 | Precaution
Before you begin using a medication, be sure to inform your doctor of any medical conditions you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Abnormal heart rhythms: This medication can cause abnormal heart rhythms. Certain medications (e.g., quinidine, procainamide, amiodarone, sotalol, chlorpromazine, thioridazine, gatifloxacin, moxifloxacin) can increase the risk of a type of abnormal heart rhythm called QT prolongation and should not be used in combination with paliperidone. People who have a slow heart rate, low potassium or magnesium levels, or have congenital prolongation of the QT interval are more at risk for this type of abnormal heart rhythm and its complications. Talk to your doctor about the risks and benefits of using this medication.
Blood sugar: This medication may cause high blood sugar levels. If you experience weakness, increased thirst, increased urination, and increased appetite while taking this medication, contact your doctor.
Body temperature: This medication, like other antipsychotic medications, can disrupt the body's ability to control body temperature. People who exercise vigorously, who are exposed to extreme heat, are dehydrated, or are taking anticholinergic medications (e.g., benztropine, oxybutynin) are more at risk. Contact your doctor as soon as possible if you feel very hot and are unable to cool down while taking this medication.
Drowsiness/reduced alertness: Paliperidone may interfere with activities requiring mental alertness. People taking this medication should not drive or operate machinery until they know how this medication affects them.
Gastrointestinal problems: Paliperidone should not be taken by people with conditions associated with narrowing of the gastrointestinal tract (e.g., esophagus disorders, inflammatory bowel disease, "short gut" syndrome, cystic fibrosis), or by people who have difficulty swallowing.
Low blood pressure: Paliperidone may cause low blood pressure when rising from a sitting or lying position. If you feel dizzy, lightheaded, or feel your pulse racing, call your doctor. While you are taking this medication, get up slowly after you have been sitting or lying down for a prolonged period.
Neuroleptic malignant syndrome (NMS): Paliperidone, like other antipsychotic medications, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you experience the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, and fainting, get immediate medical attention.
Parkinson's disease: People with Parkinson's disease or dementia with Lewy bodies (DLB) may be at an increased risk of NMS (see warning about NMS), as well as other side effects associated with paliperidone. Talk to your doctor about the risks and benefits of using this medication.
Risperidone: People who are taking risperidone should not take paliperidone at the same time. These medications are related, and taking them together may cause an increased risk of side effects.
Seizures: Paliperidone may increase the risk of seizures, especially in people who have had seizures in the past. People who are at risk of seizures who take this medication should be closely monitored by their doctor.
Tardive Dyskinesia (TD): TD, a syndrome consisting of potentially irreversible, involuntary, repetitive movements of the face and tongue muscles, may develop in people who take certain antipsychotic medications including paliperidone. Although TD appears most commonly in seniors, especially women, it is impossible to predict who will develop TD. The risk of developing TD increases with higher doses and long-term treatment. If you experience muscle twitching or abnormal movements of the face or tongue, contact your doctor as soon as possible.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: This medication passes into breast milk. Women should not breast-feed while they are taking paliperidone.
Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.
Seniors: Medications similar to paliperidone can increase the risk of death when used to treat seniors with dementia. Paliperidone should not be used to treat seniors with dementia.
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