Dosing & Uses
Dosage Forms & Strengths
tablet (Risperdal)
- 0.25mg
- 0.5mg
- 1mg
- 2mg
- 3mg
- 4mg
oral solution (Risperidal)
- 1mg/mL
kit, long-acting injectable IM suspension (Risperdal Consta)
- Kit contains prefilled 2-mL diluent syringe, vial containing risperidone microspheres, vial adapter, and needles for deltoid or gluteal IM administration
- 12.5mg
- 25mg
- 37.5mg
- 50mg
kit, extended-release IM injectable suspension (Rykindo)
- Kit includes a vial containing risperidone powder, a prefilled syringe containing diluent, vial adapter, and needle for IM administration
- 12.5mg
- 25mg
- 37.5mg
- 50mg
kit, extended-release SC injectable suspension (Perseris)
- Kit includes a prefilled syringe containing risperidone powder, a syringe prefilled with the delivery system and desiccant, and needle for SC administration into the abdomen
- 90mg
- 120mg
kit, extended-release SC injectable suspension (Uzedy)
- Kit includes a prefilled, single-dose syringe containing risperidone suspension and a 21-ga, 5/8-in needle for SC administration
- 50mg/0.14mL
- 75mg/0.21mL
- 100mg/0.28mL
- 125mg/0.35mL
- 150mg/0.42mL
- 200mg/0.56mL
- 250mg/0.7mL
Schizophrenia
PO (Risperdal or Risperdal M-Tabs)
- 2 mg/day initially; may increase in increments of 1-2 mg/day at intervals ≥24 hr
- Recommended target dosage: 2-8 mg/day once daily or divided q12hr (efficacy follows bell-shaped curve; 4-8 mg/day more effective than 12-16 mg/day)
IM (Risperdal Consta)
- 25 mg IM q2Weeks initially
- If unresponsive, may benefit from a higher dose of 37.5 or 50 mg
- Not to exceed 50 mg every 2 weeks
- Oral risperidone or another antipsychotic medication should be given with first injection of Risperdal Consta; may continue for 3 weeks (and then discontinued) to ensure adequate therapeutic plasma concentrations from Risperdal Consta
- Upward dose titration should not be made more frequently than q4Weeks
- Clinical effects of each upward dose adjustment should not be anticipated earlier than 3 weeks after injection
IM (Rykindo)
- Patients who are risperidone naïve: Establish tolerability with oral risperidone before initiating Rykindo
- 25 mg IM q2Weeks
- Do not combine 2 different dose strengths of Rykindo in a single administration
- Administer first dose along with 7 days of oral risperidone
- If unresponsive, may benefit from a higher dose of 37.5 or 50 mg
- Not to exceed 50 mg q2Weeks
- No additional benefit was observed with dosages >50 mg of risperidone long-acting injection (IM); a higher incidence of adverse reactions was observed
- Do not titrate dose more frequently than q4Weeks
SC (Perseris)
- Establish tolerability with oral risperidone before initiating SC
- 90 mg or 120 mg SC once monthly initially
- Supplementation with oral risperidone is not recommended
- Patients who are on stable oral risperidone doses <3 mg/day or >4 mg/day may not be candidates for Perseris
-
Switching from PO risperidone
- 3 mg/day PO: Initiate 90 mg SC 1 day after last oral dose
- 4 mg/day PO: Initiate 120 mg SC 1 day after last oral dose
SC (Uzedy)
- Establish tolerability with oral risperidone before initiating SC
- Initiate SC as either a once monthly injection or once every 2 month injection
- Supplementation with oral risperidone is not recommended
-
Switching from PO to once monthly risperidone SC
- Initiate SC the day after last PO dose
- 2 mg/day PO: 50 mg SC
- 3mg/day PO: 75 mg SC
- 4mg/day PO: 100 mg SC
- 5 mg/day PO: 125 mg SC
-
Switching from PO to every 2 month risperidone SC
- Initiate SC the day after last PO dose
- 2 mg/day PO: 100 mg SC
- 3mg/day PO: 150 mg SC
- 4mg/day PO: 200 mg SC
- 5 mg/day PO: 250 mg SC
-
Switching between once monthly and every 2 month SC dosing
- Can switch between once monthly and once every 2 months by administering the first dose of the new dosing regimen on next scheduled date of administration in original dosing regimen
- Revise dose administration schedule to reflect change
Bipolar Mania
PO (Risperdal or Risperidal M-Tabs)
- 2-3 mg/day initially; may be increased if necessary in increments of 1 mg/day at intervals of 24 hours to 6 mg/day; dosage recommendations not available for treatment duration >3 weeks
Bipolar Disorder
IM (Risperdal Consta)
- Monotherapy or in combination with lithium or valproate: 25 mg IM q2Weeks; some patients may benefit from a higher dose of 37.5 mg or 50 mg
- May continue for 3 weeks (and then discontinued) to ensure adequate therapeutic plasma concentrations from Risperdal Consta
- Upward dose titration should not be made more frequently than q4Weeks
- Clinical effects of each upward dose adjustment should not be anticipated earlier than 3 weeks after injection
- Dosages above 50 mg not studied in this population
- Periodically re-evaluate the long-term risks and benefits of the drug for the individual patient
IM (Rykindo)
-
Monotherapy or in combination with lithium or valproate
- 25 mg IM q2Weeks
- Administer the first Rykindo dose along with 7 days of oral risperidone
- If unresponsive, may benefit from a higher dose of 37.5 or 50 mg
- Dosages >50 mg have not studied in this population
- Do not titrate dose more frequently than q4Weeks
Tourette Syndrome (Off-label)
0.5-1 mg/day PO; may be increased or decreased in increments of 0.5 mg q12hr at intervals >3 days; not to exceed 6 mg/day
Posttraumatic Stress Disorder (Off-label)
0.5-8 mg/day PO
Dosing Modifications
Renal impairment
-
SC
- Perseris: Not to exceed 90 mg once monthly
- Uzedy: Not to exceed 50 mg once monthly
-
PO
- CrCl <30 mL/min: 0.5 mg q12hr initially; consider longer titration intervals; may be increased by up to 0.5 mg/day PO divided q12hr; dosage increase >1.5 mg q12hr should occur no more frequently than once weekly
-
Long-acting IM injection (Risperdal Consta, Rykindo)
- Titrate with oral risperidone (up to at least 2 mg) before initiating long-acting IM injection
- Start with oral risperidone 0.5 mg PO BID during first week, which can be increased to 1 mg BID or 2 mg qDay during second week; some patients may require slower titration
- If a total daily dose of at least 2 mg oral risperidone is well tolerated, administer 25 mg q2Weeks with oral supplementation for 7 days following first injection
- Alternatively, initiating at a 12.5-mg dose may be appropriate
- Although not studied in patients with renal impairment, these patients may have reduced risperidone elimination compared to patients with normal renal function
Hepatic impairment
-
SC
- Perseris: Not to exceed 90 mg once monthly
- Uzedy: Not to exceed 50 mg once monthly
-
Child-Pugh 10-15 points (PO)
- 0.5 mg q12hr initially; consider longer titration intervals; may be increased by up to 0.5 mg/day PO divided q12hr; dosage increase >1.5 mg q12hr should occur no more frequently than once weekly
-
Long-acting IM injection (Risperdal Consta, Rykindo)
- Titrate with oral risperidone (up to at least 2 mg) before initiating long-acting IM injection
- Start with oral risperidone 0.5 mg PO BID during first week, which can be increased to 1 mg BID or 2 mg qDay during second week; some patients may require slower titration
- If a total daily dose of at least 2 mg oral risperidone is well tolerated, administer 25 mg q2Weeks with oral supplementation for 7 days following first injection
- Alternatively, initiating at a 12.5-mg dose may be appropriate
- Although not studied in patients with hepatic impairment, these patients may have clinically significant increase in the free fraction of risperidone, possibly resulting in an enhanced effect
Patients with Parkinson disease or dementia with Lewy bodies
- Patients with Parkinson disease or dementia with Lewy bodies can experience increased sensitivity to long-acting IM injection
- Manifestations can include confusion, obtundation, postural instability with frequent falls, extrapyramidal symptoms, and clinical features consistent with neuroleptic malignant syndrome
Coadministration with strong CYP2D6 inhibitors
-
SC, ER suspension
- Consider reducing to lowest risperidone SC dose 2-4 weeks before planned start of strong CYP2D6 inhibitors (eg, fluoxetine, paroxetine) to adjust for expected increase in plasma concentrations of risperidone
- Perseris: 90 mg once monthly
- Uzedy: 50 mg once monthly or 100 mg once every 2 months
- Continue treatment with these doses unless clinical judgment necessitates interruption
-
IM, long-acting injectable suspension
- When initiating or discontinuing a strong CYP2D6 inhibitor (eg, fluoxetine, paroxetine), reduce IM risperidone dose between 2-4 weeks before planned initiation or discontinuation of CYP2D6 inhibitor to adjust for the expected increase in plasma risperidone concentrations
- When a CYP2D6 inhibitor initiated in patients receiving 25 mg IM of long-acting risperidone suspension, continue with 25 mg unless clinical judgment requires lowering to 12.5 mg IM or interrupting treatment
- If long-acting IM risperidone suspension is initiated in patients already receiving a strong CYP2D6 inhibitor, consider initiating at 12.5 mg IM; efficacy of the 12.5 mg dose has not been investigated in clinical trials
-
PO
- When a strong CYP2D6 inhibitor (eg, fluoxetine, or paroxetine) is coadministered with oral risperidone, reduce oral risperidone dose; dose should not exceed 8 mg/day in adults when coadministered with these drugs
- When initiating therapy, titrate oral risperidone slowly If enzyme inhibitor is discontinued, assess risperidone dose and increase if necessary
Coadministration with strong CYP3A4 inducers
-
SC, ER injectable suspension
- At initiation of therapy with CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin, phenobarbital), closely monitor during the first 4-8 weeks In patients receiving risperidone ER suspension 90 mg, consider increasing the dose to 120 mg
- Perseris 90 mg/month: Consider increasing to 120 mg/month
- Perseris 120 mg/month: Consider additional oral risperidone therapy
- Uzedy: A dose increase or additional oral risperidone, may be considered
- On discontinuation of strong CYP3A4 inducers, re-evaluated risperidone dose and if necessary, decrease to adjust for expected increase in plasma concentration
-
IM, long-acting injectable suspension
- Coadministration with strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin, phenobarbital) with risperidone would be expected to cause decreases in the plasma concentrations of the sum of risperidone and 9-hydroxyrisperidone combined, which could lead to decreased efficacy of IM risperidone; titrate accordingly for patients receiving these enzyme inducers, especially during initiation or discontinuation of therapy with these inducers
- At the initiation of therapy with CYP3A4 inducers, patients should be closely monitored during the first 4-8 weeks, since the dose of IM risperidone may need to be adjusted; a dose increase, or additional oral risperidone, may need to be considered
- If enzyme inducer is discontinued, re-evaluate risperidone dose and decrease if necessary
- May lower dose of IM risperidone between 2-4 weeks before planned discontinuation CYP3A4 inducers to adjust for expected increase in plasma concentrations of risperidone plus 9-hydroxyrisperidone
- For patients treated with 25 mg and discontinuing from CYP3A4 inducers, continue treatment with the 25-mg dose unless clinical judgment necessitates lowering dose to 12.5 mg or necessitates interruption of IM risperidone treatment
- Efficacy of the 12.5 mg dose has not been investigated in clinical trials
-
PO
- Coadministered with enzyme inducers (eg, carbamazepine), the risperidone dose should be increased up to double the patient’s usual dose If enzyme inducer is discontinued, assess risperidone dose and decrease if necessary
Dosing Considerations
For patient who have never taken risperidone, establish tolerability with PO risperidone before initiating the IM or SC dosage forms
Switching from other antipsychotics to IM risperidone (Risperdal Consta only)
- No collected data specifically addresses switching patients from other antipsychotics to IM risperidone or concerning concomitant administration with other antipsychotics
- Continue previous antipsychotics for 3 weeks after the first injection of IM risperidone to maintain therapeutic concentrations until main release phase of risperidone from the injection site has begun
- As recommended with other antipsychotic medications, periodically re-evaluate the need for continuing existing EPS medication
Switching from long-acting IM injection (eg, Risperdal Consta) to another long-acting IM injection (eg, Rykindo)
- Current long-acting IM injection (eg, Rykindo) dose for patients receiving another long-acting IM injection (eg, Risperdal Consta) should be the same as that of the previous Risperdal Consta dose
- Give first injection of Rykindo 4 weeks (no later than 5 weeks) after last Risperdal Consta was administered
- Supplementing with oral risperidone is not recommended
- Do not titrate more frequently than q4Weeks
Reinitiating treatment in patients previously discontinued (Risperdal Consta, Rykindo)
- No data are available
- When restarting after a period off treatment, reinitiate previously established dosage if patient’s general medical condition has not change
- Supplementation with oral risperidone is required
Dosage Forms & Strengths
tablet
- 0.25mg
- 0.5mg
- 1mg
- 2mg
- 3mg
- 4mg
oral solution
- 1mg/mL
Schizophrenia
<13 years: Safety and efficacy not established
>13 years: 0.5 mg/day PO in morning or evening initially; may be increased in increments of 0.5-1 mg/day at intervals ≥24 hr to recommended dosage of 3 mg/day; dosage range: 1-6 mg/day (dosages >3 mg/day have not been proved more effective and are associated with increased incidence of adverse effects)
If persistent somnolence occurs, daily dose may be divided q12hr
Bipolar Mania
<10 years: Safety and efficacy not established
>10 years: 0.5 mg/day PO in morning or evening initially; may be increased in increments of 0.5-1 mg/day at intervals ≥24 hr to recommended dosage of 2.5 mg/day; dosage range: 0.5-6 mg/day (dosages >2.5 mg/day have not been proved more effective and are associated with increased incidence of adverse effects)
If persistent somnolence occurs, daily dose may be divided q12hr
Autism
Irritability associated with autistic disorder in children aged 5-16 years
<5 years: Safety and efficacy not established
5-16 years (<20 kg): 0.25 mg/day PO initially; may be increased after ≥4 days to recommended dosage of 0.5 mg/day
5-16 years (≥20 kg): 0.5 mg/day PO initially; may be increased after ≥4 days to recommended dosage of 1 mg/day
Insufficient response to recommended dosage
- If response to recommended dosage insufficient, dosage may be adjusted as follows after minimum of 14 days and at least every 2 weeks thereafter
- <20 kg: Adjusted in increments of 0.25 mg/day; not to exceed 1 mg/day
- ≥20 kg: Adjusted in increments of 0.5 mg/day; not to exceed 2.5 mg/day
Not approved for dementia-related psychosis, because of increased risk of cardiovascular or infectious related deaths (see Black Box Warnings)
Risk of orthostatic hypotension higher in elderly; monitoring of renal function and orthostatic blood pressure may be necessary; for titrating to target dose, twice-daily regimen should be used and dosage maintained for 2-3 days before change is made to once-daily dose regimen
Schizophrenia, Bipolar Mania
Use lower initial dose, and adjust more gradually
PO: 0.5 mg q12hr; may be increased in increments ≤0.5 mg q12hr; increases to dosages >1.5 mg q12hr should occur at intervals ≥1 week
IM: 12.5-25 mg injected into deltoid or gluteal muscle every 2 weeks; dosage should not be adjusted more frequently than every 4 weeks
Recommended to establish tolerability of PO risperidone before initiating treatment with IM risperidone
Psychosis, Agitation Related to Alzheimer Dementia (Off-label)
0.25-1 mg/day PO initially; may be increased gradually as tolerated; not to exceed 1.5-2 mg/day
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (1)
- amisulpride
amisulpride, risperidone. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.
Serious - Use Alternative (74)
- adagrasib
adagrasib, risperidone. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- amiodarone
amiodarone will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. The concurrent administration of amiodarone and risperidone is not recommended due to the potential for inducing life-threatening arrhythmias. If concurrent use cannot be avoided, cautious dosing and telemetric monitoring is advised.
amiodarone and risperidone both increase QTc interval. Avoid or Use Alternate Drug. - amisulpride
amisulpride and risperidone both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- anagrelide
anagrelide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- apomorphine
risperidone decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- artemether
artemether and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
asenapine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- bromocriptine
risperidone decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- cabergoline
risperidone decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.
- calcium/magnesium/potassium/sodium oxybates
risperidone, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- ceritinib
ceritinib and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
citalopram and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- dacomitinib
dacomitinib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.
- degarelix
degarelix and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- disopyramide
disopyramide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- dopamine
risperidone decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.
- efavirenz
efavirenz and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- encorafenib
encorafenib and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
risperidone and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- erdafitinib
erdafitinib will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.
- fexinidazole
fexinidazole and risperidone both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluoxetine
fluoxetine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.
- glasdegib
risperidone and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- hydrocodone
hydrocodone, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
ibutilide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- indapamide
indapamide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- isoflurane
isoflurane and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib and risperidone both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- lasmiditan
lasmiditan increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- levodopa
risperidone decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- levodopa inhaled
risperidone decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .
- lisuride
risperidone decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.
- lonafarnib
risperidone will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
- macimorelin
macimorelin and risperidone both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- mefloquine
mefloquine increases toxicity of risperidone by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- methyldopa
risperidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.
- metoclopramide intranasal
risperidone, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
risperidone increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome. - mobocertinib
mobocertinib and risperidone both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- olopatadine intranasal
risperidone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
ondansetron and risperidone both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- pentamidine
pentamidine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
pimozide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
risperidone and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- pramipexole
risperidone decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.
- procainamide
procainamide and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
propafenone will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. The concurrent administration of propafenone and risperidone is not recommended due to the potential for inducing life-threatening arrhythmias. If concurrent use cannot be avoided, cautious dosing and telemetric monitoring is advised.
- quinidine
quinidine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.
quinidine and risperidone both increase QTc interval. Avoid or Use Alternate Drug. - ribociclib
ribociclib increases toxicity of risperidone by QTc interval. Avoid or Use Alternate Drug.
- ropinirole
risperidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- safinamide
risperidone decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.
- selinexor
selinexor, risperidone. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sevoflurane
sevoflurane and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
siponimod and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- sodium oxybate
risperidone, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- sotalol
risperidone and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- sotorasib
sotorasib will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.
- sufentanil SL
sufentanil SL, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tepotinib
tepotinib will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.
- tetrabenazine
tetrabenazine and risperidone both increase QTc interval. Avoid or Use Alternate Drug.
- umeclidinium bromide/vilanterol inhaled
risperidone increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vandetanib
risperidone, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and risperidone both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- vilanterol/fluticasone furoate inhaled
risperidone increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
Monitor Closely (427)
- abiraterone
abiraterone increases levels of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of risperidone by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- acarbose
risperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- aclidinium
aclidinium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - acrivastine
acrivastine and risperidone both increase sedation. Use Caution/Monitor.
- albiglutide
risperidone, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- albuterol
risperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and risperidone both increase QTc interval. Use Caution/Monitor. - alfentanil
alfentanil and risperidone both increase sedation. Use Caution/Monitor.
- alfuzosin
risperidone and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and risperidone both increase QTc interval. Use Caution/Monitor. - almotriptan
almotriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- alprazolam
alprazolam and risperidone both increase sedation. Use Caution/Monitor.
- amifostine
amifostine, risperidone. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor. Due to its alpha adrenergic antagonism, atypical antipsychotic agents has the potential to enhance the effect of certain antihypertensive agents. Monitor blood pressure and adjust dose accordingly.
- amiodarone
amiodarone will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- amitriptyline
amitriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and amitriptyline both increase sedation. Use Caution/Monitor. - amobarbital
amobarbital and risperidone both increase sedation. Use Caution/Monitor.
- amoxapine
amoxapine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and amoxapine both increase sedation. Use Caution/Monitor. - anticholinergic/sedative combos
anticholinergic/sedative combos decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
anticholinergic/sedative combos decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - apomorphine
risperidone and apomorphine both increase sedation. Use Caution/Monitor.
apomorphine and risperidone both increase QTc interval. Use Caution/Monitor. - arformoterol
risperidone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
arformoterol and risperidone both increase QTc interval. Use Caution/Monitor. - aripiprazole
aripiprazole and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and risperidone both increase sedation. Use Caution/Monitor.
aripiprazole and risperidone both increase QTc interval. Use Caution/Monitor. - armodafinil
risperidone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- arsenic trioxide
arsenic trioxide and risperidone both increase QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
artemether/lumefantrine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - asenapine
asenapine and risperidone both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and risperidone both increase sedation. Use Caution/Monitor.
- atogepant
risperidone will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atomoxetine
atomoxetine and risperidone both increase QTc interval. Use Caution/Monitor.
- atorvastatin
atorvastatin will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- atracurium
atracurium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine
atropine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine IV/IM
risperidone increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine IV/IM decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine IV/IM decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. - avapritinib
risperidone will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
avapritinib and risperidone both increase sedation. Use Caution/Monitor. - axitinib
risperidone increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- azelastine
azelastine and risperidone both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and risperidone both increase sedation. Use Caution/Monitor.
- bedaquiline
risperidone and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belladonna alkaloids
belladonna alkaloids decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna alkaloids decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - belladonna and opium
belladonna and opium and risperidone both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benazepril
risperidone, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.
- benperidol
benperidol and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
benperidol and risperidone both increase sedation. Use Caution/Monitor. - benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and risperidone both increase sedation. Use Caution/Monitor.
- benzphetamine
risperidone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
risperidone increases effects of benztropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use. .
- berotralstat
berotralstat will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.
- brexanolone
brexanolone, risperidone. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and risperidone both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and risperidone both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and risperidone both increase sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and risperidone both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and risperidone both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and risperidone both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and risperidone both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and risperidone both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
risperidone increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
buprenorphine, long-acting injection and risperidone both increase sedation. Use Caution/Monitor. - bupropion
bupropion will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- butabarbital
butabarbital and risperidone both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and risperidone both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and risperidone both increase sedation. Use Caution/Monitor.
- caffeine
risperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbamazepine
carbamazepine decreases levels of risperidone by increasing metabolism. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and risperidone both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and risperidone both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, risperidone. Either increases effects of the other by sedation. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and risperidone both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and risperidone both increase sedation. Use Caution/Monitor.
- chloroquine
chloroquine increases toxicity of risperidone by QTc interval. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and risperidone both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
chlorpromazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
chlorpromazine and risperidone both increase sedation. Use Caution/Monitor. - chlorpropamide
risperidone, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- chlorzoxazone
chlorzoxazone and risperidone both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and risperidone both increase sedation. Use Caution/Monitor.
- cisatracurium
cisatracurium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cisatracurium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - citalopram
citalopram will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clarithromycin
clarithromycin will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
clarithromycin and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - clemastine
clemastine and risperidone both increase sedation. Use Caution/Monitor.
- clobazam
clobazam will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.
risperidone, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). - clomipramine
clomipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and clomipramine both increase sedation. Use Caution/Monitor. - clonazepam
clonazepam and risperidone both increase sedation. Use Caution/Monitor.
- clonidine
clonidine, risperidone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- clorazepate
clorazepate and risperidone both increase sedation. Use Caution/Monitor.
- clotrimazole
clotrimazole will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- clozapine
clozapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
clozapine and risperidone both increase sedation. Use Caution/Monitor.
clozapine and risperidone both increase QTc interval. Use Caution/Monitor. - cobicistat
cobicistat will increase the level or effect of risperidone by Other (see comment). Modify Therapy/Monitor Closely. A decrease in the dose of antipsychotics that are metabolized by CYP3A or CYP2D6 may be needed upon coadministration.
- codeine
codeine and risperidone both increase sedation. Use Caution/Monitor.
- crizotinib
crizotinib and risperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- cyclizine
cyclizine and risperidone both increase sedation. Use Caution/Monitor.
cyclizine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cyclizine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclobenzaprine
cyclobenzaprine and risperidone both increase sedation. Use Caution/Monitor.
cyclobenzaprine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cyclobenzaprine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclosporine
cyclosporine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and risperidone both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and risperidone both increase sedation. Use Caution/Monitor.
- daridorexant
risperidone and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
darifenacin decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - dasatinib
dasatinib and risperidone both increase QTc interval. Use Caution/Monitor.
- desflurane
desflurane and risperidone both increase sedation. Use Caution/Monitor.
- desipramine
desipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and desipramine both increase sedation. Use Caution/Monitor. - desvenlafaxine
desvenlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg
- deutetrabenazine
risperidone and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.
risperidone and deutetrabenazine both increase sedation. Use Caution/Monitor.
deutetrabenazine and risperidone both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexchlorpheniramine
dexchlorpheniramine and risperidone both increase sedation. Use Caution/Monitor.
- dexfenfluramine
risperidone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and risperidone both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
risperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
risperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromethorphan
dextromethorphan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- dextromoramide
dextromoramide and risperidone both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and risperidone both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and risperidone both increase sedation. Use Caution/Monitor.
- dicyclomine
dicyclomine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
dicyclomine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diethylpropion
risperidone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and risperidone both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and risperidone both increase sedation. Use Caution/Monitor.
- dihydroergotamine
dihydroergotamine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- dimenhydrinate
dimenhydrinate and risperidone both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and risperidone both increase sedation. Use Caution/Monitor.
diphenhydramine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
diphenhydramine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diphenoxylate hcl
diphenoxylate hcl and risperidone both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and risperidone both increase sedation. Use Caution/Monitor.
- dobutamine
risperidone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dofetilide
dofetilide and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- dolasetron
dolasetron and risperidone both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and risperidone both increase QTc interval. Use Caution/Monitor.
- donepezil transdermal
risperidone, donepezil transdermal. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
- dopamine
risperidone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
risperidone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
risperidone and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
doxepin and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and doxepin both increase sedation. Use Caution/Monitor. - doxylamine
doxylamine and risperidone both increase sedation. Use Caution/Monitor.
- dronedarone
dronedarone will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
dronedarone and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - droperidol
droperidol and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
droperidol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
droperidol and risperidone both increase sedation. Use Caution/Monitor. - duloxetine
duloxetine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- efavirenz
efavirenz will decrease the level or effect of risperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- elagolix
elagolix will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- eletriptan
eletriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- eliglustat
eliglustat increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.
eliglustat increases levels of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.
eliglustat and risperidone both increase QTc interval. Use Caution/Monitor. - elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; A decrease in dose of the neuroleptic may be needed when coadministered.
- ephedrine
risperidone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
epinephrine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - epinephrine racemic
epinephrine racemic and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - ergoloid mesylates
ergoloid mesylates, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ergotamine
ergotamine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- eribulin
eribulin and risperidone both increase QTc interval. Use Caution/Monitor.
- erythromycin base
erythromycin base will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin base and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin ethylsuccinate and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin lactobionate and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - erythromycin stearate
erythromycin stearate will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
erythromycin stearate and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - escitalopram
escitalopram increases toxicity of risperidone by QTc interval. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, risperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and risperidone both increase sedation. Use Caution/Monitor.
- ethanol
risperidone and ethanol both increase sedation. Use Caution/Monitor.
- exenatide injectable solution
risperidone, exenatide injectable solution. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- exenatide injectable suspension
risperidone, exenatide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ezogabine
ezogabine, risperidone. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fedratinib
fedratinib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary.
- felodipine
felodipine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- fenfluramine
risperidone increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
risperidone decreases effects of fenfluramine by pharmacodynamic antagonism. Use Caution/Monitor. Potent serotonin receptor antagonists may decrease fenfluramine efficacy. If coadministered, monitor appropriately. - fentanyl
fentanyl, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
fentanyl and risperidone both increase sedation. Use Caution/Monitor. - fentanyl intranasal
fentanyl intranasal and risperidone both increase sedation. Use Caution/Monitor.
- fentanyl iontophoretic transdermal system
fentanyl iontophoretic transdermal system and risperidone both increase sedation. Use Caution/Monitor.
- fentanyl transdermal
fentanyl transdermal and risperidone both increase sedation. Use Caution/Monitor.
- fesoterodine
fesoterodine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
fesoterodine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - finerenone
risperidone will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.
- fingolimod
fingolimod and risperidone both increase QTc interval. Use Caution/Monitor.
- flavoxate
flavoxate decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
flavoxate decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - flecainide
flecainide and risperidone both increase QTc interval. Use Caution/Monitor.
- flibanserin
risperidone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.
flibanserin, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - fluconazole
fluconazole and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- fluoxetine
fluoxetine and risperidone both increase QTc interval. Use Caution/Monitor.
- fluphenazine
fluphenazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
fluphenazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
fluphenazine and risperidone both increase sedation. Use Caution/Monitor. - flurazepam
flurazepam and risperidone both increase sedation. Use Caution/Monitor.
- fluvoxamine
fluvoxamine and risperidone both increase QTc interval. Use Caution/Monitor.
- formoterol
formoterol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - foscarnet
foscarnet and risperidone both increase QTc interval. Use Caution/Monitor.
- fosphenytoin
fosphenytoin will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- fostamatinib
fostamatinib will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.
- fostemsavir
risperidone and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- frovatriptan
frovatriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- gadobenate
gadobenate and risperidone both increase QTc interval. Use Caution/Monitor.
- ganaxolone
risperidone and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and risperidone both increase QTc interval. Use Caution/Monitor.
- gepirone
gepirone and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- gilteritinib
gilteritinib and risperidone both increase QTc interval. Use Caution/Monitor.
- glecaprevir/pibrentasvir
glecaprevir/pibrentasvir will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- glimepiride
risperidone, glimepiride. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glipizide
risperidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glyburide
risperidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glycopyrrolate
risperidone increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
- glycopyrrolate inhaled
glycopyrrolate inhaled decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
glycopyrrolate inhaled decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - granisetron
granisetron and risperidone both increase QTc interval. Use Caution/Monitor.
- guanfacine
guanfacine, risperidone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- haloperidol
haloperidol and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
haloperidol and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
haloperidol and risperidone both increase sedation. Use Caution/Monitor. - henbane
henbane decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
henbane decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - homatropine
homatropine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
homatropine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hydromorphone
hydromorphone and risperidone both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and risperidone both increase sedation. Use Caution/Monitor.
hydroxyzine and risperidone both increase QTc interval. Use Caution/Monitor. - hyoscyamine
hyoscyamine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hyoscyamine spray
risperidone increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
hyoscyamine spray decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine spray decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. - iloperidone
iloperidone and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
iloperidone and risperidone both increase QTc interval. Use Caution/Monitor.
iloperidone and risperidone both increase sedation. Use Caution/Monitor. - imipramine
imipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and imipramine both increase sedation. Use Caution/Monitor. - incobotulinumtoxinA
risperidone, incobotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.
- indacaterol, inhaled
indacaterol, inhaled, risperidone. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- indinavir
indinavir will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- insulin aspart
risperidone, insulin aspart. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin degludec
risperidone decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin degludec/insulin aspart
risperidone decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin detemir
risperidone, insulin detemir. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glargine
risperidone, insulin glargine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glulisine
risperidone, insulin glulisine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin inhaled
risperidone decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin lispro
risperidone, insulin lispro. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin NPH
risperidone, insulin NPH. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin regular human
risperidone, insulin regular human. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ipratropium
risperidone increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
- isavuconazonium sulfate
risperidone will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isoproterenol
risperidone increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- istradefylline
istradefylline will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of P-gp substrates in clinical trials. Consider dose reduction of sensitive P-gp substrates.
- itraconazole
itraconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
itraconazole and risperidone both increase QTc interval. Use Caution/Monitor. - ivacaftor
ivacaftor increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.
risperidone increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors . - ketoconazole
ketoconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
ketoconazole and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - ketotifen, ophthalmic
risperidone and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lapatinib
lapatinib and risperidone both increase QTc interval. Use Caution/Monitor.
- lasmiditan
lasmiditan, risperidone. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
risperidone will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.
lemborexant, risperidone. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects. - letermovir
letermovir increases levels of risperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- levalbuterol
risperidone increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
levofloxacin and risperidone both increase QTc interval. Use Caution/Monitor.
- levoketoconazole
levoketoconazole and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
levoketoconazole will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. - levomilnacipran
levomilnacipran, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- levorphanol
levorphanol and risperidone both increase sedation. Use Caution/Monitor.
- linezolid
linezolid, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- liraglutide
risperidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- lisdexamfetamine
risperidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lithium
lithium, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
lithium and risperidone both increase QTc interval. Use Caution/Monitor. - lofepramine
lofepramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and lofepramine both increase sedation. Use Caution/Monitor. - lofexidine
risperidone and lofexidine both increase sedation. Use Caution/Monitor.
- lomitapide
risperidone increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.
- lonafarnib
lonafarnib will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Lonafarnib is a weak P-gp inhibitor. Monitor for adverse reactions if coadministered with P-gp substrates where minimal concentration changes may lead to serious or life-threatening toxicities. Reduce P-gp substrate dose if needed.
- loprazolam
loprazolam and risperidone both increase sedation. Use Caution/Monitor.
- loratadine
loratadine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- lorazepam
lorazepam and risperidone both increase sedation. Use Caution/Monitor.
- lorcaserin
lorcaserin will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
lorcaserin, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - lormetazepam
lormetazepam and risperidone both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
loxapine and risperidone both increase sedation. Use Caution/Monitor. - loxapine inhaled
loxapine inhaled and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
loxapine inhaled and risperidone both increase sedation. Use Caution/Monitor. - lumefantrine
lumefantrine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
lumefantrine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. - lurasidone
lurasidone, risperidone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
maprotiline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and maprotiline both increase sedation. Use Caution/Monitor. - marijuana
risperidone and marijuana both increase sedation. Use Caution/Monitor.
- meclizine
meclizine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
meclizine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - melatonin
risperidone and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and risperidone both increase sedation. Use Caution/Monitor.
meperidine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - meprobamate
risperidone and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
risperidone increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and risperidone both increase sedation. Use Caution/Monitor.
- metformin
risperidone, metformin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- methadone
methadone and risperidone both increase QTc interval. Use Caution/Monitor.
methadone and risperidone both increase sedation. Use Caution/Monitor.
methadone, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - methamphetamine
risperidone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and risperidone both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
methscopolamine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - methylenedioxymethamphetamine
risperidone increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methylergonovine
methylergonovine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- methylphenidate
risperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.
- methylphenidate transdermal
methylphenidate transdermal will increase the level or effect of risperidone by unspecified interaction mechanism. Use Caution/Monitor. When coadministered with methylphenidate, changes in dosage of either or both medications, may increase the risk of extrapyramidal symptoms (EPS). Monitor for signs of EPS.
- metoclopramide
risperidone and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- midazolam
midazolam and risperidone both increase sedation. Use Caution/Monitor.
- midazolam intranasal
risperidone will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.
midazolam intranasal, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect. - midodrine
risperidone increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone, risperidone. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- miglitol
risperidone, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- milnacipran
milnacipran, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- mipomersen
mipomersen, risperidone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- mirabegron
mirabegron will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- mirtazapine
risperidone and mirtazapine both increase sedation. Use Caution/Monitor.
mirtazapine and risperidone both increase QTc interval. Use Caution/Monitor. - modafinil
risperidone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and risperidone both increase sedation. Use Caution/Monitor.
- motherwort
risperidone and motherwort both increase sedation. Use Caution/Monitor.
- moxifloxacin
moxifloxacin and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- moxonidine
risperidone and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
risperidone and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and risperidone both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- nateglinide
risperidone, nateglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- nefazodone
nefazodone will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- nevirapine
nevirapine will decrease the level or effect of risperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nicardipine
nicardipine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- nifedipine
nifedipine will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- nilotinib
nilotinib and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- norepinephrine
risperidone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
nortriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and nortriptyline both increase sedation. Use Caution/Monitor. - octreotide
octreotide and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- octreotide (Antidote)
octreotide (Antidote) and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- ofloxacin
ofloxacin and risperidone both increase QTc interval. Use Caution/Monitor.
- olanzapine
olanzapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
olanzapine and risperidone both increase sedation. Use Caution/Monitor.
olanzapine and risperidone both increase QTc interval. Use Caution/Monitor. - oliceridine
oliceridine, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- olodaterol inhaled
risperidone and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- onabotulinumtoxinA
onabotulinumtoxinA decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
onabotulinumtoxinA decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - opium tincture
opium tincture and risperidone both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and risperidone both increase sedation. Use Caution/Monitor.
- osilodrostat
osilodrostat and risperidone both increase QTc interval. Use Caution/Monitor.
- oxaliplatin
oxaliplatin will increase the level or effect of risperidone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- oxazepam
oxazepam and risperidone both increase sedation. Use Caution/Monitor.
- oxybutynin
oxybutynin decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin topical
oxybutynin topical decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin topical decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin transdermal
oxybutynin transdermal decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin transdermal decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxycodone
oxycodone and risperidone both increase sedation. Use Caution/Monitor.
- oxymorphone
oxymorphone and risperidone both increase sedation. Use Caution/Monitor.
- ozanimod
ozanimod and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
paliperidone and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
paliperidone and risperidone both increase QTc interval. Use Caution/Monitor.
paliperidone and risperidone both increase sedation. Use Caution/Monitor.
paliperidone, risperidone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Paliperidone is the major active metabolite of risperidone, consideration should be given to the additive paliperidone exposure if any of these medications are coadministered. - pancuronium
pancuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - papaveretum
papaveretum and risperidone both increase sedation. Use Caution/Monitor.
- papaverine
risperidone and papaverine both increase sedation. Use Caution/Monitor.
- paroxetine
paroxetine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
paroxetine and risperidone both increase QTc interval. Use Caution/Monitor.
paroxetine increases levels of risperidone by decreasing metabolism. Use Caution/Monitor.
paroxetine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - pasireotide
risperidone and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- peginterferon alfa 2b
peginterferon alfa 2b, risperidone. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.
- pentazocine
pentazocine and risperidone both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital and risperidone both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
perphenazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
perphenazine and risperidone both increase sedation. Use Caution/Monitor. - phendimetrazine
risperidone increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenelzine
phenelzine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- phenobarbital
phenobarbital will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
phenobarbital and risperidone both increase sedation. Use Caution/Monitor. - phentermine
risperidone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
risperidone increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
risperidone increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- phenytoin
phenytoin will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- pholcodine
risperidone and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
pimozide and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
pimozide and risperidone both increase sedation. Use Caution/Monitor. - pioglitazone
risperidone, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- pirbuterol
risperidone increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ponatinib
ponatinib increases levels of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- posaconazole
posaconazole and risperidone both increase QTc interval. Use Caution/Monitor.
- pralidoxime
pralidoxime decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pralidoxime decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pramlintide
risperidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- primaquine
primaquine and risperidone both increase QTc interval. Use Caution/Monitor.
- primidone
primidone and risperidone both increase sedation. Use Caution/Monitor.
- procarbazine
procarbazine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- prochlorperazine
prochlorperazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
prochlorperazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
prochlorperazine and risperidone both increase sedation. Use Caution/Monitor. - promazine
promazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
- promethazine
promethazine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
promethazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
promethazine and risperidone both increase sedation. Use Caution/Monitor.
promethazine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - propantheline
propantheline decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
propantheline decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propofol
propofol and risperidone both increase sedation. Use Caution/Monitor.
- propylhexedrine
risperidone increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
protriptyline and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and protriptyline both increase sedation. Use Caution/Monitor. - quazepam
quazepam and risperidone both increase sedation. Use Caution/Monitor.
- quercetin
quercetin will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- quetiapine
quetiapine and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
quetiapine and risperidone both increase sedation. Use Caution/Monitor.
quetiapine, risperidone. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. - quinidine
quinidine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- quinine
risperidone and quinine both increase QTc interval. Use Caution/Monitor.
- quizartinib
quizartinib, risperidone. Either increases effects of the other by QTc interval. Modify Therapy/Monitor Closely. Monitor patients more frequently with ECG if coadministered with QT prolonging drugs.
- ramelteon
risperidone and ramelteon both increase sedation. Use Caution/Monitor.
- ranolazine
ranolazine will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
ranolazine and risperidone both increase QTc interval. Use Caution/Monitor. - rapacuronium
rapacuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rapacuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - remimazolam
remimazolam, risperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- repaglinide
risperidone, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- rifampin
rifampin will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- rilpivirine
rilpivirine increases toxicity of risperidone by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.
- rimabotulinumtoxinB
risperidone, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Anticholinergics may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.
- ritonavir
ritonavir will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- rocuronium
rocuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rolapitant
rolapitant will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.
- romidepsin
risperidone and romidepsin both increase QTc interval. Use Caution/Monitor.
- rosiglitazone
risperidone, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- salmeterol
risperidone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sarecycline
sarecycline will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor for toxicities of P-gp substrates that may require dosage reduction when coadministered with P-gp inhibitors.
- saxagliptin
risperidone, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- scopolamine
scopolamine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - scullcap
risperidone and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and risperidone both increase sedation. Use Caution/Monitor.
- selegiline
selegiline, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- selpercatinib
selpercatinib increases toxicity of risperidone by QTc interval. Use Caution/Monitor.
- sertraline
sertraline will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
sertraline and risperidone both increase QTc interval. Use Caution/Monitor. - shepherd's purse
risperidone and shepherd's purse both increase sedation. Use Caution/Monitor.
- simvastatin
simvastatin will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- sirolimus
sirolimus will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- sitagliptin
risperidone, sitagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of risperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of risperidone by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- solifenacin
solifenacin decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
solifenacin decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
solifenacin and risperidone both increase QTc interval. Use Caution/Monitor. - sorafenib
sorafenib and risperidone both increase QTc interval. Use Caution/Monitor.
- St John's Wort
St John's Wort will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- stiripentol
stiripentol will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Consider reducing the dose of P-glycoprotein (P-gp) substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
stiripentol, risperidone. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. - sufentanil
sufentanil and risperidone both increase sedation. Use Caution/Monitor.
- sulfamethoxazole
sulfamethoxazole and risperidone both increase QTc interval. Use Caution/Monitor.
- sumatriptan
sumatriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sumatriptan intranasal
sumatriptan intranasal, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sunitinib
sunitinib and risperidone both increase QTc interval. Use Caution/Monitor.
- tacrolimus
tacrolimus will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
tacrolimus and risperidone both increase QTc interval. Use Caution/Monitor. - tapentadol
tapentadol and risperidone both increase sedation. Use Caution/Monitor.
- tazemetostat
risperidone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- telavancin
risperidone and telavancin both increase QTc interval. Use Caution/Monitor.
- temazepam
temazepam and risperidone both increase sedation. Use Caution/Monitor.
- terbinafine
terbinafine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.
- terbutaline
risperidone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tetrabenazine
risperidone and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.
- thioridazine
risperidone and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
thioridazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and thioridazine both increase sedation. Use Caution/Monitor. - thiothixene
risperidone and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
risperidone and thiothixene both increase sedation. Use Caution/Monitor. - tinidazole
risperidone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tiotropium
tiotropium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tiotropium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tolazamide
risperidone, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolbutamide
risperidone, tolbutamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolterodine
tolterodine decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tolterodine decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tolvaptan
tolvaptan will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- topiramate
risperidone and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and risperidone both increase sedation. Use Caution/Monitor.
- tranylcypromine
tranylcypromine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- trazodone
trazodone will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
trazodone and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and trazodone both increase sedation. Use Caution/Monitor. - triazolam
triazolam and risperidone both increase sedation. Use Caution/Monitor.
- triclabendazole
triclabendazole and risperidone both increase QTc interval. Use Caution/Monitor.
- triclofos
triclofos and risperidone both increase sedation. Use Caution/Monitor.
- trifluoperazine
risperidone and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
trifluoperazine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and trifluoperazine both increase sedation. Use Caution/Monitor. - trihexyphenidyl
risperidone increases effects of trihexyphenidyl by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimethoprim
risperidone and trimethoprim both increase QTc interval. Use Caution/Monitor.
