Palicalm Er

Palicalm Er Uses, Dosage, Side Effects, Food Interaction and all others data.

Palicalm Er is an atypical antipsychotic developed by Janssen Pharmaceutica. Chemically, paliperidone is primary active metabolite of the older antipsychotic risperidone (paliperidone is 9-hydroxyrisperidone). While its specific mechanism of action is unknown, it is believed paliperidone and risperidone act via similar, if not the same, pathways.

Palicalm Er is the major active metabolite of risperidone. The mechanism of action of paliperidone, as with other drugs having efficacy in schizophrenia, is unknown, but it has been proposed that the drug's therapeutic activity in schizophrenia is mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism.

Palicalm Er is an atypical antipsychotic developed by Janssen Pharmaceutica. Chemically, paliperidone is primary active metabolite of the older antipsychotic risperidone (paliperidone is 9-hydroxyrisperidone). The mechanism of action is unknown but it is likely to act via a similar pathway to risperidone.

Trade Name Palicalm Er
Availability Prescription only
Generic Paliperidone
Paliperidone Other Names 9-hydroxyrisperidone, Paliperidona, Paliperidone
Related Drugs fluoxetine, quetiapine, lamotrigine, Abilify, Prozac, Seroquel, aripiprazole, olanzapine, risperidone, lithium
Type Tablet
Formula C23H27FN4O3
Weight Average: 426.4839
Monoisotopic: 426.206718955
Protein binding

The plasma protein binding of racemic paliperidone is 74%.

Groups Approved
Therapeutic Class Atypical neuroleptic drugs
Manufacturer Reliance Formulation Pvt Ltd
Available Country India
Last Updated: September 19, 2023 at 7:00 am
Palicalm Er
Palicalm Er

Uses

Schizophrenia: Palicalm Er Extended-Release Tablets are used for the treatment of schizophrenia

The efficacy of Palicalm Er in schizophrenia was established in three 6-week trials in adults and one 6-week trial in adolescents, as well as one maintenance trial in adults.

Schizoaffective Disorder: Palicalm Er Extended-Release Tablets are used for the treatment of schizoaffective disorder as monotherapy and an adjunct to mood stabilizers and/or antidepressant therapy

The efficacy of Palicalm Er in schizoaffective disorder was established in two 6-week trials in adults.

Palicalm Er is also used to associated treatment for these conditions: Delusional Parasitosis, Schizoaffective Disorders, Schizophrenia

How Palicalm Er works

Palicalm Er is the major active metabolite of risperidone. The mechanism of action of paliperidone, as with other drugs having efficacy in schizophrenia, is unknown, but it has been proposed that the drug's therapeutic activity in schizophrenia is mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism.

Dosage

Palicalm Er dosage

Schizophrenia:

  • Adults: The recommended dose of Palicalm Er Extended-Release Tablets for the treatment of schizophrenia in adults is 6 mg administered once daily. Initial dose titration is not required. Although it has not been systematically established that doses above 6 mg have additional benefit, there was a general trend for greater effects with higher doses. This must be weighed against the dose-related increase in adverse reactions. Thus, some patients may benefit from higher doses, up to 12 mg/day, and for some patients, a lower dose of 3 mg/day may be sufficient. Dose increases above 6 mg/day should be made only after clinical reassessment and generally should occur at intervals of more than 5 days. When dose increases are indicated, increments of 3 mg/day are recommended. The maximum recommended dose is 12 mg/day.
  • Adolescents (12-17 Years Of Age): The recommended starting dose of Palicalm Er Extended-Release Tablets for the treatment of schizophrenia in adolescents 12-17 years of age is 3 mg administered once daily. Initial dose titration is not required. Dose increases, if considered necessary, should be made only after clinical reassessment and should occur at increments of 3 mg/day at intervals of more than 5 days. Prescribers should be mindful that, in the adolescent schizophrenia study, there was no clear enhancement to efficacy at the higher doses, i.e., 6 mg for subjects weighing less than 51 kg and 12 mg for subjects weighing 51 kg or greater, while adverse events were dose-related.

