Comparative Pharmacology
Head-to-head clinical analysis: INVEGA HAFYERA versus QUETIAPINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVEGA HAFYERA versus QUETIAPINE.
INVEGA HAFYERA vs Quetiapine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Paliperidone palmitate is an atypical antipsychotic that antagonizes D2 and 5-HT2A receptors, with additional antagonism at alpha2, alpha1, and H1 receptors.
Antagonist at serotonin 5-HT2A, dopamine D2, histamine H1, and adrenergic α1 receptors; weak partial agonist at 5-HT1A and serotonin transporter.
INVEGA HAFYERA (paliperidone palmitate) is dosed once weekly via intramuscular injection in the gluteal or deltoid muscle. The recommended starting dose is 1,092 mg (deltoid or gluteal) or 1,560 mg (gluteal only) on treatment day 1 and day 8, both given in the deltoid muscle. Subsequent maintenance doses are administered once monthly. Note: INVEGA HAFYERA is only for once-weekly administration; once-monthly formulations (INVEGA SUSTENNA) are also available.
Initial: 25 mg PO BID, titrate to effective range 150-750 mg/day divided BID-TID; schizophrenia: 150-750 mg/day, bipolar disorder: 400-800 mg/day, major depressive disorder (adjunct): 150-300 mg/day at bedtime.
None Documented
None Documented
Clinical Note
moderateQuetiapine + Levofloxacin
"Quetiapine may increase the QTc-prolonging activities of Levofloxacin."
Clinical Note
moderateQuetiapine + Norfloxacin
"Quetiapine may increase the QTc-prolonging activities of Norfloxacin."
Clinical Note
moderateQuetiapine + Gemifloxacin
"Quetiapine may increase the QTc-prolonging activities of Gemifloxacin."
Clinical Note
moderateQuetiapine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Quetiapine is combined with Fluticasone propionate."
Terminal elimination half-life is 25-49 days (mean ~36 days) due to slow dissolution from intramuscular depot. Steady-state reached after 4-5 monthly injections.
Terminal elimination half-life: ~6-7 hours (parent drug); extended-release: ~7 hours. Clinically, dosing is twice daily for immediate-release; once daily for extended-release.
Primarily renal: 59% of paliperidone excreted unchanged in urine; 32% as metabolites; 6-12% fecal. Biliary excretion is minimal.
Renal: 73% (as metabolites), Fecal: 20% (as metabolites), unchanged drug: <1% renal
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic