Resources Medication Resource Centre Invega Trinza (paliperidone palmitate)

Invega Trinza (paliperidone palmitate)

Invega Trinza (paliperidone palmitate)
Brand name: Invega® Trinza®
Active ingredient name: Paliperidone palmitate
Type of drug: Atypical antipsychotic
Available in Canada from: Janssen Inc.
Form: Injection
Generic: No
Listed on Ontario formulary: Yes (with suggested criteria for coverage*)

*This product has a therapeutic note which suggests a physician should prescribe it for the treatment of schizophrenia or schizoaffective disorders in individuals with a history of non-adherence and either inadequate control or significant side effects from 2 or more formulary oral antipsychotics (including at least one atypical agent); or inadequate control or significant side effects from one or more typical depot antipsychotics; and adequate treatment of using 1-month paliperidone palmitate prolonged-release injectable suspension has been established for at least four months.

What this means is that for most individuals with schizophrenia, Invega Trinza will not be a first-line medication choice. Each physician will assess the use of this medication on a case-by-case basis. If this medication is deemed appropriate for you it will be covered by the Ontario Drug Benefit program.

Note: Invega® Trinza® is also available in tablet form as Invega®[Invega]

What is Invega Trinza used for?
Invega Trinza  is the newest antipsychotic medication on the Canadian market. It was approved by Health Canada on June 23, 2016. It is used to treat the symptoms of schizophrenia and psychotic illnesses in adults. It may be used to treat other conditions as well. Discuss the reason you are taking Invega Trinza with your doctor.
How much Invega Trinza should I take?
Invega Trinza is a long acting depot injection. It is avaliable in prefilled 
syringes containing 175, 263, 350 and 525 mg of paliperidone palmitate.
You will receive an injection every 3 months, so you do not need to take medication every day. The injection will be given to you by a healthcare provider, usually a nurse. You may receive the injection in a clinic, in your doctor’s office or you may have a community nurse who comes to your home.

Before you begin Invega Trinza you will most likely be treated with Invega Sustenna (once monthly injections) for about 4 months to be sure you can tolerate the medication and to ensure your symptoms improve. After that you may be switched to Invega Trinza, which you will then receive every 3 months.  
Your doctor will decide on the best dosage for you and will adjust the dose based on your response.

What are the common side effects seen with Invega Trinza

The most common side effects of Invega Trinza include:

  • Headache
  • Insomnia
  • Constipation
  • Nausea
  • Vomiting
  • Injection site pain
  • Weight gain
  • Feeling of restlessness (akathisia)
  • Dizziness
  • Abnormal movements (extrapyramidal side effects)

What are rare, but potentially serious side effects seen with Invega Trinza?

  • Decreased white blood cell count (agranulocytosis)
  • Cerebrovascular event (stroke)
  • Anaphylactic reaction (severe allergy)
  • Diabetic ketoacidosis (DKA)
  • Neuroleptic malignant syndrome (NMS)

Elderly individuals with dementia-related psychosis treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotic medication.  Most deaths appear to be either cardiovascular or infectious.  Invega Trinza is not approved for the treatment of dementia-related psychosis.  Some individuals with dementia may however be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.
What drugs interact with Invega Trinza?
Tell all your doctors, pharmacists, and dentist that you are taking Invega Trinza. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription and herbal and vitamin products.When the levels of a medication are increased or decreased in your bloodstream, this can affect the medication’s efficacy and safety.
The following types of medications may interact with Invega Trinza:

  • Certain medications for  allergies (e.g., Benadryl [diphenhydramine])
  • Certain medications for sleep (e.g., lorazepam, zopiclone)
  • Certain medications for pain (e.g., fentanyl)

Avoid drinking alcohol or using illegal drugs while taking Invega Trinza.