Schizoaffective Disorder: The recommended dose of Palicalm Er Extended-Release Tablets for the treatment of schizoaffective disorder in adults is 6 mg administered once daily. Initial dose titration is not required. Some patients may benefit from lower or higher doses within the recommended dose range of 3 to 12 mg once daily. A general trend for greater effects was seen with higher doses. This trend must be weighed against dose-related increase in adverse reactions. Dosage adjustment, if indicated, should occur only after clinical reassessment. Dose increases, if indicated, generally should occur at intervals of more than 4 days. When dose increases are indicated, increments of 3 mg/day are recommended. The maximum recommended dose is 12 mg/day.

Palicalm Er can be taken with or without food. Palicalm Er must be swallowed whole with the aid of liquids. Tablets should not be chewed, divided, or crushed. The medication is contained within a nonabsorbable shell designed to release the drug at a controlled rate. The tablet shell, along with insoluble core components, is eliminated from the body; patients should not be concerned if they occasionally notice in their stool something that looks like a tablet.

Side Effects

The following adverse reactions are observed:Increased mortality in elderly patients with dementia-related psychosis, Cerebrovascular adverse reactions, including stroke, in elderly patients with dementia-related psychosis, Neuroleptic malignant syndrome, QT prolongation, Tardive dyskinesia, Metabolic changes, Hyperprolactinemia, Potential for gastrointestinal obstruction, Orthostatic hypotension and syncope, Falls, Leukopenia, neutropenia, and agranulocytosis, Potential for cognitive and motor impairment, Seizures, Dysphagia, Suicide, Priapism, Thrombotic thrombocytopenic purpura (TTP), Disruption of body temperature regulation, Antiemetic effect, Increased sensitivity in patients with Parkinson's disease or those with dementia with Lewy bodies, Diseases or conditions that could affect metabolism or hemodynamic responses

Toxicity

The possibility of obtundation, seizures, or dystonic reaction of the head and neck following overdose may create a risk of aspiration with induced emesis.

Food Interaction

  • Avoid alcohol.

[Moderate] GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of paliperidone.

Use in combination may result in additive central nervous system depression and



Administration with food may increase the bioavailability of paliperidone from the extended release tablets.

In healthy ambulatory subjects, administration of a 12 mg paliperidone extended release tablet with a standard high-fat

The clinical significance of these changes is unknown.

MANAGEMENT: Patients receiving paliperidone should be advised to avoid the consumption of alcohol.

Since clinical trials establishing the safety and efficacy of paliperidone were carried out without regard to the timing of meals, presumably paliperidone may be administered with or without food.

Palicalm Er Cholesterol interaction

[Moderate] Atypical antipsychotic drugs have been associated with undesirable alterations in lipid levels.

While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile.

Before or soon after initiation of antipsychotic medication, obtain a fasting lipid profile at baseline and monitor periodically during treatment.

Volume of Distribution

  • 487 L

Elimination Route

The absolute oral bioavailability of paliperidone following paliperidone administration is 28%.

Half Life

The terminal elimination half-life of paliperidone is approximately 23 hours.

Elimination Route

One week following administration of a single oral dose of 1 mg immediate-release 14C-paliperidone to 5 healthy volunteers, 59% (range 51% – 67%) of the dose was excreted unchanged into urine, 32% (26% – 41%) of the dose was recovered as metabolites, and 6% – 12% of the dose was not recovered.

Pregnancy & Breastfeeding use

Pregnancy Category C. There are no adequate and well controlled studies of Palicalm Er in pregnant women.

Use of first generation antipsychotic drugs during the last trimester of pregnancy has been associated with extrapyramidal symptoms in the neonate. These symptoms are usually self- limited. It is not known whether paliperidone, when taken near the end of pregnancy, will lead to similar neonatal signs and symptoms.

Nursing Mothers: Palicalm Er is excreted in human breast milk. The known benefits of breastfeeding should be weighed against the unknown risks of infant exposure to paliperidone.

Contraindication

Palicalm Er is contraindicated in patients with a known hypersensitivity to either paliperidone or risperidone, or to any of the excipients in the Palicalm Er formulation. Hypersensitivity reactions, including anaphylactic reactions and angioedema, have been reported in patients treated with risperidone and in patients treated with paliperidone. Palicalm Er is a metabolite of risperidone.

Interaction with other Medicine

Renal Impairment: Dosing must be individualized according to the patient's renal function status

Hepatic Impairment: No dosage adjustment is required in patients with mild to moderate hepatic impairment. Palicalm Er has not been studied in patients with severe hepatic impairment.

Elderly: No dosage adjustment is recommended based on age alone. However, dose adjustment may be required because of age-related decreases in creatinine clearance

Storage Condition

Store up to 25°C; excursions permitted to 15 -30°C. Protect from moisture. Keep out of reach of children.

Innovators Monograph

You find simplified version here Palicalm Er

Palicalm Er contains Paliperidone see full prescribing information from innovator Palicalm Er Monograph, Palicalm Er MSDS, Palicalm Er FDA label

FAQ

What is Palicalm Er used for?

Palicalm Er is an antipsychotic medicine that is used to treat schizophrenia in adults and teenagers who are at least 12 years old.Palicalm Er may also be used for purposes not listed in this medication guide.

How safe is Palicalm Er?

Palicalm Er is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality.

How does Palicalm Er work?

Palicalm Er work by blocking the receptors for the neurotransmitters dopamine and 5-hydroxytryptamine, which are involved in schizophrenia. By blocking these receptors.Palicalm Er helps to normalise the activity of the brain and reduce symptoms.

What are the common side effects of Palicalm Er?

Common side effects of Palicalm Er are include:

  • pain, swelling, redness at injection site
  • extreme tiredness
  • dizziness, feeling unsteady, or having trouble keeping your balance
  • restlessness
  • agitation
  • headache
  • dry mouth
  • weight gain
  • stomach pain or discomfort
  • breast discharge
  • missed menstrual period
  • breast enlargement in males
  • decreased sexual ability

Is Palicalm Er safe during pregnancy?

Palicalm Er  should not be used during pregnancy unless the benefit outweighs the risk to the fetus. No data available on use of Palicalm Er in pregnant women to inform a drug-related risk.

Is Palicalm Er safe during breastfeeding?

Risperidone data indicate that the concentrations of Palicalm Er in breastmilk are low, and amounts ingested by the infant are small. A safety scoring system finds Palicalm Er possible to use cautiously during breastfeeding,although others do not recommend it.

Can I drink alcohol with Palicalm Er?

You should avoid the use of alcohol while being treated with Palicalm Er .Combining alcohol with Palicalm Er can increase side effects like dizziness, drowsiness,and trouble concentrating.

Can I drive after taking Palicalm Er?

Palicalm Er may make you dizzy or drowsy. Alcohol  can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely.

When should be taken of Palicalm Er?

It is usually taken once a day in the morning with or without food. Take Palicalm Er at around the same time every day.

What time of day should I take Palicalm Er?

Take Palicalm Er once a day at breakfast time. Even if you don't eat breakfast, you should still take paliperidone first thing each morning.

Can Palicalm Er be taken at night?

Palicalm Er was administered once daily in the morning, but it was allowed in the evening in the case of excessive sedation.

How fast does Palicalm Er work?

To begin with, most people find that this medication will help them feel more relaxed and calm. Later, after one or two weeks, other symptoms should begin to improve. Some people may get some side effects before they start to feel any better. Most side effects should go away after a few weeks.

How long should I take Palicalm Er?

The Sustenna Palicalm Er of long-acting injection Palicalm Er is administered twice in the first 8 days of treatment, then every 4 weeks.

How long does Palicalm Er stay in my system?

Release of Palicalm Er starts as early as one day after the injection and lasts for as long as 126 days.

Does Palicalm Er make I tired?

You should know that receiving Palicalm Er extended-release injection may make you drowsy and may affect your ability to think clearly, make decisions, and react quickly.

Can Palicalm Er cause permanent damage?

Palicalm Er may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent.

Does Palicalm Er cause shortness of breath?

Fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness.

How does Palicalm Er make me feel?

Palicalm Er can make some people feel dizzy, sleepy, or less alert.

Can I overdose on Palicalm Er?

Overdose symptoms may include severe drowsiness, fast heartbeats, and fainting. While you are taking Palicalm Er, you may be more sensitive to heat. Avoid getting too hot, or becoming overheated or dehydrated.

Does Palicalm Er make my gain weight?

Palicalm Er caused significant weight gain.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.Get your prescription refilled before you run out of medicine completely.

*** Taking medicines without doctor's advice can cause long-term problems.
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