Invega (paliperidone) is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat the following mental health conditions:

Here are some fast facts about Invega:

  • Active ingredient: paliperidone
  • Drug class: atypical antipsychotic
  • Drug form: extended-release (ER) oral tablets*

Invega may be prescribed as a long-term treatment. As with other drugs, Invega can cause side effects (also called adverse effects). Read on to learn about potential common, mild, and serious side effects.

For a general overview of Invega, including details about its uses, see this article.

* Invega also comes as a solution for intramuscular injection. Injectable forms of the drug are available as Invega Hafyera, Invega Sustenna, and Invega Trinza. This article focuses on Invega tablets only. For information about the other forms of Invega, talk with your doctor or pharmacist.

Invega can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Invega in clinical trials. These side effects can vary depending on which condition the drug is being taken to treat.

More common side effects in people taking Invega for schizoaffective disorder include:

More common side effects in people taking Invega for schizophrenia include:

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Invega. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Invega’s prescribing information.

Mild side effects that have been reported with Invega include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Invega and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Invega may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Invega’s prescribing information.

If you develop serious side effects while taking Invega, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.
† For more information about this side effect, see “Side effect specifics” below.
‡ Invega has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.

Invega is approved to treat schizophrenia in children ages 12 years and older. (For information about the use of Invega in children, see this article.)

Many of Invega’s side effects in children are expected to be the same as those in adults. However, certain side effects may occur more commonly in children. These side effects can include:

  • cogwheel rigidity (painful muscle stiffness that typically affects the arms)
  • anxiety
  • weight gain

To learn more about your child’s risk of side effects with Invega, talk with their doctor.

Invega may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Does Invega cause long-term side effects? How long do its side effects last?

Potentially. Most of Invega’s side effects are expected to be temporary. They should last only a few days or weeks. And the drug’s side effects will likely go away shortly after you start or stop taking Invega.

However, in rare cases, Invega may cause certain long-term side effects. For example, there have been reports of neuroleptic malignant syndrome (NMS) after the use of antipsychotic drugs such as Invega. NMS is a rare, possibly life threatening reaction to antipsychotic drugs. If NMS isn’t treated right away, it can lead to long-term complications, including kidney failure.

The length of time side effects will last with Invega can vary from person to person.

If you’re concerned about long-term side effects of Invega, talk with your doctor.

Can Invega cause withdrawal side effects after I stop taking it?

Probably not. Withdrawal side effects weren’t reported in clinical trials of Invega. (These are side effects that may happen after you stop taking a drug your body has become dependent on.)

However, withdrawal side effects can happen in a child born to a person who took Invega during pregnancy. For more information, see the “Precautions for Invega” section below.

Can Invega cause problems with my heart?

It’s possible. Invega is known to cause metabolic changes in your body that can increase your risk of heart problems. These metabolic changes can include high blood sugar, high lipid (fat) level, and weight gain.

Invega is also known to cause long QT syndrome. This causes your heart to take a longer time to contract and relax than it typically takes. This can increase the risk of having an abnormal heart rhythm and can lead to sudden cardiac arrest. Because of this, it’s important not to take Invega with other medications that are also known to cause long QT syndrome. Examples of other medications include amiodarone (Pacerone), chlorpromazine (Thorazine), and moxifloxacin (Avelox).

If you have questions about your risk of heart problems with Invega, talk with your doctor.

Learn more about some of the side effects that Invega may cause. To find out how often side effects occurred in clinical trials, see Invega’s prescribing information.

Weight gain

Taking Invega may lead to weight gain. This was a common side effect in clinical trials of the drug.

Keep in mind that weight gain with Invega could happen because of changes in your metabolism. (Metabolism describes the chemical processes that happen in your body.) A slowed metabolism with Invega could lead to weight gain.

What you can do

Talk with your doctor about weight changes you may expect with Invega. They can suggest ways to reach or maintain a weight that’s healthy for you.

If you have extreme or bothersome weight gain with Invega, talk with your doctor. They may recommend a different treatment for your condition.

Sleepiness

Taking Invega may cause sleepiness. This was one of the most common side effects in clinical trials of the drug.

However, Invega can affect people differently. For example, in rare cases, Invega may cause insomnia instead of sleepiness. So it’s possible that Invega could either make you sleepy or keep you awake.

What you can do

Sleepiness with Invega could lead to problems with coordination, judgment, or thinking. Due to this risk, it’s recommended that you avoid driving until you know how Invega affects you. You’ll likely know how the drug will affect you after taking several doses.

Invega is typically taken once daily. If Invega causes sleepiness for you, consider taking your dose at bedtime. Talk with your doctor about when it’s best for you to take Invega.

Extrapyramidal symptoms

Extrapyramidal symptoms may occur with Invega treatment. These are uncontrollable muscle movements that can affect the whole body. Extrapyramidal symptoms were common in clinical trials of Invega.

Examples of extrapyramidal symptoms can include:

What you can do

If you have extrapyramidal symptoms while taking Invega, talk with your doctor. They may prescribe a different treatment option for your condition.

Risk of death in certain older adults

Taking Invega can increase the risk of death in older adults who have psychosis related to dementia. (Psychosis is a mental health condition that causes delusions, hallucinations, and other disorganized behaviors or thoughts.) In fact, Invega has a boxed warning about this side effect. This is a serious warning from the Food and Drug Administration (FDA).

This side effect wasn’t reported in clinical trials of Invega. However, antipsychotic medications such as Invega are known to increase the risk of death in adults ages 65 years and older who have psychosis related to dementia.

Some common causes of death in older adults who took antipsychotic medications in other clinical trials included heart problems such as heart failure and infections such as pneumonia.

Antipsychotic drugs can also increase the risk of a stroke in older adults. In some cases, a stroke may lead to death.

Symptoms of a stroke can include:

  • headache
  • confusion
  • trouble speaking, seeing, or walking
  • weakness on one side of your body, typically in your face, arm, or leg

What you can do

Due to this risk, doctors typically won’t prescribe Invega for older adults with psychosis related to dementia. If you’re an older adult, your doctor can recommend a different treatment option for your condition.

If you have symptoms of a stroke while taking Invega, immediately call 911 or your local emergency number.

Allergic reaction

As with most drugs, Invega can cause an allergic reaction in some people. However, this side effect was rare in clinical trials.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Invega. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Keep reading to learn more about warnings for Invega, which may affect whether you can safely take the medication.

Boxed warning: Risk of death in certain older adults

This drug has a boxed warning for increased risk of death in older adults who have psychosis related to dementia. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Invega. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Seizures. Before taking Invega, tell your doctor if you have a history of seizures. You may have a higher risk of seizures as a side effect of the drug. Your doctor can recommend whether it’s safe for you to take Invega.

Parkinson’s disease or Lewy body dementia. If you have Parkinson’s disease or Lewy body dementia, talk with your doctor before taking Invega. These conditions can increase your risk of side effects of Invega. Your doctor can advise if Invega is a safe treatment option for you.

Kidney problems. Before starting Invega treatment, tell your doctor about any kidney problems you have. They may give you a lower dosage of the drug than is typical.

Heart problems, including high blood pressure. If you have heart or blood pressure problems, talk with your doctor before taking Invega. Invega may cause orthostatic hypotension as a side effect. (This is a sudden drop in blood pressure when sitting up or standing.) You may have a higher risk of this side effect if you have heart or blood pressure problems. Your doctor will recommend if it’s safe for you to take Invega.

Problems with swallowing or digestion. Before taking Invega, tell your doctor if you have problems with swallowing or digestion. (Examples include short bowel syndrome and peritonitis.) This is because, in rare cases, Invega tablets may obstruct (block) digestion in people with these conditions. If you have problems with swallowing or digestion, your doctor can advise if Invega is the right treatment option for you.

Allergic reaction. If you’ve had an allergic reaction to Invega or any of its ingredients, your doctor will likely not prescribe Invega. Ask your doctor what other medications may be better options for you.

Alcohol with Invega

There isn’t a known interaction between alcohol and Invega.

However, your doctor may suggest that you avoid alcohol while taking Invega. This is because drinking alcohol with Invega may worsen certain side effects of the drug, including sleepiness.

If you drink alcohol, talk with your doctor. They can recommend whether there’s a safe amount of alcohol for you to drink while taking Invega.

Pregnancy and breastfeeding while taking Invega

Below is important information about taking Invega while pregnant or breastfeeding.

Pregnancy

It’s not known if Invega is safe to take during pregnancy. Clinical trials haven’t studied Invega in pregnant people.

However, antipsychotic drugs (such as Invega) may cause withdrawal side effects in a child born to a person who took Invega during pregnancy. Examples of these withdrawal side effects can include:

  • sleepiness
  • tremors
  • trouble breathing or eating
  • agitation (feeling bothered or restless)
  • decreased or increased muscle tone

If you’re pregnant or planning to become pregnant, talk with your doctor before taking Invega. They’ll advise you on the risks and benefits of taking Invega while pregnant.

If you do take Invega while pregnant, consider enrolling in a pregnancy registry. Pregnancy registries help collect important about the safety of medications in pregnancy.

To learn more about the National Pregnancy Registry for Atypical Antipsychotics, call 866-931-2388. You can also visit the registry website or talk with your doctor.

Breastfeeding

It isn’t known if Invega is safe to take while breastfeeding. The drug can pass into breast milk, which could cause side effects in a child who is breastfed.

If you breastfeed while taking Invega, it’s important to watch the child for sleepiness, jitteriness, and abnormal muscle movements. These could be symptoms of side effects from Invega.

If you’re breastfeeding or planning to breastfeed while taking Invega, talk with your doctor. They can discuss the risk and benefits of taking Invega while breastfeeding.

Invega may cause mild and serious side effects. If you have long lasting or bothersome side effects with Invega, talk with your doctor or pharmacist.

If you’d like to learn more about Invega, talk with your doctor or pharmacist. They can help answer any questions you have about side effects of taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Invega. For details about other aspects of Invega, refer to this article.
  • A look at schizophrenia. For details about your condition, see this list of articles related to schizophrenia. Our mental health hub may also be helpful.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.