Risperidone, Oral/Injection

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KEY POINTS

• This medicine is taken by mouth or given by injection to treat bipolar disorder or schizophrenia. It is also used to treat irritability in children with autistic spectrum disorder. Take it exactly as directed.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause uncontrolled muscle movements that may not go away even after you stop taking this medicine. This medicine may also cause other unwanted side effects. Older adults with dementia are at greater risk for side effects including death. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• This medicine may interact with many other medicines. Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antipsychotic

Generic and brand names: risperidone, oral; risperidone, injection; Risperdal; Risperdal M-Tab; Risperdal Consta

What is this medicine used for?

This medicine is taken by mouth to treat mental disorders such as schizophrenia and bipolar disorder. It is also used to treat irritability in children with autistic spectrum disorder.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood or bone marrow disorder, or low white blood cell count
• A stroke or transient ischemic attack (TIA)
• Alzheimer's disease or dementia
• Breast cancer
• Diabetes
• Heart disease, a heart attack, heart failure, or irregular heartbeat
• High cholesterol or high triglycerides
• High or low blood pressure
• Kidney or liver disease
• Parkinson's disease
• Phenylketonuria (PKU). The disintegrating tablet contains phenylalanine.
• Problems with dehydration
• Seizures
• Thoughts of suicide
• Trouble swallowing

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant while you are taking this medicine. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while you are taking this medicine. Taking this medicine during the last 3 months of pregnancy may cause problems for the baby. Symptoms the baby may have include restlessness, tight muscles, floppy muscles, shaking, trouble breathing, or trouble feeding. Talk with your provider about this.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes. Check the label on the medicine for directions about your specific dose. Your healthcare provider may adjust your dosage depending on your response. Do not take more or less or take it longer than prescribed. If you do not understand how or when to take this medicine, ask your healthcare provider or pharmacist to explain.

Check with your healthcare provider before using this medicine in children.

This medicine comes as regular tablets, dissolving tablets, or as an oral solution. You may take this medicine with or without food. Carefully measure the oral solution with the special tube (pipette) that comes with your medicine. You can mix the oral solution with water, coffee, orange juice, or low-fat milk. Do not mix it with cola or tea.

If you are taking the orally disintegrating tablets, do not remove from the blister pack until you need to take the medicine. Do not push the tablet through the foil because it could break the tablet. Do not chew, crush, or break the tablet. These tablets dissolve very quickly. Peel back the foil to get the tablet out. With dry hands, place a tablet on your tongue and let the tablet dissolve in your mouth.

The injection form of this medicine is given by your healthcare provider. It is usually given every 2 weeks. Keep all appointments for these injections.

What if I miss a dose?

If you miss a dose, take it as soon as you remember, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: drowsiness; fast or irregular heartbeat; lightheadedness; fainting; restless movements in your eyes, tongue, or neck; seizures.

What should I watch out for?

Older adults with dementia are at greater risk for side effects including death. Talk with your provider about this.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Newborn babies may have trouble breathing or feeding, or other symptoms, if the mother takes this medicine in the last 3 months of pregnancy. This medicine should be used during pregnancy only if the benefit is greater than the possible risk to your baby. Talk with your healthcare provider about this.

Using this medicine may cause muscle spasms, twitching in the face and body, and uncontrolled tongue or jaw movement. Talk to your healthcare provider about this.

This medicine may affect your ability to be alert and think clearly. Do not drive or operate machinery unless you are fully alert.

When you first start taking this medicine, you may get dizzy or lightheaded or feel faint when you get up quickly from sitting or lying down. Try getting up slowly. If this reaction continues, contact your healthcare provider.

Rarely, this medicine may cause a painful erection of the penis that will not return to normal. If this happens, contact your healthcare provider or get medical care right away. It can lead to permanent erectile dysfunction if not treated.

This medicine may also cause you to gain weight. Talk with your healthcare provider about this.

This medicine may make it harder for your body to cool down when it gets very hot or warm up when it gets very cold. Be careful with activities that could cause you to get very cold or very hot.

This medicine increases the effects of alcohol and other medicines that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

While taking this medicine, be careful when you exercise, especially when it is hot. This medicine may make it harder for your body to cool down when it gets very hot or warm up when it gets very cold. If you get too hot, you might vomit, feel dizzy, have a fast heartbeat, get very stiff muscles, or be confused. Contact your provider right away if you have these symptoms.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine may increase the risk of developing diabetes, especially if you are overweight or have a family history of diabetes. If you have diabetes, this medicine may affect your blood sugar level and change the amount of insulin or other diabetes medicines you may need. Talk to your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking.

Serious (Report these to your healthcare provider right away.): Seizures; thoughts of suicide; involuntary movements (facial or body twitching that you cannot control); tremors; severe dizziness or fainting; slow, fast, or irregular heartbeat; high or unexplained fever; muscle stiffness or pain; confusion; heavy sweating; chest pain; extreme weakness; muscle or joint pain; dark urine; light-colored bowel movements; yellowing of the skin or eyes; increased thirst; increased urination; extreme hunger; cough; sore throat; severe drowsiness; trouble swallowing; painful or persistent erection of the penis; unusual bruising or bleeding.

Other: Increased sensitivity to heat or cold, trouble sleeping, restlessness, anxiety, headache, mild dizziness, constipation, mild nausea or vomiting, diarrhea, stuffy or runny nose, stomach pain, skin sensitivity to sunlight, mild sleepiness, dry mouth, blurred vision, nightmares, weight gain, increased appetite; change in sexual desire or ability; breast enlargement, change in menstrual periods; irritation where the shot was given.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), and prazosin (Minipress)
• Anagrelide (Agrylin)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antianxiety medicines such as alprazolam (Xanax), buspirone, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as azithromycin (Zithromax, Zmax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), isoniazid, linezolid (Zyvox), moxifloxacin (Avelox), pentamidine (NebuPent, Pentam), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Anticholinergic medicines such as benztropine (Cogentin), dicyclomine (Bentyl), glycopyrrolate (Cuvposa, Robinul), hyoscyamine (HyoMax, Levbid, Levsin), propantheline, and trihexyphenidyl
• Antidepressants such as amitriptyline, citalopram (Celexa), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), sertraline (Zoloft), and trazodone
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), terbinafine (Lamisil), and voriconazole (Vfend)
• Antihistamines such as azelastine (Astelin, Astepro), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and hydroxyzine (Vistaril)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), haloperidol (Haldol), iloperidone (Fanapt), paliperidone (Invega), pimozide (Orap), quetiapine (Seroquel), thioridazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), clobazam (Onfi), phenobarbital, phenytoin (Dilantin, Phenytek), and valproic acid (Depacon, Depakene, Depakote)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bladder control medicines such as darifenacin (Enablex), mirabegron (Myrbetriq), oxybutynin (Ditropan XL, Oxytrol), and tolterodine (Detrol)
• Blood pressure medicines such as hydralazine, methyldopa, minoxidil, and reserpine
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as abiraterone (Zytiga), arsenic trioxide (Trisenox), crizotinib (Xalkori), degarelix (Firmagon), imatinib (Gleevec), nilotinib (Tasigna), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cinacalcet (Sensipar)
• Clonidine (Catapres, Kapvay)
• Dextromethorphan, an ingredient in many cough, cold, or allergy medicines such as Robitussin-DM
• Dextromethorphan/quinidine (Nuedexta)
• Diuretics (water pills) such as furosemide (Lasix) and hydrochlorothiazide (Microzide)
• Donepezil (Aricept)
• Doxepin (Silenor)
• Eliglustat (Cerdelga)
• Fingolimod (Gilenya)
• Heart medicines such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dronedarone (Multaq), flecainide, procainamide, quinidine, and ranolazine (Ranexa)
• HIV medicines such as delavirdine (Rescriptor), lopinavir/ritonavir (Kaletra), ritonavir (Norvir), and tipranavir (Aptivus)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Lithium (Lithobid)
• Lorcaserin (Belviq)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to block or prevent stomach acid such as cimetidine (Tagamet) and ranitidine (Zantac)
• Metoclopramide (Metozolv, Reglan)
• Mifepristone (Korlym, Mifeprex)
• Migraine medicines such as almotriptan (Axert), dihydroergotamine (D.H.E. 45, Migranal), eletriptan (Relpax), ergotamine (Ergomar), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, Sumavel), and zolmitriptan (Zomig)
• Milnacipran (Savella)
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), methocarbamol (Robaxin), orphenadrine (Norflex), and tizanidine (Zanaflex)
• Natural remedies such as gotu kola, kava, SAMe, St. John's wort, tryptophan, and valerian
• Nausea medicines such as aprepitant (Emend), dolasetron (Anzemet), ondansetron (Zofran), prochlorperazine (Compro), and promethazine
• Pain medicines such as buprenorphine (Buprenex, Butrans), codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), pentazocine (Talwin), and tramadol (ConZip, Ultram)
• Parkinson’s disease medicines such as apomorphine (Apokyn), bromocriptine (Cycloset, Parlodel), entacapone (Comtan), levodopa/carbidopa (Duopa, Rytary, Sinemet), pramipexole (Mirapex), and ropinirole (Requip)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Pasireotide (Signifor)
• Procarbazine (Matulane)
• Products that contain methylene blue (Hyophen, Prosed DS, Urophen, Uta)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Rivastigmine (Exelon)
• Sleeping pills such as butabarbital (Butisol), flurazepam, pentobarbital (Nembutal), temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Stimulants and diet pills such as dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), and methylphenidate (Concerta, Daytrana, Metadate, Ritalin)
• Tetrabenazine (Xenazine)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.