What long-acting injectable (LAI) antipsychotic medications are available in the U.S.?

LAI Drug Name

FDA Indications

(Adult 18+ unless otherwise noted*)

Dosing Tips

(frequency of administration, oral overlap)

***First Generation Antipsychotics***

Prolixin Decanoate (fluphenazine decanoate) 

Schizophrenia

2-6 weeks
Overlap PO 4-8 weeks

Haldol Decanoate (haloperidol decanoate)

Schizophrenia

4 weeks

***Second Generation Antipsychotics***

Abilify Maintena (aripiprazole monohydrate LAI)

Schizophrenia (ages 13+)
Bipolar maintenance (ages 12+)

4 weeks
Overlap PO 2 weeks

Aristada (aripiprazole lauroxil LAI)

Schizophrenia

4 or 6 or 8 weeks
Aristada Initio IM & PO 1 dose or
Overlap PO 3 weeks

Aristada Initio (aripiprazole lauroxil LAI)

Schizophrenia

Only for initiation of Aristada once
Given with Aristada first injection

Invega Sustenna (paliperidone palmitate LAI)

Schizophrenia

4 weeks
Loading IM day 1 & day 8

Invega Trinza (paliperidone palmitate 12-week LAI)

Schizophrenia

12 weeks; after adequately treated with INVEGA SUSTENNA for at least four months, with the last 2 doses of INVEGA SUSTENNA at the same dosage strength  

Invega Hafyera (paliperidone palmitate 6-month LAI)

Schizophrenia

6 months; after adequately treated with INVEGA SUSTENNA for at least 4 months OR INVEGA TRINZA for at least one three-month cycle

Risperdal Consta (risperidone microspheres LAI)

Schizophrenia 
Bipolar I maintenance 

2 weeks
Overlap PO 3 weeks

Perseris (risperidone subcutaneous LAI)

Schizophrenia

4 weeks
Subcutaneous (SC)

Zyprexa Relprevv (olanzapine LAI)

Schizophrenia

2 or 4 weeks
Smoking status dosing considerations
Risk: Post-injection delirium sedation syndrome (PDSS) – registry required

References:

1. INVEGA TRINZA USPI, Section 1: Indications and Usage; Section 2.2: Schizophrenia 
2. INVEGA HAFYERA USPI, Section 1: Indications and Usage

3. RISPERDAL CONSTA USPI, Section 8.4: Pediatric Use 
4. HALDOL DECANOATE USPI