Comparative Pharmacology
Head-to-head clinical analysis: INVEGA versus TOVALT ODT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: INVEGA versus TOVALT ODT.
INVEGA vs TOVALT ODT
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.
Tovalt ODT (selegiline) is a selective, irreversible inhibitor of monoamine oxidase type B (MAO-B). At therapeutic doses, it inhibits MAO-B more selectively than MAO-A, leading to increased levels of dopamine in the brain.
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.
20 mg sublingually as needed for BTP, with a minimum interval of 2 hours between doses; maximum 4 doses per day.
None Documented
None Documented
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 approximately 40–60 hours after multiple dosing; clinical context: reaches steady-state after 2–3 weeks.
Primarily renal: 59-80% of dose excreted unchanged in urine (as parent drug and metabolites). Fecal: ~20-30%. Biliary elimination is minimal.
Primarily hepatic metabolism; 70–80% as inactive metabolites in urine, <5% unchanged in urine, 20–30% fecal.
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic