Invega Hafyera is a long-acting injectable (LAI) formulation of Paliperidone. It is the first available antipsychotic LAI that provides coverage for 6 months. It is FDA-indicated to treat adults with schizophrenia.
Establishing Efficacy and Tolerability
Prior to initiating Invega Hafyera, treat the patient with either:
Paliperidone Conversion from Oral to LAI Formulations
LAI/Invega Sustenna Dose
<3 mg Paliperidone
39 mg Invega Sustenna every 4 weeks
3 mg Paliperidone
78 mg Invega Sustenna every 4 weeks
273 mg Invega Trinza every 12 weeks
6 mg Paliperidone
117 mg Invega Sustenna every 4 weeks
410 mg Invega Trinza every 12 weeks
9 mg Paliperidone
156 mg Invega Sustenna every 4 weeks
546 mg Invega Trinza every 12 weeks
1,092 mg Invega Hafyera every 6 months
12 mg Paliperidone
234 mg Invega Sustenna every 4 weeks
819 mg Invega Trinza every 12 weeks
1,560 mg Invega Hafyera every 6 months
*Stabilization with at least four months (4 injections) of Invega Sustenna required prior to initiation of Invega Trinza.
**Stabilization with at least four months (4 injections) of Invega Sustenna or at least one three month cycle (1 injection) of Invega Trinza prior to initiation of Invega Hafyera.
If administering a strong CYP3A4/P-glycoprotein inducer, considering managing the patient using Paliperidone extended-release tablet.
1. Stahl, S.M. (2017). The prescribers guide: Stahl’s essential psychopharmacology (6th ed.). New York: Cambridge University Press.
2. American Psychiatric Association. (2020). The American Psychiatric Association Practice Guideline for the Treatment of Patients with Schizophrenia. American Psychiatric Association Publishing. https://doi.org/10.71176/appi.books.9780890424841
3. INVEGA SUSTENNA USPI, Section 2.8: Instructions for Use; Section 17: How Supplied/Storage and Handling
4. INVEGA TRINZA USPI, Section 2.2: Schizophrenia
5. INVEGA HAFYERA USPI, Section 2.4: Instruction for Preparation and Administration
Practical Issues (including administration)
FDA Medication Label
Information on this topic is found in the FDA medication label. Prescribing should always be informed by the FDA medication label. Medication labels can be found searching Drugs@FDA at the FDA website. Labels are available using the Drugs@FDA app for Apple or Android devices.
Labels change over time, and the current label should always be consulted. Here is the most recent label, at time of writing.
More information about administration (including a detailed video) and dosing can be found here.
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