ECG should be monitored closely. With dry hands, place the disintegrating tablet on tongue and allow to disintegrate for a few seconds, then swallow with or without water. Minor (1)risperidone and eucalyptus both increase sedation. risperidone, vandetanib. unspecified interaction mechanism. Use Caution/Monitor. Use Caution/Monitor. Applies only to oral form of both agents. SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, drooling, nausea, weight gain, or tiredness may occur. Use Caution/Monitor. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. citalopram and risperidone both increase QTc interval. Use Caution/Monitor. Profound sedation, respiratory depression, coma, and death may result if coadministered. Monitor Closely (1)risperidone and scullcap both increase sedation. Use Caution/Monitor. Applies only to oral form of both agents. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. chloroquine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor.risperidone increases effects of dicyclomine by pharmacodynamic synergism. venlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. risperidone and papaverine both increase sedation. Monitor Closely (3)risperidone increases effects of hyoscyamine spray by pharmacodynamic synergism. It can take several days or even months for some symptoms to get better. artemether and risperidone both increase QTc interval. Monitor Closely (1)indacaterol, inhaled, risperidone. Other (see comment). fluphenazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely. This information is not individual medical advice and does not substitute for the advice of your health care professional. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. unspecified interaction mechanism. Use Caution/Monitor.propantheline decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. Use Caution/Monitor.Serious - Use Alternative (1)benzhydrocodone/acetaminophen, risperidone. Do not push the tablet through the foil because that could damage the tablet. Modify Therapy/Monitor Closely. dronedarone will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. risperidone and lofexidine both increase sedation. Use Caution/Monitor. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval. Monitor Closely (2)artemether/lumefantrine and risperidone both increase QTc interval. Use Caution/Monitor. Use Caution/Monitor.risperidone increases effects of solifenacin by pharmacodynamic synergism. Do not keep outdated medicine or medicine no longer needed. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. haloperidol and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. risperidone, glimepiride. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)risperidone and topiramate both increase sedation. Modify Therapy/Monitor Closely.droperidol and risperidone both increase sedation. Drink all of the mixture. Either increases toxicity of the other by pharmacodynamic synergism. Monitor Closely (2)risperidone and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. Effect of interaction is not clear, use caution. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. Use Caution/Monitor. tolterodine decreases levels of risperidone by pharmacodynamic antagonism. Follow all directions on your prescription label and read all medication guides or instruction sheets. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Older antipsychotics, most notably haloperidol, also work by dampening dopamine activity. Monitor Closely (1)desvenlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Use Caution/Monitor. venlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Your reactions could be impaired. Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Monitor or titrate P-gp substrate dose if coadministered. atracurium decreases levels of risperidone by inhibition of GI absorption. unspecified interaction mechanism. Serious - Use Alternative (1)risperidone and olopatadine intranasal both increase sedation. Use Caution/Monitor. Other (see comment). Use Caution/Monitor. Monitor Closely (1)risperidone increases and salmeterol decreases sedation. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. risperidone and glasdegib both increase QTc interval. risperidone increases effects of darifenacin by pharmacodynamic synergism. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). Monitor Closely (1)levomilnacipran, risperidone. unspecified interaction mechanism. quetiapine, risperidone. Monitor Closely (1)osilodrostat and risperidone both increase QTc interval. Monitor Closely (2)levoketoconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. flibanserin, risperidone. Use Caution/Monitor. Your doctor may adjust your dose as needed. Additive anticholinergic effects, possible hypoglycemia. Modify Therapy/Monitor Closely. Use Caution/Monitor.Minor (1)chloroquine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. We comply with the HONcode standard for trustworthy health information. Use Caution/Monitor. Caution recommended. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Use Caution/Monitor. Tell your doctor about all your other medicines, especially: blood pressure medication; risperidone increases effects of henbane by pharmacodynamic synergism. paliperidone and risperidone both increase sedation. Use Caution/Monitor. Use Caution/Monitor. Contraindicated. Monitor Closely (3)atropine decreases levels of risperidone by inhibition of GI absorption. clobazam will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Minor (1)ethanol, risperidone. azelastine and risperidone both increase sedation. clozapine and risperidone both increase sedation. Monitor Closely (1)sarecycline will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. doxylamine and risperidone both increase sedation. risperidone increases effects of fesoterodine by pharmacodynamic synergism. Additive anticholinergic effects, possible hypoglycemia. Modify Therapy/Monitor Closely.risperidone increases and epinephrine decreases sedation. remimazolam, risperidone. Drug type Drug Starting dosage Cost* Manic Mixed Maintenance Depression; Salts: Lithium: . What are the side effects of Risperidone (Risperdal)? Avoid or Use Alternate Drug. Use Caution/Monitor. risperidone decreases effects of lisuride by pharmacodynamic antagonism. unspecified interaction mechanism. Monitor Closely (1)lurasidone, risperidone. Use Caution/Monitor. unspecified interaction mechanism. If coadministered, monitor appropriately. Use Caution/Monitor. Use Caution/Monitor. Swallow several times as the tablet dissolves. Use Caution/Monitor. fosphenytoin will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Serious - Use Alternative (1)risperidone decreases effects of methyldopa by pharmacodynamic antagonism. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. Peel back the foil. clomipramine and risperidone both increase QTc interval. Other (see comment). Use Caution/Monitor.Minor (1)marijuana will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. In 30% of the veterans in this case series, nightmares resolved over 12 weeks of risperidone in the low-dose range (0.5-2 mg HS). Kit contains prefilled 2-mL diluent syringe, vial containing risperidone microspheres, vial adapter, and needles for deltoid or gluteal IM administration, Kit includes a vial containing risperidone powder, a prefilled syringe containing diluent, vial adapter, and needle for IM administration, Kit includes a prefilled syringe containing risperidone powder, a syringe prefilled with the delivery system and desiccant, and needle for SC administration into the abdomen, Kit includes a prefilled, single-dose syringe containing risperidone suspension and a 21-ga, 5/8-in needle for SC administration, 2 mg/day initially; may increase in increments of 1-2 mg/day at intervals 24 hr, Recommended target dosage: 2-8 mg/day once daily or divided q12hr (efficacy follows bell-shaped curve; 4-8 mg/day more effective than 12-16 mg/day), If unresponsive, may benefit from a higher dose of 37.5 or 50 mg, Oral risperidone or another antipsychotic medication should be given with first injection of Risperdal Consta; may continue for 3 weeks (and then discontinued) to ensure adequate therapeutic plasma concentrations from Risperdal Consta, Upward dose titration should not be made more frequently than q4Weeks, Clinical effects of each upward dose adjustment should not be anticipated earlier than 3 weeks after injection, Patients who are risperidone nave: Establish tolerability with oral risperidone before initiating Rykindo, Do not combine 2 different dose strengths of Rykindo in a single administration, Administer first dose along with 7 days of oral risperidone, No additional benefit was observed with dosages >50 mg of risperidone long-acting injection (IM); a higher incidence of adverse reactions was observed, Do not titrate dose more frequently than q4Weeks, Establish tolerability with oral risperidone before initiating SC, 90 mg or 120 mg SC once monthly initially, Supplementation with oral risperidone is not recommended, Patients who are on stable oral risperidone doses <3 mg/day or >4 mg/day may not be candidates for Perseris, 3 mg/day PO: Initiate 90 mg SC 1 day after last oral dose, 4 mg/day PO: Initiate 120 mg SC 1 day after last oral dose, Initiate SC as either a once monthly injection or once every 2 month injection, Can switch between once monthly and once every 2 months by administering the first dose of the new dosing regimen on next scheduled date of administration in original dosing regimen, Revise dose administration schedule to reflect change, 2-3 mg/day initially; may be increased if necessary in increments of 1 mg/day at intervals of 24 hours to 6 mg/day; dosage recommendations not available for treatment duration >3 weeks, Monotherapy or in combination with lithium or valproate: 25 mg IM q2Weeks; some patients may benefit from a higher dose of 37.5 mg or 50 mg, May continue for 3 weeks (and then discontinued) to ensure adequate therapeutic plasma concentrations from Risperdal Consta, Dosages above 50 mg not studied in this population, Periodically re-evaluate the long-term risks and benefits of the drug for the individual patient, Administer the first Rykindo dose along with 7 days of oral risperidone, Dosages >50 mg have not studied in this population, Perseris: Not to exceed 90 mg once monthly, CrCl <30 mL/min: 0.5 mg q12hr initially; consider longer titration intervals; may be increased by up to 0.5 mg/day PO divided q12hr; dosage increase >1.5 mg q12hr should occur no more frequently than once weekly, Titrate with oral risperidone (up to at least 2 mg) before initiating long-acting IM injection, Start with oral risperidone 0.5 mg PO BID during first week, which can be increased to 1 mg BID or 2 mg qDay during second week; some patients may require slower titration, If a total daily dose of at least 2 mg oral risperidone is well tolerated, administer 25 mg q2Weeks with oral supplementation for 7 days following first injection, Alternatively, initiating at a 12.5-mg dose may be appropriate, Although not studied in patients with renal impairment, these patients may have reduced risperidone elimination compared to patients with normal renal function, 0.5 mg q12hr initially; consider longer titration intervals; may be increased by up to 0.5 mg/day PO divided q12hr; dosage increase >1.5 mg q12hr should occur no more frequently than once weekly, Although not studied in patients with hepatic impairment, these patients may have clinically significant increase in the free fraction of risperidone, possibly resulting in an enhanced effect, Patients with Parkinson disease or dementia with Lewy bodies can experience increased sensitivity to long-acting IM injection, Manifestations can include confusion, obtundation, postural instability with frequent falls, extrapyramidal symptoms, and clinical features consistent with neuroleptic malignant syndrome, Consider reducing to lowest risperidone SC dose 2-4 weeks before planned start of strong CYP2D6 inhibitors (eg, fluoxetine, paroxetine) to adjust for expected increase in plasma concentrations of risperidone, Uzedy: 50 mg once monthly or 100 mg once every 2 months, Continue treatment with these doses unless clinical judgment necessitates interruption, When initiating or discontinuing a strong CYP2D6 inhibitor (eg, fluoxetine, paroxetine), reduce IM risperidone dose between 2-4 weeks before planned initiation or discontinuation of CYP2D6 inhibitor to adjust for the expected increase in plasma risperidone concentrations, When a CYP2D6 inhibitor initiated in patients receiving 25 mg IM of long-acting risperidone suspension, continue with 25 mg unless clinical judgment requires lowering to 12.5 mg IM or interrupting treatment, If long-acting IM risperidone suspension is initiated in patients already receiving a strong CYP2D6 inhibitor, consider initiating at 12.5 mg IM; efficacy of the 12.5 mg dose has not been investigated in clinical trials, When a strong CYP2D6 inhibitor (eg, fluoxetine, or paroxetine) is coadministered with oral risperidone, reduce oral risperidone dose; dose should not exceed 8 mg/day in adults when coadministered with these drugs, When initiating therapy, titrate oral risperidone slowly If enzyme inhibitor is discontinued, assess risperidone dose and increase if necessary, At initiation of therapy with CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin, phenobarbital), closely monitor during the first 4-8 weeks In patients receiving risperidone ER suspension 90 mg, consider increasing the dose to 120 mg, Perseris 90 mg/month: Consider increasing to 120 mg/month, Perseris 120 mg/month: Consider additional oral risperidone therapy, Uzedy: A dose increase or additional oral risperidone, may be considered, On discontinuation of strong CYP3A4 inducers, re-evaluated risperidone dose and if necessary, decrease to adjust for expected increase in plasma concentration, Coadministration with strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin, phenobarbital) with risperidone would be expected to cause decreases in the plasma concentrations of the sum of risperidone and 9-hydroxyrisperidone combined, which could lead to decreased efficacy of IM risperidone; titrate accordingly for patients receiving these enzyme inducers, especially during initiation or discontinuation of therapy with these inducers, At the initiation of therapy with CYP3A4 inducers, patients should be closely monitored during the first 4-8 weeks, since the dose of IM risperidone may need to be adjusted; a dose increase, or additional oral risperidone, may need to be considered, If enzyme inducer is discontinued, re-evaluate risperidone dose and decrease if necessary, May lower dose of IM risperidone between 2-4 weeks before planned discontinuation CYP3A4 inducers to adjust for expected increase in plasma concentrations of risperidone plus 9-hydroxyrisperidone, For patients treated with 25 mg and discontinuing from CYP3A4 inducers, continue treatment with the 25-mg dose unless clinical judgment necessitates lowering dose to 12.5 mg or necessitates interruption of IM risperidone treatment, Efficacy of the 12.5 mg dose has not been investigated in clinical trials, Coadministered with enzyme inducers (eg, carbamazepine), the risperidone dose should be increased up to double the patients usual dose If enzyme inducer is discontinued, assess risperidone dose and decrease if necessary, No collected data specifically addresses switching patients from other antipsychotics to IM risperidone or concerning concomitant administration with other antipsychotics, Continue previous antipsychotics for 3 weeks after the first injection of IM risperidone to maintain therapeutic concentrations until main release phase of risperidone from the injection site has begun, As recommended with other antipsychotic medications, periodically re-evaluate the need for continuing existing EPS medication, Current long-acting IM injection (eg, Rykindo) dose for patients receiving another long-acting IM injection (eg, Risperdal Consta) should be the same as that of the previous Risperdal Consta dose, Give first injection of Rykindo 4 weeks (no later than 5 weeks) after last Risperdal Consta was administered, Supplementing with oral risperidone is not recommended, Do not titrate more frequently than q4Weeks, When restarting after a period off treatment, reinitiate previously established dosage if patients general medical condition has not change, Supplementation with oral risperidone is required, If response to recommended dosage insufficient, dosage may be adjusted as follows after minimum of 14 days and at least every 2 weeks thereafter, <20 kg: Adjusted in increments of 0.25 mg/day; not to exceed 1 mg/day, 20 kg: Adjusted in increments of 0.5 mg/day; not to exceed 2.5 mg/day, calcium/magnesium/potassium/sodium oxybates, elvitegravir/cobicistat/emtricitabine/tenofovir DF, sodium sulfate/?magnesium sulfate/potassium chloride, sodium sulfate/potassium sulfate/magnesium sulfate, Not approved for dementia-related psychosis, Elderly patients with dementia-related psychosis who are treated with antipsychotic drugs are at increased risk of death, as shown in short-term controlled trials; deaths in these trials appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature, A syndrome consisting of potentially irreversible, involuntary, dyskinetic movements, may develop in patients treated with antipsychotic drugs; although prevalence appears to be highest among elderly, especially elderly women, it is impossible to predict which patients will develop the syndrome; whether antipsychotic drug products differ in their potential to cause tardive dyskinesia is unknown, Risk of developing tardive dyskinesia and likelihood that it will become irreversible increase with the duration of treatment and the cumulative dose. Use Caution/Monitor. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Monitor Closely (1)risperidone will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. elagolix will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Modify Therapy/Monitor Closely. ondansetron and risperidone both increase QTc interval. Use Caution/Monitor.sertraline and risperidone both increase QTc interval. Additive anticholinergic effects, possible hypoglycemia. Use Caution/Monitor. maprotiline and risperidone both increase QTc interval. Monitor Closely (2)erythromycin lactobionate will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor Closely (3)trifluoperazine and risperidone both increase QTc interval. Use Caution/Monitor. Effect of interaction is not clear, use caution. Monitor Closely (2)amitriptyline and risperidone both increase QTc interval. Paliperidone is the major active metabolite of risperidone, consideration should be given to the additive paliperidone exposure if any of these medications are coadministered. Use Caution/Monitor. Use Caution/Monitor. trazodone and risperidone both increase QTc interval. commonly, these are "non-preferred" brand drugs or specialty Use Caution/Monitor. This drug may be administered orally once a day or in divided doses twice a day; patients experiencing somnolence may benefit from twice a day dosing. selegiline, risperidone. Avoid or Use Alternate Drug. risperidone increases and xylometazoline decreases sedation. Additive anticholinergic effects, possible hypoglycemia. Do not double the dose to catch up. ranolazine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor Closely (2)loxapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. risperidone increases effects of trihexyphenidyl by pharmacodynamic synergism. Available for Android and iOS devices. Potential for additive anticholinergic effects. Use Caution/Monitor. Modify Therapy/Monitor Closely. Advertisement Can Risperidone Cause Insomnia by Summer | Oct 3, 2022 | Insomnia Aripiprazole (Abilify), quetiapine (Seroquel), and risperidone (Risperdal) are antipsychotic medications that are commonly used to treat schizophrenia and bipolar disorder. Use Caution/Monitor.hyoscyamine decreases levels of risperidone by pharmacodynamic antagonism. The concurrent administration of amiodarone and risperidone is not recommended due to the potential for inducing life-threatening arrhythmias. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.Serious - Use Alternative (1)lasmiditan increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. Applies only to oral form of both agents. Effect of interaction is not clear, use caution. Use Caution/Monitor. With dry hands, peel back the foil on the blister pack to carefully remove the tablet. Serious - Use Alternative (1)sufentanil SL, risperidone. Serious - Use Alternative (1)risperidone decreases effects of pramipexole by pharmacodynamic antagonism. risperidone and trifluoperazine both increase sedation. risperidone and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. risperidone decreases effects of insulin inhaled by Other (see comment). Serious - Use Alternative (1)encorafenib and risperidone both increase QTc interval. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. Use Caution/Monitor.methscopolamine decreases levels of risperidone by pharmacodynamic antagonism. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Use Caution/Monitor. Use Caution/Monitor. risperidone and tropisetron both increase QTc interval. risperidone, tolazamide. 1. Monitor Closely (1)risperidone increases and dextroamphetamine decreases sedation. Monitor Closely (1)ponatinib increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. What is the difference between Perseris and Risperdal Consta? Risperidone is also used to treat symptoms of irritability in autistic children who are 5 to 16 years old. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely. Minor/Significance Unknown. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Monitor Closely (1)risperidone, pioglitazone. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Additive anticholinergic effects, possible hypoglycemia.
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