- trimipramine
trimipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and trimipramine both increase sedation. Use Caution/Monitor. - triprolidine
triprolidine and risperidone both increase sedation. Use Caution/Monitor.
- tropisetron
risperidone and tropisetron both increase QTc interval. Use Caution/Monitor.
- trospium chloride
trospium chloride decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tucatinib
tucatinib will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Consider reducing the dosage of P-gp substrates, where minimal concentration changes may lead to serious or life-threatening toxicities.
- valbenazine
valbenazine and risperidone both increase QTc interval. Use Caution/Monitor.
- vecuronium
vecuronium decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
vecuronium decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - venlafaxine
venlafaxine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
risperidone and venlafaxine both increase QTc interval. Use Caution/Monitor.
venlafaxine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - verapamil
verapamil will increase the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
- vilazodone
vilazodone, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- voclosporin
voclosporin, risperidone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
risperidone and voriconazole both increase QTc interval. Use Caution/Monitor.
- vorinostat
vorinostat and risperidone both increase QTc interval. Use Caution/Monitor.
- xylometazoline
risperidone increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
risperidone increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
risperidone and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
risperidone and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
risperidone and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and ziprasidone both increase sedation. Use Caution/Monitor. - zolmitriptan
zolmitriptan, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- zotepine
risperidone and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
risperidone and zotepine both increase sedation. Use Caution/Monitor.
Minor (29)
- amoxapine
risperidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Minor/Significance Unknown.
- asenapine
asenapine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- azithromycin
azithromycin and risperidone both increase QTc interval. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of risperidone by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- celecoxib
celecoxib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- chasteberry
chasteberry decreases effects of risperidone by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).
- chloroquine
chloroquine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cimetidine
cimetidine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- darifenacin
darifenacin will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- diphenhydramine
diphenhydramine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- dronedarone
dronedarone will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ethanol
ethanol, risperidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.
- eucalyptus
risperidone and eucalyptus both increase sedation. Minor/Significance Unknown.
- haloperidol
haloperidol will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- imatinib
imatinib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- maraviroc
maraviroc will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- marijuana
marijuana will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- nilotinib
nilotinib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- parecoxib
parecoxib will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- pazopanib
pazopanib and risperidone both increase QTc interval. Minor/Significance Unknown.
- perphenazine
perphenazine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- quinacrine
quinacrine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ranolazine
ranolazine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ritonavir
ritonavir will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ruxolitinib
risperidone will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- ruxolitinib topical
risperidone will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- sage
risperidone and sage both increase sedation. Minor/Significance Unknown.
- thioridazine
thioridazine will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tipranavir
tipranavir will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
Adverse Effects
>10%
Somnolence (40-45%)
Insomnia (26-30%)
Agitation (20-25%)
Anxiety (10-15%)
Headache (10-15%)
Rhinitis (10-15%)
Fatigue (18-31%)
Parkinsonism (28-62%)
Akathisia (5-11%)
Increased appetite (4-44%)
Vomiting (10-20%)
Drooling (<12%)
Urinary incontinence (5-22%)
Tremor (11-24%)
Nasopharyngitis (4-19%)
Rhinorrhea (4-12%)
Enuresis (1-16%)
ER suspension
- Increased weight (12.8-13%)
1-10%
Constipation (5-10%)
Dyspepsia (5-10%)
Nausea (5-10%)
Abdominal pain (1-5%)
Aggressive reaction (1-5%)
Facial edema (<4%)
QT prolongation (<4%)
Dizziness (1-5%)
Extrapyramidal symptoms (EPS; 1-5%)
Gynecomastia in children (1-5%)
Rash (1-5%)
Tachycardia (1-5%)
Syncope (1-2%)
Bradycardia (<4%)
Palpitation (<4%)
Chest pain (<4%)
Agitation (<4%)
Postural dizziness (<4%)
Pruritus (<4%)
Acne (1-2%)
Hyperprolactinemia (<4%)
Sexual dysfunction (<4%)
Xerostomia (7-10%)
ER suspension
- Sedation (7-7.7%)
- Pain in extremity (0.9-7.7%)
- Constipation (7-7/7%)
- Anxiety (2.6-6.8%)
- Akathisia (2.6-6.8%)
- Back pain (3.5-6.8%)
- Musculoskeletal pain (5.2%)
- Extrapyramidal disorder (1.7-4.3%)
- Increased appetite (1.7-3.4%)
- Musculoskeletal stiffness (0.9-2.6%)
- Abdominal discomfort (2.6%)
- Muscle spasms (0-2.6%)
- Dry mouth (1.7-2.6%)
<1%
Agranulocytosis
Cholesterol increased
Delirium
Ketoacidosis
Orthostatic hypotension
Seizures
Frequency Not Defined
Diabetes mellitus
Hyperthermia
Hypoglycemia
Hypothermia
Myelosuppression
Neuroleptic malignant syndrome (NMS)
Priapism
Prolonged QT interval
Tardive dyskinesia
Thrombotic thrombocytopenic purpura (TTP)
Sleep apnea syndrome
Urinary retention
Blood and lymphatic system disorders: Anemia, granulocytopenia
Cardiac disorders: Tachycardia, sinus bradycardia, sinus tachycardia, atrioventricular block first degree, bundle branch block left, bundle branch block right, atrioventricular block
Ear and labyrinth disorders: Ear pain, tinnitus
Eye Disorders: Vision blurred, oculogyration, ocular hyperemia, eye discharge, conjunctivitis, eye rolling, eyelid edema, eye swelling, eyelid margin crusting, dry eye, lacrimation increased, photophobia, glaucoma, visual acuity reduced
Gastrointestinal disorders: Dysphagia, fecaloma, fecal incontinence, gastritis, lip swelling, cheilitis, aptyalism
General disorders: Thirst, gait disturbance, chest pain, influenza-like illness, pitting edema, edema, chills, sluggishness, malaise, face edema, discomfort, generalized edema, drug withdrawal syndrome, peripheral coldness, feeling abnormal
Immune system disorders: Drug hypersensitivity
Infections and infestations: Nasopharyngitis, upper respiratory tract infection, sinusitis, urinary tract infection, pneumonia, influenza, ear infection, viral infection, pharyngitis, tonsillitis, bronchitis, eye infection, localized infection, cystitis, cellulitis, otitis media, onychomycosis, acarodermatitis, bronchopneumonia, respiratory tract infection, tracheobronchitis, otitis media chronic
Investigations: Body temperature increased, alanine aminotransferase increased, heart rate increased, eosinophil count increased, white blood cell count decreased, hemoglobin decreased, blood creatine phosphokinase increased, hematocrit decreased, body temperature decreased, blood pressure decreased, transaminases increased
Metabolism and nutrition disorders: Polydipsia, anorexia
Musculoskeletal, connective tissue, and bone disorders: Joint swelling, musculoskeletal chest pain, posture abnormal, myalgia, neck pain, muscular weakness, muscle rigidity, muscle contracture, rhabdomyolysis
Nervous system disorders: Dizziness postural, disturbance in attention, unresponsive to stimuli, depressed level of consciousness, movement disorder, hypokinesia, bradykinesia, transient ischemic attack, coordination abnormal, cerebrovascular accident, masked facies, speech disorder, syncope, loss of consciousness, muscle contractions involuntary, Parkinson disease, tongue paralysis, akinesia, cerebral ischemia, cerebrovascular disorder, neuroleptic malignant syndrome, diabetic coma, head titubation
Psychiatric disorders: Agitation, blunted affect, confusional state, middle insomnia, nervousness, sleep disorder, listlessness
Renal and urinary disorders: Enuresis, dysuria, pollakiuria, urinary incontinence Reproductive system and breast disorders: Vaginal discharge, menstrual disorder, retrograde ejaculation, sexual dysfunction
Postmarketing Reports
Falls
Alopecia, anaphylactic reaction, angioedema, atrial fibrillation, cardiopulmonary arrest, diabetic ketoacidosis in patients with impaired glucose metabolism, dysgeusia, hypoglycemia, hypothermia, ileus, inappropriate antidiuretic hormone secretion, intestinal obstruction, jaundice, mania, pancreatitis, pituitary adenoma, precocious puberty, pulmonary embolism, QT prolongation, sleep apnea syndrome, sudden death, thrombocytopenia, thrombotic thrombocytopenic purpura, urinary retention, Stevens-Johnson syndrome, toxic epidermal necrolysis (SJS/TEN), and water intoxication
Warnings
Black Box Warnings
Elderly patients with dementia-related psychosis
- Not approved for dementia-related psychosis
- Elderly patients with dementia-related psychosis who are treated with antipsychotic drugs are at increased risk of death, as shown in short-term controlled trials; deaths in these trials appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature
Contraindications
Documented hypersensitivity
Cautions
Increased incidence of cerebrovascular disease reported; may alter cardiac conduction; life threatening arrhythmias reported with therapeutic doses of antipsychotics
May cause anticholinergic effects including blurred vision, urinary retention, agitation, confusion, blurred vision, and xerostomia
Use with caution in patients with history of seizures, Parkinson disease, Lewy body dementia, cardiovascular disease, hypovolemia, dehydration
Leukopenia/neutropenia and agranulocytosis reported; possible risk factors for leukopenia/neutropenia include preexisting low white blood cell (WBC) count and history of drug-induced leukopenia/neutropenia
If patient has history of clinically significant low WBC count or drug-induced leukopenia/neutropenia, monitor complete blood count (CBC) frequently during first few months of therapy; discontinue drug at first sign of clinically significant WBC decline <1000/μL in absence of other causative factors, and continue monitoring WBC count until recovery
May cause somnolence, postural hypotension, motor and sensory instability, which may lead to falls and, consequently, fractures or other injuries; perform complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy
Use caution in patients at risk of pneumonia; esophageal dysmotility and aspiration reported with antipsychotic use
May cause extrapyramidal symptoms including acute dystonic reactions, akathisia, pseudoparkinsonism, and tardive dyskinesia
Intraoperative floppy iris syndrome reported in patients receiving risperidone therapy
Monitor for fever, mental status changes, muscle rigidity and or autonomic instability; neuroleptic malignant syndrome (NMS) associated with risperidone use; if NMS suspected, discontinue therapy immediately and provide symptomatic treatment and monitoring
Use with caution in children <15 kg
Cases of priapism reported with therapy
Prolactin elevations occur and persist during chronic administration; risperidone is associated with higher levels of prolactin elevation than other antipsychotic agents
Use caution when operating heavy machinery
FDA warning regarding off-label use for dementia in elderly
Seizures observed during premarketing studies of risperidone in adult patients with schizophrenia
Esophageal dysmotility and aspiration have been associated with antipsychotic use
Disruption of body temperature regulation has been attributed to antipsychotic agents
Tardive dyskinesia
- A syndrome consisting of potentially irreversible, involuntary, dyskinetic movements, may develop in patients treated with antipsychotic drugs; although prevalence appears to be highest among elderly, especially elderly women, it is impossible to predict which patients will develop the syndrome; whether antipsychotic drug products differ in their potential to cause tardive dyskinesia is unknown
- Risk of developing tardive dyskinesia and likelihood that it will become irreversible increase with the duration of treatment and the cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low doses. It may also occur after discontinuation of treatment
- Tardive dyskinesia may remit, partially or completely, if antipsychotic treatment is discontinued; antipsychotic treatment, itself, however, may suppress (or partially suppress) signs and symptoms of the syndrome, possibly masking the underlying process
- Therapy should be prescribed in a manner that is most likely to minimize occurrence of tardive dyskinesia; chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness known to respond to antipsychotic drugs, and for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate
- In patients who do require chronic treatment, use lowest dose and shortest duration of treatment producing a satisfactory clinical response; periodically reassess need for continued treatment;
- If signs and symptoms of tardive dyskinesia appear in a patient receiving therapy, consider discontinuing drug; however, some patients may require treatment with the drug despite the presence of the syndrome
Orthostatic hypotension
- May induce orthostatic hypotension associated with dizziness, tachycardia, and in some patients, syncope, especially during initial dose-titration period, probably reflecting its alpha-adrenergic antagonistic properties
- risk of orthostatic hypotension and syncope may be minimized by limiting the initial dose to 2 mg total (either once daily or 1 mg twice daily) in normal adults and 0.5 mg twice daily in the elderly and patients with renal or hepatic impairment
- Risk of orthostatic hypotension and syncope may be minimized by limiting initial dose to 2 mg total (either once daily or 1 mg twice daily) in normal adults and 0.5 mg twice daily in the elderly and patients with renal or hepatic impairment
- Consider monitoring orthostatic vital signs in patients at risk; consider dose reduction if hypotension occurs
- Use caution in patients with known cardiovascular disease (history of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions that would predispose patients to hypotension, eg, dehydration and hypovolemia, and in the elderly and patients with renal or hepatic impairment
- Consider monitoring for orthostatic vital signs if hypotension occurs; clinically significant hypotension observed with concomitant use of drug and antihypertensive medication
Metabolic changes
- Atypical antipsychotic drugs have been associated with metabolic changes that may increase cardiovascular or cerebrovascular risk (eg, hyperglycemia, dyslipidemia, and body weight gain)
- In some cases, hyperglycemia concomitant with use of atypical antipsychotics has been associated with ketoacidosis, hyperosmolar coma, or death
- In some cases, hyperglycemia has resolved when the atypical antipsychotic, including risperidone, was discontinued; however, some patients required continuation of antidiabetic treatment despite discontinuation of risperidone
Pregnancy & Lactation
Pregnancy
Neonates exposed to antipsychotic drugs during third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery
Available data from published epidemiologic studies of pregnant females exposed to risperidone have not established a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
There are risks to the mother associated with untreated schizophrenia or bipolar disorder and with exposure to antipsychotics
Risperidone has been detected in plasma in adult subjects up to 6 weeks after a single dose
Clinical significance administered before or during pregnancy is unknown
Pregnancy exposure registry
- Registry monitors pregnancy outcomes in females exposed to atypical antipsychotics during pregnancy
- Register patients by contacting the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961- 2388 or online at http://womensmentalhealth.org/clinicaland-research-programs/pregnancyregistry/
Infertility
- Based on the pharmacologic action of risperidone, treatment may result in an increase in serum prolactin levels, which may lead to reversible reduction in fertility in females of reproductive potential
Disease-associated maternal and/or embryo/fetal risk
- There is a risk to the mother from untreated schizophrenia, including increased risk of relapse, hospitalization, and suicide
- Schizophrenia is associated with increased adverse perinatal outcomes, including preterm birth It is not known if this is a direct result of the illness or other comorbid factors
Fetal/neonatal adverse reactions
- Extrapyramidal and/or withdrawal symptoms, including agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress, and feeding disorder reported in neonates who were exposed to antipsychotic drugs, including risperidone, during the third trimester of pregnancy; symptoms varied
- Monitor neonates for extrapyramidal and/or withdrawal symptoms and manage symptoms appropriately
Lactation
Limited data are available the presence of risperidone and its metabolite, 9- hydroxyrisperidone, in human breast milk at relative infant dose ranging between 2.3 and 4.7% of the maternal weight-adjusted dosage
Reports of sedation, failure to thrive, jitteriness, and extrapyramidal symptoms (tremors and abnormal muscle movements) in breastfed infants exposed to risperidone
Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or from the underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Has high affinity for serotonin type 2 (5-HT2) receptors; binds to dopamine D2 receptors with 20 times lower affinity than that for 5-HT2 receptors; antagonizes alpha1-adrenergic, alpha2-adrenergic, and histaminergic receptors; has moderate affinity for serotonin type 1 (5-HT1C, 5-HT1D, 5-HT1A) receptors; has weak affinity for dopamine D1 receptors; has no affinity for muscarinic, beta1-adrenergic, and beta2-adrenergic receptors
Absorption
Peak plasma concentration: 6.33-10.9 ng/mL (risperidone, 9-hydroxyrisperidone)
AUC: 2262-3891 ng·hr/mL
Bioavailability: 70%
Peak plasma time
PO: 3 hr (extensive metabolizers); 17 hr (poor metabolizers)
IM (Rykindo): 14 days (risperidone); 17 days (9-hydroxyrisperidone)
Steady state reached at
IM: 4-6 weeks (Risperdal Consta): 2-3 weeks (Rykindo)
SC: 4-6 hr
Distribution
Risperidone once absorbed is rapidly distributed
Vd
Risperdal Consta: 1-2 L/kg
Protein bound
- Risperidone: ~90%
- 9-hydroxyrisperidone (major metabolite): 77%
Metabolism
Extensively metabolized by liver
Metabolite: 9-hydroxyrisperidone (paliperidone)
Elimination
Half-life
- IM: 3-6 days
- PO: Extensive metabolizers, 3 hr (parent and metabolite combined); poor metabolizers, 20 hr (parent and metabolite combined); prolonged in renal impairment; free fraction increase in hepatic disease
Excretion
- Urine (70%)
- Feces (14%)
Administration
Oral Administration
Oral solution
- Administer directly from the calibrated pipette, or can be mixed with a beverage prior to administration
- Compatible in the following beverages: Water, coffee, orange juice, and low-fat milk; it is NOT compatible with either cola or tea
Orally disintegrating tablets
- Do not open the blister until ready to administer
- For single tablet removal, separate one of the four blister units by tearing apart at the perforations
- Bend the corner where indicated
- Peel back foil to expose the tablet
- DO NOT push the tablet through the foil because this could damage the tablet
- The child-resistant pouch should be torn open at the notch to access the blister; do not open the blister until ready to administer
- Peel back foil from the side to expose the tablet
- DO NOT push the tablet through the foil, because this could damage the tablet
- Using dry hands, remove the tablet from the blister unit and immediately place the entire oral disintegration on the tongue; consumed immediately, as the tablet cannot be stored once removed from the blister unit
- Disintegrate in the mouth within seconds and can be swallowed subsequently with or without liquid; patients should not attempt to split or to chew the tablet
SC Preparation
Perseris
- Remove kit from refrigerator and allow to sit at room temperature (20-25ºC [68-77ºF]) for at least 15 minutes
- Visually inspect for particulate matter and discoloration before administering
- Hold powder syringe upright tap barrel of the syringe to unpack the powder
- Remove caps from both powder syringe and diluent syringe
- Connect both syringes; do not over tighten
- Keep your fingers off the plunger to avoid drug spillage
- Failure to fully mix the product could result in incorrect dosage
-
Premixing
- Transfer contents of liquid syringe into powder syringe
- Gently push powder syringe plunger until you feel resistance (to wet powder and avoid compacting)
- Repeat this gentle back-and-forth process for 5 cycles
-
Complete mixing
- Continue mixing syringes for an additional 55 cycles; mixing can be more vigorous than when premixing
- When fully mixed, product should be a cloudy suspension that is uniform in color; varies between white to yellow-green in color
- If any clear areas appear in mixture, continue to mix until color is evenly distributed
SC Preparation (Uzedy)
- Remove kit from refrigerator and allow to sit at room temperature (20-25C [68-77F]) for at least 30 minutes
- Uzedy is a solid at refrigerated temperatures and must reach room temperature before administration; do not warm any other way and keep protected from light
- Ensure drug in syringe is white to off-white, opaque in color, and free from non-white particulate matter
- See complete instructions in prescribing information on how to prepare syringe to move the bubble to the cap in ensure complete dosage
SC Administration
For SC injection only; do not administer by any other route
Administer SC in abdomen or back of upper arm
To be administered by a healthcare professional only
Choose an injection site with adequate SC tissue that has no skin conditions (eg, nodules, lesions, excessive pigment); recommended patient be in the supine position; rotate injection sites (refer to prescribing information)
Only prepare medication when you are ready to administer the dose
As a universal precaution, always wear gloves
IM preparation
Remove dose pack from refrigerator; allow to sit at room temperature at least 30 minutes before reconstituting; do not warm any other way
Remove vial cap; connect vial adapter
Keep vial vertical to prevent leakage
Hold base of vial and pull up on the sterile blister to remove; do not shake; do not touch exposed luer opening on vial adapter; this will result in contamination
Remove cap from liquid cap; connect liquid syringe to the vial adapter
Inject entire amount of diluent from syringe to vial
Keep syringe plunger down; shake vigorously for at least 30 sec (Rykindo) and at least 10-20 sec for (Risperdal Consta)
When properly mixed, suspension appears uniform, thick, and milky in color
Risperdal Consta has microspheres visible in the liquid
Immediately invert vial completely, slowly pull plunger rod down to withdraw entire contents from vial into syringe
Hold Luer-lock adapter on syringe and unscrew from vial adapter; tear section of vial label at the perforation; apply detached label to syringe for identification
Discard both vial and vial adapter appropriately
Peel blister pouch open part way and attach needle to syringe with a firm clockwise twisting motion
Just before administration, shake syringe vigorously for 20-30 seconds until no deposition of powder, as some settling will have occurred
Hold syringe upright and tap gently to make any air bubbles rise to top; slowly and carefully press plunger rod upward to remove air
Immediately use once prepared; do NOT store
IM Administration
Immediately inject entire contents of syringe
Alternate injections between the two buttocks
Rykindo: Administer IM upper-outer quadrant of gluteal muscle
Risperdal Consta: Administer IM deltoid or gluteal muscle
Do not IV administer
Storage
Tablets and oral disintegrating tablets
- Store at room temperature 15-25°C (59-77°F); protect from light and moisture
Oral solution
- Store at controlled room temperature 15- 25°C (59-77°F); protect from light and freezing
SC and IM kits
-
Risperdal Consta, Rykindo
- Unopened: Refrigerate at 2-8°C (36-46°F); may store at room temperature in its original packaging at 20-25°C (68-77°F) for up to 7 days
- After removal from refrigerator, use within 7 days or discard
-
Perseris
- Unopened: Refrigerate 2-8°C (36-46°F); may store at room temperature in its original packaging at 20-25°C (68-77°F) for up to 30 days
- After removal from refrigerator, use within 30 days or discard
-
Uzedy
- Refrigerate at 2-8ºC (36-46ºF) in the original carton to protect from light
- May be stored in unopened original packaging at 20-25ºC (68-77ºF) for up to 90 days
- If unopened, may be returned to refrigerated storage within 90 days
- Once carton is opened, administer or discard
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Perseris abdominal subcutaneous - | 90 mg syringe | ![]() | |
Perseris abdominal subcutaneous - | 120 mg syringe | ![]() | |
Risperdal oral - | 1 mg tablet | ![]() | |
Risperdal oral - | 2 mg tablet | ![]() | |
Risperdal oral - | 3 mg tablet | ![]() | |
Risperdal oral - | 4 mg tablet | ![]() | |
Risperdal oral - | 0.5 mg tablet | ![]() | |
Risperdal oral - | 1 mg/mL solution | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 1 mg/mL solution | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 1 mg/mL solution | ![]() | |
risperidone oral - | 1 mg/mL solution | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 1 mg/mL solution | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 2 mg tablet | ![]() | |
risperidone oral - | 4 mg tablet | ![]() | |
risperidone oral - | 3 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 0.5 mg tablet | ![]() | |
risperidone oral - | 0.25 mg tablet | ![]() | |
risperidone oral - | 1 mg tablet | ![]() | |
risperidone oral - | 1 mg/mL solution | ![]() | |
Uzedy subcutaneous - | 250 mg/0.7 mL syringe | ![]() | |
Uzedy subcutaneous - | 200 mg/0.56 mL syringe | ![]() | |
Uzedy subcutaneous - | 150 mg/0.42 mL syringe | ![]() | |
Uzedy subcutaneous - | 125 mg/0.35 mL syringe | ![]() | |
Uzedy subcutaneous - | 100 mg/0.28 mL syringe | ![]() | |
Uzedy subcutaneous - | 75 mg/0.21 mL syringe | ![]() | |
Uzedy subcutaneous - | 50 mg/0.14 mL syringe | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
risperidone oral
RISPERIDONE DISINTEGRATING TABLET - ORAL
(riss-PAIR-ih-doan)
COMMON BRAND NAME(S): Risperdal M
WARNING: There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.If you are using risperidone in combination with other medication to treat depression, also carefully read the drug information for the other medication.
USES: Risperidone is used to treat certain mental/mood disorders (such as schizophrenia, bipolar disorder, irritability associated with autistic disorder). This medication can help you to think clearly and take part in everyday life.Risperidone belongs to a class of drugs called atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily.This medication comes in a blister pack. Do not remove the tablet from the packaging until you are ready to take it. With dry hands, peel back the foil on the blister pack to carefully remove the tablet. Do not try to push the tablet through the foil because doing so can damage the tablet. Place the tablet on your tongue right away and allow it to dissolve on your tongue. Do not split or chew the tablet. After the tablet has melted on the tongue, it can be swallowed with or without water.The dosage is based on your age, medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day. Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Drowsiness, dizziness, lightheadedness, drooling, nausea, weight gain, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: difficulty swallowing, muscle spasms, shaking (tremor), mental/mood changes (such as anxiety, restlessness), interrupted breathing during sleep.This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This drug may also cause significant weight gain and a rise in your blood cholesterol (or triglyceride) levels. These effects, along with diabetes, may increase your risk for developing heart disease. Discuss the risks and benefits of treatment with your doctor. (See also Notes section.)Risperidone may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, lips, mouth, tongue, arms or legs).This medication may increase a certain natural substance (prolactin) made by your body. For females, this increase in prolactin may result in unwanted breast milk, missed/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, seizures.This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking risperidone, tell your doctor or pharmacist if you are allergic to it; or to paliperidone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, seizures, difficulty swallowing, low white blood cell count, Parkinson's disease, dementia, certain eye problems (cataracts, glaucoma), personal or family history of diabetes, heart disease, high cholesterol/triglyceride levels, breathing trouble during sleep (sleep apnea).Risperidone may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using risperidone, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using risperidone safely.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery (including cataract/glaucoma eye surgery), tell your doctor or dentist if you are taking or have ever taken this medication, and about all the other products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, lightheadedness, and QT prolongation (see above). Drowsiness, dizziness, and lightheadedness can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.Since untreated mental/mood problems (such as schizophrenia, bipolar disorder, depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops symptoms such as muscle stiffness or shakiness, unusual sleepiness, or difficulty feeding. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: metoclopramide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness, fast/irregular heartbeat, unusual/uncontrolled movements, seizures.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood sugar, weight, blood pressure, blood cholesterol/triglyceride levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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