Flupenthixol LA-Paliperidone LA
There are 2 switch possibities:
Number 1 (the general approach):
- Day 1: Switch to oral risperidone (or oral paliperidone): see this switch in the main cross table.
- Day 1-29: Maintain on oral risperidone (or oral paliperidone) and examine the effects.
- Day 30: stop oral risperidone (or oral paliperidone) and administer paliperidone-LA: see this switch in the main cross table.
Oral risperidone has better and more stable bioavailability properties than has oral 9-OH-risperidone=paliperidone. Food increases the absorption with 50-60% of the latter.
Number 2 (if a patient in the past reacted well on risperidon or paliperidone=9-OH-risperidone):
Switch medication from Flupenthixol_LA to Paliperidone_LA.
- Day 1: Last depot injection
- Start depot according to general dosing advice on the day you normally would have injected the former depot.
- Testing for acceptance and possible allergic reactions in a low dose can be carried out earlier.
- During this switch you could monitor ECG, especially in patients prone to QT-conduction problems.
- There is a possibility of QT interval prolongation.
- Stöllberger C, Huber JO, Finsterer J, Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol. 2005 Sep;20(5):243-51.