disintegrating Tablets,Tablets
Children age 5 and over and adolescents weighing less than 20 kg (44 lb). Initial: 0.25 mg daily, increased after 4 days to 0.5 mg daily. Dosage further increased, as needed in 2 wk intervals in 0.25 mg increments.
Children age 5 and over and adolescents weighing 20 kg or more. Initial: 0.5 mg daily, increased after 4 days to 1 mg daily. Dosage further increased, as needed in 2 wk intervals in 0.5 mg increments.
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Incompatibilities
Don't mix oral solution with cola or tea.
Contraindications of Drug
Hypersensitivity to risperidone or its components
Generic Drug Interactions
Drugs
antihypertensives: Increased antihypertensive effects
bromocriptine, levodopa, pergolide: Possibly antagonized effects of these drugs carbamazepine: Increased risperidone clearance with long-term concurrent use clozapine: Decreased risperidone clearance with long-term concurrent use CNS depressants: Additive CNS depression
fluoxetine, paroxetine: Increased plasma
risperidone level
Activities
alcohol use: Additive CNS depression
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Drugs Adverse Reactions
Central Nervous System: Aggressiveness, agitation, akathisia, anxiety, asthenia, confusion, decreased concentration, dizziness, dream disturbances, drowsiness, dyskinesia, dystonia, fatigue, fever, headache, lassitude, memory loss, nervousness, neuroleptic malignant syndrome, parkinsonism, restlessness, seizures, somnolence, tremor
Cardiovascular: Atrial fibrillation, chest pain, hypercholesterolemia, orthostatic hypotension, palpitations, QT-interval prolongation, tachycardia
Eyes, Ears, Nose, And Throat: Decreased or increased salivation, dry mouth, pharyngitis, retinal artery occlusion, rhinitis, sinusitis, vision changes
Endocrine: Diabetic ketoacidosis (patients with diabetes), elevated prolactin level, galactorrhea, hyperglycemia, pituitary adenoma
Gastrointestinal: Abdominal pain, anorexia, constipation, diarrhea, indigestion, intestinal obstruction, nausea, vomiting
Genitourinary: Amenorrhea, decreased libido, dysmenorrhea, dysuria, hypermenorrhea, incontinence, increased appetite, polyuria, sexual dysfunction, urinary tract infection
Hematologic: Agranulocytosis, leukopenia, neutropenia
Musculoskeletal: Arthralgia, back pain, myalgia
Respiratory: Cough, dyspnea, sleep apnea, upper respiratory tract infection
Skin: Diaphoresis, dry skin, hyperpigmentation, photosensitivity, pruritus, rash, seborrhea
Other: Anaphylaxis, angioedema, injection site induration, pain, redness, or swelling; weight gain or loss
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Nursing Considerations for Generic Drugs
• Use risperidone cautiously in debilitated patients, elderly patients, and patients with hepatic or renal dysfunction or hypotension because of their increased sensitivity to drug. Also use risperidone cautiously in patients with a history of seizures; although rare, seizures may occur in those with schizophrenia.
WARNING Be aware that risperidone should not be used to treat elderly patients with dementia-related psychosis because it solution with water, coffee, orange juice, or low-fat milk but not with cola or tea. Tell patient prescribed orally disintegrating tablets to break open the blister unit with dry hands by peeling the foil back to expose the tablet. Stress the importance of not pushing tablet through the foil because this could damage the tablet. Once patient has removed tablet, she should place immediately on her tongue, where it will dissolve within seconds. Tell patient not to chew orally disintegrating tablet or attempt to spit it out of her mouth.
Urge patient to avoid alcohol because of its additive CNS effects. Caution diabetic patient to monitor blood glucose level closely because risperidone may increase it.
Risperidone
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
The United States Pharmacopeia 31, 2008: Risperidone Tablets.
Proprietary Preparations
Argentina: Dozic; Dropicine; Edalen; Restelea; Riatul; Risper; Risperdal; Risperin; Rispex; Sequinan;
Australia: Risperdal;
Austria: Belivon; Risperdal; Rispolin;
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Belgium: Risperdal;
Brazil: Respidon; Risperdal; Viverdal; Zargus;
Canada: Risperdal;
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Chile: Dagotil; Goval; Radigen; Risperdal; Spiron;
Czech Republic: Apo-Risper; Medorisper; Ridoner; Rigenin; Rileptid; Ripetomar; Risepro; Rispadim; Rispedep; Rispedolet; Rispedospes; Rispemar; Rispen; Rispera; Risperdal; Risperinin; Risperit; Rispimed; Rispolux; Risset; Rorendo;
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India: Respidon; Risnia; Risperdal; Rispid; Rozidal; Sizorisp;
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Netherlands or Holland: Belivon; Risperdal; Rispimed; Rispimedica;
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Venezuela: Ridal; Risperdal; Risperid.
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