Trevicta Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Trevicta Injection contains paliperidone (as paliperidone palmitate), an atypical antipsychotic medicine. It is a long-acting injectable suspension given into a muscle once every 3 months to provide maintenance treatment for schizophrenia in adults already stable on monthly paliperidone injections. It must be administered only by a healthcare professional and offers a less frequent dosing schedule compared to daily pills or monthly injections.

What is Trevicta Injection

Trevicta is a long-acting injectable antipsychotic medicine containing paliperidone palmitate. It is given as a prolonged-release suspension that slowly releases the medicine into the body over a few months after being injected into a muscle.

Trevicta Injection uses

• Maintenance treatment of schizophrenia in adults who are already stable on monthly paliperidone injections
• Used for schizophrenia in adults and adolescents aged 12 to 17 (per one source)
• Used for schizoaffective disorder in adults, alone or with mood stabilizers or antidepressants (per one source)

Benefits of Trevicta Injection

• Given just once every 3 months instead of daily pills or monthly injections
• Works as well as monthly paliperidone injections at preventing relapse of schizophrenia symptoms
• Reduces the need for daily oral antipsychotic pills or frequent doctor visits, which can help people stick with treatment

How Trevicta Injection works

Paliperidone works by blocking certain brain chemical receptors, mainly for dopamine and serotonin. By blocking these receptors, it helps calm down overactive brain signaling and reduces symptoms of schizophrenia.

Trevicta Injection dosage

This medicine must be given only by a healthcare professional as an injection into a muscle (the shoulder or buttock area); it is not for self-injection. It is given once every 3 months, with some flexibility in timing (up to 2 weeks early or late). The syringe must be shaken well right before the injection to mix the suspension properly. It can only be started after a patient has been stable on monthly paliperidone injections for a period of time. If a dose is missed for a long time, a special re-starting schedule or restarting with the monthly injection may be needed.

Available forms and strengths

Prolonged-release suspension for injection in pre-filled syringes (175 mg, 263 mg, 350 mg, and 525 mg)

Side effects of Trevicta Injection

Common

• Weight gain and increased blood sugar levels
• Insomnia or sleep difficulties, and fatigue
• Headaches and dizziness
• Anxiety or restlessness
• Upper respiratory tract infections (like colds)
• Injection site reactions (pain, redness, or swelling where the shot was given)
• Movement changes such as tremors, muscle stiffness, or abnormal muscle movements

Serious

• Neuroleptic Malignant Syndrome: a rare, life-threatening reaction with high fever, severe muscle stiffness, and confusion
• Heart rhythm changes (QT prolongation)
• Blood clots
• Increased risk of stroke in elderly patients with dementia-related psychosis
• Tardive dyskinesia: involuntary, repetitive movements of the face, tongue, or other body parts
• Severe allergic (anaphylactic) reactions
• Low white blood cell counts (which can increase infection risk)
• Severe drop in blood pressure upon standing

Warnings and precautions

• This medicine must only be prescribed and given by a qualified psychiatrist or other healthcare specialist.
• This medicine should not be given to people allergic to paliperidone, risperidone, or any of its other ingredients.
• This medicine is not meant for calming people who are severely agitated or in an acute psychotic crisis needing immediate symptom control.
• Elderly people with dementia-related psychosis have a higher risk of death and stroke-related problems when using this type of medicine, so it is not recommended for them.
• Because this medicine stays in the body for a long time, any side effects may also last longer or take longer to go away.
• There isn't enough information from studies in pregnant women about this medicine's safety. Babies born to mothers who used this medicine late in pregnancy may have withdrawal or movement symptoms after birth, and should be watched closely by doctors.
• This medicine should not be used while breastfeeding, because it passes into breast milk and can affect the nursing baby, even long after the injection was given due to how long it stays in the body.
• This medicine is not recommended for people with moderate or severe kidney problems. People with mild kidney problems need a dose adjustment and must first be stabilized on the monthly injection before switching to this one.
• No dose change is needed for people with mild or moderate liver problems. There isn't enough information on people with severe liver problems, so caution is advised.
• Alcohol should be avoided while using this medicine.
• This medicine may cause sleepiness, fainting, or blurred vision, which can affect your ability to drive or use machines safely. Do not drive or operate machinery until you know how this medicine affects you.

Storage

• This medicinal product does not require any special storage conditions. Any unused product or waste material should be disposed of in accordance with local requirements.

When to see a doctor

• Get emergency medical help right away if you develop high fever, severe muscle stiffness, and confusion, which could be signs of a rare but life-threatening reaction.
• Seek urgent medical care if you have a painful erection that lasts more than 4 hours.
• Tell your doctor right away if you notice uncontrollable, repeated movements of your face, tongue, or other body parts, as this may need the medicine to be stopped.
• Seek medical attention if you notice signs of high blood sugar, such as excessive thirst, frequent urination, excessive hunger, or weakness.

Alternatives

• Olanzapine
• Aripiprazole
• Risperidone