How do I switch a patient treated with LAI to Risperdal Consta (risperidone microspheres)?

Detailed protocols for switching between LAIs have not all been established, and this is true for risperidone microspheres LAI (Risperdal Consta) as well. For an overview, see the guidance for using Risperdal Consta.

Establish tolerability to risperidone. Plan to administer the first dose of Risperdal Consta three weeks prior to the next scheduled injection of the original LAI. Risperdal Consta will not be at steady state for three weeks following the initial injection.

• Week 1: Administer original LAI.  Start oral risperidone to establish tolerability.
• Week 2: Administer first Risperdal Consta injection.  Continue oral risperidone to cover 3-week delay until optimal plasma levels achieved.
• Week 3: Continue oral risperidone.
• Week 4: Administer second Risperdal Consta injection.  Continue oral risperidone.
• Week 5: Do NOT give original LAI or oral risperidone (both now discontinued).
• Week 6: Administer Risperdal Consta and continue every two weeks.

When thinking about the dose of the new LAI (here Risperdal Consta), refer to the conversion table for approximate equivalent doses. Risperdal Consta is available in 12.5 mg, 25 mg, 37.5 mg, and 50 mg strengths.

FDA medication label

• Information on this topic is found in the FDA medication label. Here is the most recent label, at the time of writing.
• Medication labels can be found by searching Drugs@FDA at the FDA website. Labels are also available using the Drugs@FDA app for Apple or Android devices. Labels change over time, and the current label should always be consulted.

REFERENCES

• Stahl, S. M. (2014). The prescriber’s guide: Stahl’s essential psychopharmacology (5th ed.). New York: Cambridge University Press.

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