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Risperidone

 
Drug Info:

Risperidone

Brand names: Risperdal®, Risperdal® Consta®, Risperdal® M-Tab®

Chemical formula:



Risperidone Injection

What is Risperidone Injection?

RISPERIDONE (Risperdal® Consta™) helps to treat schizophrenia. Risperidone can help you to keep in touch with reality and reduce your mental problems. Occasionally risperidone is used to treat other mood disturbances. Generic risperidone injection is not yet available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• frequently drink alcohol or alcohol-containing beverages
• blood disorder or disease
• dementia
• diabetes (increased blood sugar) or a family history of diabetes
• difficulty swallowing
• heart disease
• history of brain tumor or head injury
• history of breast cancer
• irregular heartbeat
• kidney disease
• liver disease
• low blood pressure
• Parkinson's disease
• previous heart attack
• seizures (convulsions)
• an unusual or allergic reaction to risperidone, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Risperidone injection is for injection into a muscle. It is given by a health-care professional in a hospital or clinic setting.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What drug(s) may interact with risperidone?

• alcohol
• arsenic trioxide
astemizole
bromocriptine
cabergoline
carbamazepine
clarithromycin
cimetidine
cisapride
droperidol
erythromycin
halofantrine
imatinib, STI-571
• levodopa and other medications for Parkinson's disease
levomethadyl
• medicines for high blood pressure
• medicines for irregular heartbeats
• medicines for sleep or sedation
• medicines for treating seizures (convulsions)
• other medicines for mental anxiety, depression or psychotic disturbances
pentamidine
• prescription pain medications
probucol
rifampin
ritonavir
• some medicines for infertility
• some medicines for the hormonal treatment of cancer
• some quinolone antibiotics for treating infections (gatifloxacin, levofloxacin, moxifloxacin, sparfloxacin
terfenadine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking risperidone?

Visit your prescriber or health care professional for regular checks on your progress. Do not suddenly stop taking risperidone; you may need to gradually reduce the dose. Only stop taking risperidone on your prescriber's advice.

You may get dizzy or drowsy. Do not drive, use machinery, or do anything that needs mental alertness until you know how risperidone affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can increase dizziness and drowsiness. Avoid alcoholic drinks. You can get a hangover effect the morning after a bedtime dose.

If you notice an increased hunger or thirst, different from your normal hunger or thirst, or if you find that you must frequently use the restroom (excessive urination), you should contact your health care provider as soon as possible. You may need to have your blood sugar monitored.

Do not treat yourself for colds, diarrhea or allergies. Ask your prescriber or health care professional for advice, some nonprescription medicines may increase possible side effects.

Risperidone may make you more sensitive to sun or ultraviolet light. Keep out of the sun, or wear protective clothing outdoors and use a sunscreen (at least SPF 15). Do not use sun lamps, or sun tanning beds or booths. To protect your eyes wear sunglasses even on cloudy days.

If you are going to have surgery tell your prescriber or health care professional that you are taking risperidone.

What side effects may I notice from taking risperidone?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• aching muscles and joints
• changes in vision
• confusion
• fast or irregular heartbeat (palpitations)
• fainting spells
• increased thirst or hunger
• increased need to pass urine
• inner restlessness, unable to keep still
• loss of balance, difficulty walking or falls
• stiffness, spasms, trembling

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• constipation
• decreased sexual ability
• difficulty sleeping
• drowsiness or dizziness
• headache
• increase or decrease in saliva
• increased sensitivity to the sun
• injection site pain, redness or swelling
• menstrual irregularity
• nausea, vomiting
• stomach pain
• stuffy or runny nose, cough
• unusual tiredness
• weight gain

Where can I keep my medicine?

This does not apply. You will not keep the injection at home.

Last updated: 5/7/2003 9:18:00 AM

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

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An atypical antipsychotic drug used for the treatment of acute and chronic psychoses, including schizophrenia: it controls both the positive symptoms (e.g. delusions) and the negative symptoms (e.g. apathy) of the disease. It is also used to treat mania and persistent aggression. Risperidone is available as tablets, dispersible tablets, a liquid, or a depot injection on prescription only.

Side effects:
include weight gain, dizziness, low blood pressure on standing (which can cause fainting in some people), insomnia, agitation, anxiety, headache, drowsiness, lack of concentration, constipation, indigestion, nausea and vomiting, blurred vision, menstrual irregularities, and sexual dysfunction.

Precautions:
risperidone should be used with caution in elderly patients, pregnant and breastfeeding women, and in people with liver, heart, or kidney disease, epilepsy, or Parkinson's disease. Drowsiness can affect skilled tasks.

Interactions with other drugs:

Anaesthetics: their effect in lowering blood pressure is enhanced.
Antidepressants: fluoxetine increases the plasma concentration of risperidone; there is an increased risk of antimuscarinic effects and arrhythmias if risperidone is taken with tricyclic antidepressants.
Antiepileptic drugs: their anticonvulsant effects are antagonized by risperidone; carbamazepine reduces the effects of risperidone.
Clozapine should not be taken with injections of risperidone.
Ritonavir may increase the effects of risperidone.
Sedatives: the sedative effects of risperidone are increased if it is taken with anxiolytic or hypnotic drugs, or any other drug that causes sedation.
Sibutramine there is an increased risk of adverse effects on the nervous system and this drug should not be taken with risperidone.

Proprietary preparations:
Risperdal; Risperdal Consta (injection); Risperdal Quicklet (dispersible tablets).

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Mosby's Dental Dictionary:

risperidone

Top

n

trade name: Risperdal; drug class: antipsychotic; action: may be related to antagonism for dopamine and serotonin receptors; also has affinity for alpha receptors and histamine (H1) receptors; use: psychotic disorders.

Wikipedia on Answers.com:

Risperidone

Top
Risperidone
Systematic (IUPAC) name
4-[2-[4-(6-fluorobenzo[d]isoxazol-3-yl)-
1-piperidyl]ethyl]-3-methyl-
2,6-diazabicyclo[4.4.0]deca-1,3-dien-5-one
Clinical data
Trade names Risperdal
AHFS/Drugs.com monograph
MedlinePlus a694015
Pregnancy cat. C
Legal status Prescription only
Routes Oral and extended-release intramuscular injection
Pharmacokinetic data
Bioavailability 70% (oral)
Metabolism Hepatic (CYP2D6-mediated)
Half-life 3–20 hours
Excretion Urinary
Identifiers
CAS number 106266-06-2 YesY
ATC code N05AX08
PubChem CID 5073
IUPHAR ligand 96
DrugBank DB00734
ChemSpider 4895 YesY
UNII L6UH7ZF8HC YesY
KEGG D00426 YesY
ChEBI CHEBI:8871 YesY
ChEMBL CHEMBL85 YesY
Chemical data
Formula C23H27FN4O2 
Mol. mass 410.485 g/mol
SMILES eMolecules & PubChem
 YesY(what is this?)  (verify)

Risperidone (ris-pair-ih-doan) (Risperdal, and generics) is a second generation[1] or atypical antipsychotic. It is used to treat schizophrenia (including adolescent schizophrenia), schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism. It is associated with significant weight gain and metabolic problems, as well as tardive dyskinesia and neuroleptic malignant syndrome. Risperidone and other antipsychotics also increase the risk of death in patients with dementia.[2] The drug was developed by Janssen-Cilag and first released in 1994.[3]

Contents

Medical uses

Risperidone is used for the treatment of schizophrenia, bipolar disorder, and behavior problems in people with autism.[4] In autism, however, it does not improve conversational ability or social skills, and does not appear to reduce obsessive behavior in most autistic people. [4]

Risperidone was approved by the United States Food and Drug Administration (FDA) in 1993 for the treatment of schizophrenia.[5] On August 22, 2007, risperidone was approved as the only drug agent available for treatment of schizophrenia in youth ages 13–17; it was also approved that same day for treatment of bipolar disorder in youth and children ages 10–17, joining lithium. Risperidone contains the functional groups of benzisoxazole and piperidine as part of its molecular structure. In 2003 the FDA approved risperidone for the short-term treatment of the mixed and manic states associated with bipolar disorder. In 2006 the FDA approved risperidone for the treatment of irritability in children and adolescents with autism.[6] The FDA's decision was based in part on a study of autistic people with severe and enduring problems of violent meltdowns, aggression, and self-injury; risperidone is not recommended for autistic people with mild aggression and explosive behavior without an enduring pattern.[7] Like other atypical antipsychotics, risperidone has also been used off-label for the treatment of anxiety disorders, such as obsessive-compulsive disorder; severe, treatment-resistant depression with or without psychotic features; tourette syndrome; disruptive behavior disorders in children; and eating disorders, among others. In two small studies risperidone was reported to successfully treat the symptoms of phencyclidine (PCP) psychosis due to acute intoxication[8] and chronic use.[9]

Availability

Risperdal (risperidone) 4 mg tablets (UK)

Janssen's patent on Risperdal expired on December 29, 2003, opening the market for cheaper generic versions of the drug from other companies, and Janssen's exclusive marketing rights expired on June 29, 2004 (the result of a pediatric extension.)

Risperidone is available as a tablet, as an oral solution, and as an ampule Risperdal Consta, which is a depot injection administered once every two weeks. It is also available as a wafer known in the United States and Canada as Risperdal M-Tabs and elsewhere as Risperdal Quicklets.

Risperidone became available as a generic drug in October 2008 from Teva Pharmaceuticals, Dr. Reddy's Laboratories, Inc. and Patriot Pharmaceutics. The Patriot generic is Janssen Pharmaceutical's "authorized generic pharmaceutical." The drug is currently marketed in India, with the brand name Risdone by Intas Biopharmaceuticals.

Adverse effects

Risperidone has been associated with weight gain.[10] Other common side effects include akathisia, sedation, dysphoria, insomnia, sexual dysfunction, low blood pressure, high blood pressure, muscle stiffness, muscle pain, tremors, hypersalivation, constipation, and stuffy nose. In addition, risperidone treatment can cause photosensitivity and patients should be warned to avoid prolonged exposure to the sun or to use effective sunscreen (SPF 15+). Other skin conditions have also been reported, including rash, xerosis (dry skin), acne vulgaris, alopecia (hair loss), and seborrhea. At high doses skin hyperpigmentation may also occur.[11]

Many antipsychotics are known to cause hyperprolactinemia which may lead to hypogonadism-induced osteoporosis, galactorrhoea (unexpected female breast-milk production), gynaecomastia (male breast development), irregular menstruation and sexual dysfunction.

Neuroleptic malignant syndrome has been reported with risperidone, and at least 2 fatal cases of neuroleptic malignant syndrome induced by risperidone have been reported. Tardive Dyskinesia, an irreversible movement disorder, has also been reported with risperidone.[12]

Patients With Dementia

Clinical tests conducted in Canada[13] and the United Kingdom [14] have indicated that the use of anti-psychotic medications such as risperidone in people with dementia, such as those suffering from Alzheimer's disease, have been linked to higher incidences of death. In addition to a higher rate of death, patients with dementia taking anti-psychotics are susceptible to serious side effects, including stroke.[15]

Pharmacology

Risperidone has been classified as a "qualitatively atypical" antipsychotic agent with a relatively low incidence of extrapyramidal side effects (EPS) (when given at low doses) that has more pronounced serotonin antagonism than dopamine antagonism. Risperidone is unique among most other atypicals in that it has high affinity for the D2 receptor (also known as 'tight binding') whereas most other atypicals have 'loose binding' of the D2 receptor. It has actions at several 5-HT (serotonin) receptor subtypes. These are 5-HT2C, linked to weight gain, 5-HT2A, linked to its antipsychotic action and relief of some of the extrapyramidal side effects experienced with the typical neuroleptics.

It reaches peak plasma levels quickly regardless of whether it is administered as a liquid or pill. Risperidone is metabolized fairly quickly, so the potential for nausea subsides usually in two to three hours. However, the active metabolite, 9-hydroxy-risperidone, which has similar pharmacodynamics to risperidone, remains in the body for much longer, and has been developed as an antipsychotic in its own right, called paliperidone.

An intramuscular preparation, marketed as Risperdal Consta, can be given once every two weeks. It is slowly released from the injection site. This method of administration may be used on sanctioned patients who are declining, or consenting patients who may have disorganized thinking and cannot remember to take their daily doses.[19] Doses range from 12.5 to 50 mg given as an intramuscular injection once every two weeks.

Brand names

It is sold under the trade name Risperdal in the Netherlands, United States, Canada, Australia, United Kingdom, Portugal, Spain, Turkey, New Zealand, Saudi Arabia, Venezuela, Ireland[1] and several other countries, Risperdal or Ridal in New Zealand and Venezuela, Sizodon or Riscalin or Risdone in India, Rispolept in Eastern Europe and Russia,Zepidone in Nigeria, Riperidone in South Korea, Risperidona in Spain and Belivon, or Rispen elsewhere.

References

  1. ^ a b Healy, David (2009). Psychiatric Drugs Explained (5 ed.). Churchill Livingstone. http://books.google.com/books?id=ikTJViYMPIEC&printsec=frontcover&dq=psychiatric+drugs+explained&hl=en&src=bmrr&ei=aPwITerYHcnDhAf4z92nAw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCkQ6AEwAA#v=onepage&q&f=false. 
  2. ^ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000944/
  3. ^ http://www.naminh.org/resources-medications-treatments-medications-risperdal.php
  4. ^ a b "Respiridone". The American Society of Health-System Pharmacists. http://www.drugs.com/monograph/risperidone.html. Retrieved 3 April 2011. 
  5. ^ "Electronic Orange Book". Food and Drug Administration. April 2007. http://www.accessdata.fda.gov/scripts/cder/ob/docs/obdetail.cfm?Appl_No=020272&TABLE1=OB_Rx. Retrieved 2007-05-24. 
  6. ^ "FDA approves the first drug to treat irritability associated with autism, Risperdal" (Press release). FDA. October 6, 2006. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2006/ucm108759.htm. Retrieved 2009-08-14. 
  7. ^ Scahill L (2008). "How do I decide whether or not to use medication for my child with autism? should I try behavior therapy first?". J Autism Dev Disord 38 (6): 1197–8. doi:10.1007/s10803-008-0573-7. PMID 18463973. 
  8. ^ AJ Giannini, GL Colapietro, DK Cook. Risperidone therapy in phencyclidine intoxication, Society for Neuroscience Abstracts. 22:77.12, 1996.
  9. ^ JF Gabbert,AJ Giannini. Dopaminergic/serotonergic actions of phencyclidine as a model for schizophrenia psychosis. American Journal of Therapeutics. 4:159-164, 1997.
  10. ^ Newcomer JW (2005). "Second-generation (atypical) antipsychotics and metabolic effects: a comprehensive literature review". CNS Drugs. 19 Suppl 1: 1–93. PMID 15998156. 
  11. ^ Risperdal (risperidone) package insert. Titusville, NJ: Janssen Pharmaceutica Products, L.P.; 2010 Aug.
  12. ^ http://ajp.psychiatryonline.org/cgi/content/full/156/8/1290
  13. ^ Gardner, Amanda (May 27, 2008). "Antipsychotics Dangerous for Elderly With Dementia". Washington Post. http://www.washingtonpost.com/wp-dyn/content/article/2008/05/26/AR2008052601510.html. Retrieved 14 July 2011. 
  14. ^ "Avoid antipsychotic drugs for elderly, experts urge, after death risk study". CBC News. January 9, 2009. http://www.cbc.ca/news/health/story/2009/01/09/anti-psychotic-risks.html. Retrieved 14 July 2011. 
  15. ^ "Statement Regarding Treatment of Behavioral and Psychiatric Symptoms of Alzheimer’s Disease". Alzheimer's Association. http://www.alz.org/national/documents/statements_antipsychotics.pdf. 
  16. ^ a b c Alan F. Schatzberg, Charles B. Nemeroff. "The American Psychiatric Publishing textbook of psychopharmacology". American Psychiatric Pub, 2009, p. 629.
  17. ^ a b Atypicality of Atypical Antipsychotics
  18. ^ "Risperidone Irreversibly Binds to and Inactivates the h5-HT7 Serotonin Receptor". The American Society for Pharmacology and Experimental Therapeutics, 2006. Vol. 70 No. 4.
  19. ^ Antipsychotic Medications, About.com: Mental Health May 30, 2006

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Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
 Oxford A-Z of Medicinal Drugs. Market University Press. © 2000, 2003, 2010 An A-Z of Medicinal Drugs. All rights reserved.  Read more
Mosby's Dental Dictionary. Mosby's Dental Dictionary. Copyright © 2004 by Elsevier, Inc. All rights reserved.  Read more
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