Classification Antipsychotic

Action/Kinetics: Mechanism may be due to a combination of antagonism of dopamine (D2) and serotonin (5-HT2) receptors. Also has high affinity for the alpha-1, alpha-2, and hist-amine-1 receptors. Metabolized significantly in the liver to the active metabolite 9-hydroxyrisperidone, which has equal receptor-binding activity as risperidone. Thus, the effect is likely due to both the parent compound and the metabolite. Food does not affect either the rate or extent of absorption. Peak plasma levels, risperidone: 1 hr; peak plasma levels, 9-hydroxyrisperi-done: 3 hr for extensive metabolizers and 17 hr for poor metabolizers. tV2, risperidone and 9-methylrisperi-done: 3 and 21 hr, respectively, for extensive metabolizers and 20 and 30 hr, respectively, for poor metabol-izers. The clearance of the drug is decreased in geriatric clients and in clients with hepatic and renal impairment.

Uses: Treatment of psychotic disorders.

Contraindications: Lactation. Special Concerns: Use with caution in clients with known CV disease (including history of MI or ischemia, heart failure, conduction abnormalities), cerebrovascular disease, and conditions that predispose the client to hypotension (e.g., dehydration, hypovolemia, use of antihyperten-sive drugs). Use with caution in clients who will be exposed to extreme heat or when taken with other CNS drugs or alcohol. The effectiveness of risperidone for more than 6—8 weeks has not been studied. Safety and effectiveness have not been established for children. Side Effects: Neuroleptic malignant syndrome: Hyperpyrexia, muscle rigidity, altered mental status, auto-nomic instability (i.e., irregular pulse or BP, tachycardia, diaphoresis, cardiac dysrhythmia), elevated CPK, rhabdomyolysis, acute renal failure, death. CNS: Tardive dyskinesia (especially in geriatric clients), somnolence, insomnia, agitation, anxiety, aggressive reaction, extrapyramidal symptoms, headache, dizziness, increased dream activity, decreased sexual desire, nervousness, impaired concentration, depression, apathy, catatonia, euphoria, increased libido, amnesia, increased duration of sleep, dysarthria, vertigo, stupor, pa-resthesia, confusion. Oral: Increased or decreased salivation, toothache, stomatitis, dry mouth. GI: Constipa tion, nausea, dyspepsia, vomiting, abdominal pain, anorexia, flatulence, diarrhea, increased appetite, melena, dysphagia, hemorrhoids, gastritis. CV: Prolongation of the QT interval that might lead to torsades de pointes,. Orthostatic hypotension, tachycardia, palpitation, hypertension or hypotension, AV block, MI. Respiratory: Rhinitis, coughing, upper respiratory infection, sinusitis, pharyngitis, dyspnea. Body as a whole: Arthral-gia, back pain, chest pain, fever, fatigue, rigors, malaise, edema, flu-like symptoms, increase or decrease in weight. Hematologic: Purpura, anemia, hypochromic anemia. GU: Poly-uria, polydipsia, urinary incontinence, hematuria, dysuria, menor-rhagia, orgastic dysfunction, dry vagina, erectile dysfunction, non-puerperal lactation, amenorrhea, female breast pain, leukorrhea, mastitis, dysmenorrhea, female perineal pain, intermenstrual bleeding, vaginal hemorrhage, failure to ejaculate. Dermatologic: Rash, dry skin, sebor-rhea, increased pigmentation, increased or decreased sweating, acne, alopecia, hyperkeratosis, pruritus, skin exfoliation. Ophthalmic: Abnormal vision, abnormal accommodation, xerophthalmia. Miscellaneous: Increased prolactin, photo-sensitivity, diabetes mellitus, thirst, myalgia, epistaxis.

Drug Interactions: See also Antipsychotic Agents, Phenothiazines. Carbamazepine / T Clearance of risperidone following chronic use of carbamazepine

How Supplied: Solution: 1 mg/mL; Tablet: 1 mg, 2 mg, 3 mg, 4 mg


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