Comparative Pharmacology
Head-to-head clinical analysis: INVEGA versus QUETIAPINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVEGA versus QUETIAPINE.
INVEGA vs Quetiapine
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Paliperidone is the major active metabolite of risperidone. It is a benzisoxazole derivative antipsychotic with high affinity for serotonin 5-HT2A and dopamine D2 receptors. It also acts as an antagonist at α1 and α2 adrenergic receptors and H1 histaminergic receptors. It has no affinity for muscarinic receptors.
Antagonist at serotonin 5-HT2A, dopamine D2, histamine H1, and adrenergic α1 receptors; weak partial agonist at 5-HT1A and serotonin transporter.
Oral: 6 mg once daily; may increase to 9 mg/day if needed. IM (extended-release): 234 mg on day 1, 156 mg on day 8, then 117 mg monthly; adjust within range 39-234 mg per month.
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 approximately 23-29 hours for oral administration (paliperidone extended-release). Once-daily dosing achieves steady-state within 4-5 days.
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: 59-80% of dose excreted unchanged in urine (as parent drug and metabolites). Fecal: ~20-30%. Biliary elimination is minimal.
Renal: 73% (as metabolites), Fecal: 20% (as metabolites), unchanged drug: <1% renal
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic