- Approval Id
- 314fdf1e811d8a39
- Drug Name
- INVEGA TRINZA PROLONGED RELEASE SUSPENSION FOR IM INJECTION 263MG/1.315ML
- Product Name
- INVEGA TRINZA PROLONGED RELEASE SUSPENSION FOR IM INJECTION 263MG/1.315ML
- Approval Number
- SIN15187P
- Approval Date
- 2017-03-06
- Registrant
- JOHNSON & JOHNSON INTERNATIONAL (SINGAPORE) PTE LTD
- Licence Holder
- JOHNSON & JOHNSON INTERNATIONAL (SINGAPORE) PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- INJECTION, SUSPENSION, EXTENDED RELEASE
- Dosage
- <p><strong>Dosage and Administration</strong><br>
INVEGA TRINZA® is to be used only after the 1-month paliperidone palmitate injectable product has been established as adequate treatment for at least four months. In order to establish a consistent maintenance dose, it is recommended that the last two doses of the 1-month injection be the same dosage strength before starting INVEGA TRINZA®.</p>
<p><strong>Dosage</strong><br>
Initiate INVEGA TRINZA® at the time when the next 1-month paliperidone palmitate dose was to be scheduled with a INVEGA TRINZA® dose based on the previous 1-month injection dose as shown in Table 1. INVEGA TRINZA® may be administered up to 7 days before or after the monthly time point of the next scheduled paliperidone palmitate 1-month dose.</p>
<img src="/TGIF/InvegaTrinza-Table1.png" alt="Invega Trinza Dosage Table 1" /><br><br>
<p>Following the initial INVEGA TRINZA® dose, INVEGA TRINZA® should be administered every 3 months. If needed, dose adjustment can be made every 3 months in increments within the range of 175 mg to 525 mg based on individual patient tolerability and/or efficacy. Due to the long-acting nature of INVEGA TRINZA®, the patient’s response to an adjusted dose may not be apparent for several months (see <em>Pharmacokinetic Properties</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><strong>Missed dose(s)</strong><br>
<em>Dosing Window</em>. Missing doses of INVEGA TRINZA® should be avoided. However, on exceptional occasions, patients may be given the injection up to 2 weeks before or after the 3-month time point.</p>
<p><em>Missed Dose > 3½ Months up to 4 Months</em>. If more than 3½ months (up to 4 months) have elapsed since the last injection of INVEGA TRINZA®, the previously administered INVEGA TRINZA® dose should be administered as soon as possible, then continue with the 3-month injections following this dose.</p>
<p><em>Missed Dose > 4 Months up to 9 Months</em>. If more than 4 months (up to 9 months) have elapsed since the last injection of INVEGA TRINZA®, do NOT administer the next dose of INVEGA TRINZA®. Instead, use the re-initiation regimen shown in Table 2.</p>
<img src="/TGIF/InvegaTrinza-Table2.png" alt="Invega Trinza Dosage Table 2" /><br><br>
<p><em>Missed Dose > 9 Months</em>. If more than 9 months have elapsed since the last injection of INVEGA TRINZA®, re-initiate treatment with the 1-month paliperidone palmitate injectable product as described in the prescribing information for that product. INVEGA TRINZA® can then be resumed after the patient has been adequately treated with the 1-month paliperidone palmitate injectable product for at least 4 months.</p>
<p><strong>Administration information</strong><br>
Parenteral drug products should be inspected visually for foreign matter and discoloration prior to administration.<strong> Within 5 minutes prior to administration of INVEGA TRINZA® to the patient, it is important to shake the syringe vigorously for at least 15 seconds to ensure a homogeneous suspension</strong> (see <em>Instructions for Use and Handling and Disposal</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>INVEGA TRINZA® is intended for intramuscular use only. Do not administer intravascularly or subcutaneously. Avoid inadvertent injection into a blood vessel. Each injection must be administered only by a health care professional. Administer the dose in a single injection; do not administer the dose in divided injections. Inject slowly, deep into the deltoid or gluteal muscle.</p>
<p>INVEGA TRINZA® must be administered using only the thin wall needles that are provided in the INVEGA TRINZA® pack. Needles from the 1-month paliperidone palmitate injectable product pack or other commercially-available needles are not to be used when administering INVEGA TRINZA®.</p>
<p>The recommended needle size for administration of INVEGA TRINZA® into the deltoid muscle is determined by the patient’s weight. For those ≥ 90 kg (≥ 200 lbs), the 1½-inch, 22 gauge thin wall needle is recommended. For those < 90 kg (< 200 lbs), the 1-inch, 22 gauge thin wall needle is recommended. Administer into the center of the deltoid muscle. Deltoid injections should be alternated between the two deltoid muscles.</p>
<p>The recommended needle size for administration of INVEGA TRINZA® into the gluteal muscle regardless of body weight is the 1½-inch, 22 gauge thin wall needle. Administer into the upper-outer quadrant of the gluteal muscle. Gluteal injections should be alternated between the two gluteal muscles.</p>
<p>Since paliperidone is the active metabolite of risperidone, caution should be exercised when INVEGA TRINZA® is coadministered with risperidone or with oral paliperidone for extended periods of time. Safety data involving concomitant use of INVEGA TRINZA® with other antipsychotics is limited.</p>
<p><em>Incomplete Administration</em>. To avoid an incomplete administration of INVEGA TRINZA®, ensure that the prefilled syringe is <strong>shaken vigorously for at least 15 seconds within 5 minutes prior to administration to ensure a homogeneous suspension</strong> (see <em>Instructions for Use and Handling and Disposal</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). However, in the event of an incompletely administered dose, do <strong>not</strong> re-inject the dose remaining in the syringe and do <strong>not</strong> administer another dose. Closely monitor and treat the patient appropriately until the next scheduled 3-month injection of INVEGA TRINZA®.</p>
<p><strong>Special populations</strong><br>
<em><strong>Pediatrics (less than 18 years of age)</strong></em><br>
Safety and effectiveness of INVEGA TRINZA® in patients < 18 years of age have not been studied.</p>
<p><em><strong>Elderly (65 years of age and older)</strong></em><br>
In general, recommended dosing of INVEGA TRINZA® for elderly patients with normal renal function is the same as for younger adult patients with normal renal function. As elderly patients may have reduced renal function, see <em>Renal impairment</em> below for dosing recommendations in patients with renal impairment. Efficacy and safety in elderly >65 years of have not been established.</p>
<p><em><strong>Renal impairment</strong></em><br>
INVEGA TRINZA® has not been systematically studied in patients with renal impairment (see <em>Pharmacokinetic Properties</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). For patients with mild renal impairment (creatinine clearance ≥ 50 to < 80 mL/min), dose adjustment is done when initiating treatment with the 1-month paliperidone palmitate injectable product; no dose adjustment of INVEGA TRINZA® is required. Transition to INVEGA TRINZA® is with a dose in a 3.5 to 1 ratio to the previous stabilized 1-month paliperidone palmitate injectable product as described in <em>Dosage</em> above. The maximum recommended dose of INVEGA TRINZA® in patients with mild renal impairment is 350 mg.</p>
<p>INVEGA TRINZA® is not recommended in patients with moderate or severe renal impairment (creatinine clearance < 50 ml/min).</p>
<p><em><strong>Hepatic impairment</strong></em><br>
INVEGA TRINZA® has not been studied in patients with hepatic impairment. Based on a study with oral paliperidone, no dose adjustment is required in patients with mild or moderate hepatic impairment. Paliperidone has not been studied in patients with severe hepatic impairment. (See <em>Pharmacokinetic Properties</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>)</p>
<p><em><strong>Other populations</strong></em><br>
No dose adjustment for INVEGA TRINZA® is recommended based on gender, race, or smoking status. (For pregnant women and nursing mothers, see <em>Pregnancy and Breast-feeding</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>.)</p>
<p><strong>Switching from other antipsychotic agents</strong><br>
INVEGA TRINZA® is to be used only after the patient has been adequately treated with the 1-month paliperidone palmitate injectable product for at least 4 months (see <em>Indications</em> and <em>Dosage and Administration</em>).</p>
<p>If INVEGA TRINZA® is discontinued, its prolonged-release characteristics must be considered. As recommended with other antipsychotic medications, the need for continuing existing extrapyramidal symptoms (EPS) medication should be re-evaluated periodically.</p>
<p><strong>Switching from INVEGA TRINZA® to the 1-Month Paliperidone Palmitate Injectable Product</strong><br>
For switching from INVEGA TRINZA® to the 1-month paliperidone palmitate injectable product, the 1-month paliperidone palmitate injectable product should be administered at the time the next INVEGA TRINZA® dose was to be administered using the equivalent 3.5-fold lower dose as shown in Table 3. The 1-month paliperidone palmitate injectable product should then continue dosed at monthly intervals.</p>
<img src="/TGIF/InvegaTrinza-Table3.png" alt="Invega Trinza Dosage Table 3" /><br><br>
<p><strong>Switching from INVEGA TRINZA® to Oral Paliperidone Extended-Release Tablets</strong><br>
For switching from INVEGA TRINZA® to oral paliperidone extended-release tablets, the daily dosing of the paliperidone extended-release tablets should be started 3 months after the last INVEGA TRINZA® dose and transitioned over the next several months following the last INVEGA TRINZA® dose as described in Table 4. Table 4 provides dose conversion regimens to allow patients previously stabilized on different doses of INVEGA TRINZA® to attain similar paliperidone exposure with once daily paliperidone extended-release tablets.</p>
<img src="/TGIF/InvegaTrinza-Table4.png" alt="Invega Trinza Dosage Table 4" /><br><br>
- Route Of Administration
- INTRAMUSCULAR
- Indication Info
- <p><strong>Indications</strong><br>
INVEGA TRINZA®, a 3-month injection, is indicated for the treatment of schizophrenia in adult patients who have been adequately treated with the 1-month paliperidone palmitate injectable product for at least four months.</p>
- Contraindications
- <p><strong>Contraindications</strong><br>
INVEGA TRINZA® is contraindicated in patients with a known hypersensitivity to paliperidone or to any of the components in the formulation. Since paliperidone is an active metabolite of risperidone, INVEGA TRINZA® is contraindicated in patients with a known hypersensitivity to risperidone.</p>
- Atc Code
- N05AX13
- Atc Item Name
- paliperidone
- Pharma Manufacturer Name
- JOHNSON & JOHNSON INTERNATIONAL (SINGAPORE) PTE. LTD.
- Company Detail Path
- /organization/johnson-and-johnson-international-singapore-pte-ltd