Palip XR
Palip XR (Paliperidone 3/6/9 mg XR) — OROS extended-release atypical for schizophrenia and schizoaffective disorder. once-daily, renally cleared — unaffected by CYP-altering drugs.
✓ Medicinsk gennemgået af Morgan Ellis — Apoteksforsker · 8 års erfaring · Sidst gennemgået: maj 2026
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Palip XR (Paliperidone 3 / 6 / 9 mg XR, extended-release) is an atypical antipsychotic for schizophrenia and schizoaffective disorder. Active metabolite of risperidone, dosed once daily via OROS osmotic-pump tablet. Largely renally cleared — dose-adjust in renal impairment.
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Hvorfor bestille fra MedsBase
Palip XR at MedsBase is supplied directly from a WHO-GMP certified manufacturer in plain, discreet packaging. Every order is covered by our Reshipment Assurance Policy — 20-hverdages leveringsvindue eller vi gensender uden ekstra omkostninger — og kvalificerer sig til vores kundeloyalitetsprogram. Verdensomspændende forsendelse er tilgængelig til de fleste destinationer.
What Palip XR is and how it works
Palip XR is a paliperidone extended-release tablet supplied by Sun Pharma. Available strengths: 3 / 6 / 9 mg XR. Paliperidone is the major active metabolite of risperidone (9-hydroxyrisperidone). Pharmacologically very similar — strong D2 and 5-HT2A antagonism, prolactin elevation, EPS at higher doses — but with two practical differences: (1) the OROS extended-release formulation produces a flat 24-hour plasma curve (smoother tolerability than risperidone IR), and (2) paliperidone is largely renally cleared (75%) rather than hepatically metabolised, so it is unaffected by CYP-altering drugs but requires dose adjustment in renal impairment.
Indikationer og dosering
| Indikation | Startdosis | Måldosis | Maksimal dosis |
|---|---|---|---|
| Schizophrenia (adult) | 6 mg OD morning | 3–12 mg OD | 12 mg |
| Schizophrenia (adolescent ≥ 12 y, ≥ 51 kg) | 3 mg OD | 3–12 mg OD | 12 mg |
| Schizoaffective disorder | 6 mg OD | 3–12 mg OD | 12 mg |
| Renal impairment (CrCl 50–80) | 3 mg OD | up to 6 mg | 6 mg |
| Renal impairment (CrCl 10–50) | 1.5 mg OD | up to 3 mg | 3 mg |
| Nedsat nyrefunktion (CrCl < 10) | not recommended | — | — |
Take whole — do not crush, chew, or split. The OROS osmotic pump shell will pass intact in stool — this is normal and expected.
Vigtige sikkerhedsovervejelser
All atypical antipsychotics carry an FDA black-box warning for increased mortality (mostly cardiovascular and infectious) when used to treat behavioural disturbance in older adults with dementia. Atypicals are not approved for dementia-related psychosis or agitation. Use in this population is off-label, last-resort, time-limited, and requires explicit risk-benefit conversation.
As an active risperidone metabolite, paliperidone produces the same prolactin elevation: amenorrhoea, galactorrhoea, sexual dysfunction, and long-term bone-density loss. Monitor as for risperidone; switch to a prolactin-sparing atypical (aripiprazole, quetiapine) if symptomatic.
Above 6 mg/day, EPS and akathisia rise in frequency. Dose-dependent.
The non-deformable OROS tablet is theoretically problematic in pre-existing severe GI narrowing (severe Crohn’s strictures, oesophageal stricture, prior bowel resection). Rare clinically, but worth noting.
Almindelige bivirkninger
- Hyperprolactinaemia and downstream effects — same profile as risperidone.
- Akathisia, EPS — dose-dependent.
- Somnolence, sedation — moderate.
- Vægtøgning — moderate (2–4 kg / 6 months).
- Orthostatic hypotension — common at initiation.
- QT-forlængelse — modest dose-dependent.
Lægemiddelinteraktioner
- Less affected by CYP inhibitors/inducers than risperidone (75% renal clearance).
- QT-forlængende lægemidler — additive risk.
- Antihypertensives, CNS depressants, anticholinergics — additive class effects.
- Strong CYP3A4 + P-gp inducers (carbamazepine, rifampicin, phenytoin) — meaningful reduction in paliperidone levels.
Graviditet, amning, pædiatrisk
Pregnancy: limited data; late-pregnancy exposure can produce neonatal EPS. Breastfeeding: passes into milk; usually requires monitoring. Paediatric: licensed from 12 (schizophrenia, ≥ 51 kg).
Opbevaring
Opbevares ved 15–30 °C i original emballage.
Ofte stillede spørgsmål
How is Palip XR different from risperidone?
Paliperidone is risperidone’s major active metabolite — they are pharmacologically similar. The two practical differences: (1) once-daily OROS dosing produces flatter plasma levels and smoother tolerability than BID risperidone IR; (2) paliperidone is largely renally cleared, so it is unaffected by CYP-interacting drugs but requires renal dose adjustment.
Why does the empty tablet shell appear in my stool?
The OROS (osmotic-controlled-release oral delivery system) tablet is a non-deformable shell containing the drug in a semipermeable membrane. Water enters slowly, pushing drug out through a laser-drilled pore. The empty shell passes intact — this is the design, not a problem. Do not stop the medication because of this.
Is the once-daily LAI different from the oral tablet?
Paliperidone palmitate (Invega Sustenna monthly, Trinza three-monthly, Hafyera six-monthly) is the depot injectable LAI. The oral tablet is for initiation, titration, and patients who prefer oral therapy. The LAI is a separate product with separate dosing.
Will Palip XR affect my fertility?
Paliperidone’s prolactin elevation can suppress fertility in both men and women. Most effects are reversible on discontinuation. If pregnancy is desired, discuss switching to aripiprazole or quetiapine.
How long until Palip XR works?
Acute effect on agitation within days. Antipsychotic effect on positive symptoms 1–2 weeks; full effect at 4–6 weeks.
Kan jeg dele eller knuse tabletten?
No — never. The OROS osmotic-pump formulation depends on the tablet remaining intact. Crushing or splitting destroys the controlled release and produces an immediate-release dose-dump.
What about driving on Palip XR?
Sedation is moderate and concentrated in the first 1–2 weeks. Most patients on stable doses drive normally. Avoid alcohol when driving.
Will Palip XR make me gain weight?
Yes — typically 2–4 kg over 6 months. Less than olanzapine or quetiapine; similar to risperidone.
Can Palip XR be stopped abruptly?
Taper over 2–4 weeks. Relapse risk in schizophrenia and schizoaffective disorder is the main concern.
Why is Palip XR better in liver disease than risperidone?
Paliperidone is largely renally cleared (75%) rather than hepatically metabolised — so it is less affected by hepatic impairment and by CYP-interacting drugs. The trade-off: it requires renal dose adjustment, where risperidone does not.
Andre Mental Sundhedsmedicin
- Aripicon (Aripiprazole — D2 partial agonist)
- Olanzap (Olanzapine — robust antipsychotic)
- Risdone (Risperidone)
- Seroquit (Quetiapine — bipolar depression)
- Atlura (Lurasidone — metabolically clean)
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Rangeret efter seneste MedsBase ordrevolumen — hvad andre kunder i denne kategori vælger.
| Styrke | 3 mg |
|---|---|
| Antal | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
Palip XR
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