Risperdal

Generic name: Risperidone

What is Risperdal?

Risperdal is an antipsychotic medication prescribed for the treatment of schizophrenia and for the short-term treatment of mania associated with bipolar disorder. It is also used in the treatment of irritability associated with autistic disorder in children.

What is the most important information I should know about Risperdal?

Risperdal may increase the risk of death when used to treat mental problems caused by dementia in elderly patients. Risperdal is not approved to treat mental problems caused by dementia.

Risperdal may cause tardive dyskinesia, a potentially irreversible condition that causes involuntary muscle spasms and twitches in the face and body. Elderly women appear to be at a higher risk for this condition. Tell your doctor immediately if you begin to have any involuntary movements. You may need to discontinue Risperdal therapy.

Risperdal may mask signs and symptoms of drug overdose and of conditions such as intestinal obstruction, brain tumor, and Reye's syndrome (a dangerous neurological condition that may follow viral infections, usually occurring in children). Risperdal may also cause difficulty when swallowing, which in turn can cause a type of pneumonia.

Risperdal may cause neuroleptic malignant syndrome (NMS), a potentially fatal condition marked by muscle stiffness or rigidity, fast heartbeat or irregular pulse, increased sweating, high fever, and blood pressure irregularities. Call your doctor immediately if you notice any of these symptoms.

Certain antipsychotic drugs, including Risperdal, are associated with an increased risk of developing high blood sugar, which on rare occasions has led to coma or death. See your doctor right away if you develop signs of high blood sugar, including dry mouth, unusual thirst, increased urination, and fatigue. If you have diabetes or have a high risk of developing it, see your doctor regularly for blood sugar testing.

Risperdal may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. This effect may be more prominent when you first start taking Risperdal.

Do not drive or perform other possibly unsafe tasks until you know how you react to Risperdal.

Do not drink alcohol while you are using Risperdal.

Check with your doctor before taking medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Risperdal because the drug may add to their effects.

Risperdal may increase the amount of a certain hormone (prolactin) in your blood. Symptoms may include enlarged breasts, missed menstrual period, decreased sexual ability, or nipple discharge. Contact your doctor right away if you experience any of these symptoms.

Risperdal may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.

Who should not take Risperdal?

If you are sensitive to or have ever had an allergic reaction to Risperdal or other major tranquilizers, you should not take Risperdal.

Risperdal should not be used to treat elderly patients who have dementia because the drug could increase the risk of stroke.

What should I tell my doctor before I take the first dose of Risperdal?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Risperdal. Also, talk to your doctor about your complete medical history, especially if you have breast cancer, liver, kidney or heart disease, high or low blood pressure, heart rhythm problems, a history of heart attack or stroke, seizures, epilepsy, alcohol or substance abuse or dependence, diabetes, Alzheimer's disease, stomach or bowel problems, history of neuroleptic malignant syndrome, a history of suicidal thoughts, phenylketonuria, Parkinson's disease, or trouble swallowing. In addition, tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Schizophrenia

Adults: Doses of Risperdal can be taken once a day, or divided in half and taken twice daily. The usual dose on the first day is 1 milligram (mg) taken twice a day. Incremental increases in dose are recommended. On the second day, the dose increases to 2 mg taken twice a day (for a second-day total of 4 mg). On the third day, the dose rises to 3 mg taken twice a day (for a third-day total of 6 mg). Further dosage adjustments can be made at intervals of 1 week. Over the long term, typical daily doses range from 2 to 8 mg. When dosage adjustments are necessary, small increases/decreases of 1 to 2 mg are recommended.

Bipolar Mania (Short-term Treatment of Acute Episodes)

Adults: The recommended starting dose is 2 to 3 mg per day, given as a single dose. If needed, the doctor will adjust the dose by 1 mg at intervals of at least 24 hours. The effective dosage range is 1 to 6 mg a day.

Debilitated, elderly, liver or kidney disease, or high risk for low blood pressure: The usual starting dose is 0.5 milligram (or 0.5 milliliter of oral solution) twice a day. The doctor may switch you to a once-a-day dosing schedule after the first 2 to 3 days of treatment. You may also need your Risperdal dose adjusted if you're taking certain medications. Dosage increases in these patients should be in increments of no more than 0.5 mg twice a day. Increases to dosages above 1.5 mg twice a day should generally occur at intervals of at least 1 week.

Irritability Associated with Autistic Disorder

Children 5 years and older: The recommended starting dose is 0.25 mg once a day for patients less than 44 pounds and 0.5 mg once a day for patients 44 pounds and over. The patient should continue on the starting dose for a minimum of 4 days. The dose can then be increased to the recommended dose of 0.5 mg per day for patients less than 44 pounds and 1 mg per day for patients 44 pounds and over. This dose should be maintained for a minimum of 14 days. If sufficient clinical response is not achieved, dose increases of 0.25 mg per day for patients less than 44 pounds and 0.5 mg per day for patients 44 pounds and over can be made at no less than 2-week intervals.

No dosing information is available in children under 33 pounds. Children who experience persistent drowsiness may benefit from a once-daily dose given at bedtime.

The safety and effectiveness of Risperdal have not been studied in autistic children less than 5 years old.

How should I take Risperdal?

Do not take more or less of Risperdal than prescribed. Higher doses are more likely to cause unwanted side effects.

Risperdal may be taken with or without food. Risperdal oral solution comes with a calibrated pipette to use for measuring. The oral solution can be taken with water, coffee, orange juice, and low-fat milk, but not with cola drinks or tea.

Take Risperdal on a regular schedule to get the most benefit from it. Taking Risperdal at the same time each day will help you remember to take it.

Continue to take Risperdal even if you feel well. Do not miss any doses.

What should I avoid while taking Risperdal?

Risperdal may make you sleepy. Avoid driving or operating potentially dangerous machinery. Do not participate in any activities that require full alertness until you know how this medication affects you.

Do not drink alcohol with Risperdal.

Check with your doctor before taking medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Risperdal; it may add to their effects.

What are possible food and drug interactions associated with Risperdal?

If Risperdal is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Risperdal with the following: blood pressure medicines, bromocriptine mesylate, carbamazepine, clozapine, fluoxetine, levodopa, paroxetine, phenobarbital, phenytoin, quinidine, rifampin, and valproic acid.

You may experience drowsiness and other potentially serious effects if Risperdal is combined with alcohol and other drugs that slow the central nervous system.

What are the possible side effects of Risperdal?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: agitation, anxiety, constipation, dizziness, hallucinations, headache, indigestion, insomnia, rapid or irregular heartbeat, restlessness, runny nose, sleepiness, vomiting, weight change

Can I receive Risperdal if I am pregnant or breastfeeding?

The effects of Risperdal during pregnancy are unknown. Tell your doctor immediately if you are pregnant or plan to become pregnant. Because Risperdal is excreted in breast milk, do not use it if you are breastfeeding.

What should I do if I miss a dose of Risperdal?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at once.

How should I store Risperdal?

Store at room temperature. Protect the tablets from light and moisture; protect the oral solution from light and freezing.