Comparative Pharmacology
Head-to-head clinical analysis: INVEGA SUSTENNA versus QUETIAPINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVEGA SUSTENNA versus QUETIAPINE.
INVEGA SUSTENNA vs Quetiapine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Paliperidone is an atypical antipsychotic that acts primarily as a central dopamine type 2 (D2) receptor antagonist and serotonin type 2A (5-HT2A) receptor antagonist. It also blocks α1- and α2-adrenergic receptors and H1 histamine receptors.
Antagonist at serotonin 5-HT2A, dopamine D2, histamine H1, and adrenergic α1 receptors; weak partial agonist at 5-HT1A and serotonin transporter.
Initiate with 234 mg intramuscular injection on day 1, then 156 mg on day 8, both deltoid. Maintenance: 117 mg monthly (range 39-234 mg) via deltoid or gluteal injection. Dosing based on paliperidone palmitate.
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 ranges from 25 to 49 days (mean ~38 days) for deltoid injection and 30 to 50 days (mean ~45 days) for gluteal injection, supporting monthly dosing.
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.
Renal: approximately 59-80% as unchanged drug and metabolites, with about 1% unchanged; biliary/fecal: approximately 20-41% primarily as metabolites.
Renal: 73% (as metabolites), Fecal: 20% (as metabolites), unchanged drug: <1% renal
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic