Risperdal

Risperdal is a prescription-only medicine approved for use in patients with:

• Schizophrenia (a serious mental disorder)
• Bipolar disorder (manic-depressive illness)
• Autistic disorder, who have symptoms of irritability

DO NOT USE risperidone in older adults who have dementia-associated behavioral disorders.

Though not mentioned on the product labels, your doctor based on his/her experience may use risperidone in:

• Tourette syndrome (inherited neurological disorder affecting motor and vocal functions)

It is available as:

• Disintegrating tablet
• Tablet
• Solution

If you are about to start using Risperdal, speak with your doctor about what you need to know.

Consider the following factors before using this medicine:

Allergies: Inform your doctor about the allergies you have, such as to this medication, other medications, or to foods, dyes, or preservatives.

Pediatric: Safety and efficacy of this medicine in children have not been well documented.

Geriatric: Use only for the prescribed conditions after adjusting the doses. DO NOT USE in older adults who have dementia-associated behavioral disorders.

Pregnancy: It falls under pregnancy category C for all trimesters, meaning that due to lack of sufficient studies, it’s not clear if this medication is safe for use in pregnancy.

Breastfeeding: Use only after assessing the risks and benefits.

Drug Interactions: Taking two medicines together can be harmful due to possible interactions. Here is a list of the medicines which in general are not recommended to be used with this medicine.

Inform your doctor if you are using any of these medicines:

• Amifampridine
• Bepridil
• Cisapride
• Dronedarone
• Levomethadyl
• Mesoridazine
• Metoclopramide
• Pimozide
• Piperaquine
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Though usually not recommended, your doctor may decide, after adjusting dose or frequency of one or both medicines, to use this medicine with any of the following medicines:

• Acecainide
• Ajmaline
• Amiodarone
• Amisulpride
• Amitriptyline
• Anagrelide
• Aprindine
• Aripiprazole
• Arsenic Trioxide
• Asenapine
• Astemizole
• Azimilide
• Bupropion
• Buserelin
• Chloral Hydrate
• Chloroquine
• Chlorpromazine
• Citalopram
• Clarithromycin
• Crizotinib
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Dibenzepin
• Disopyramide
• Dofetilide
• Domperidone
• Donepezil
• Doxepin
• Encainide
• Enflurane
• Erythromycin
• Escitalopram
• Flecainide
• Fluconazole
• Fluoxetine
• Foscarnet
• Gemifloxacin
• Ginkgo Biloba
• Gonadorelin
• Goserelin
• Halofantrine
• Haloperidol
• Histrelin
• Hydrocodone
• Hydromorphone
• Hydroquinidine
• Hydroxychloroquine
• Ibutilide
• Itraconazole
• Ivabradine
• Ketoconazole
• Leuprolide
• Linezolid
• Lithium
• Lorcainide
• Metronidazole
• Milnacipran
• Nafarelin
• Octreotide
• Ondansetron
• Panobinostat
• Pasireotide
• Pentamidine
• Probucol
• Procainamide
• Prochlorperazine
• Propafenone
• Quetiapine
• Sematilide
• Sertindole
• Sertraline
• Sevoflurane
• Simvastatin
• Sotalol
• Spiramycin
• Sulfamethoxazole
• Sultopride
• Tacrolimus
• Tedisamil
• Tetrabenazine
• Tramadol
• Trimethoprim
• Vandetanib
• Vinflunine
• Zotepine

Rarely and only when absolutely needed, this medicine may be used with the following medicines even if using them together may put you at risk of certain side effects.

In such cases, you may have to take the adjusted dose or change the frequency of intake.

• Carbamazepine
• Cimetidine
• Fosphenytoin
• Lamotrigine
• Midodrine
• Phenobarbital
• Phenytoin
• Ranitidine
• Ritonavir
• Valproic Acid

Other Interactions: Taking your medicine together with certain foods or items such as alcohol or tobacco may cause undesirable interactions. Talk to your doctor to know if using this medicine with food, alcohol, or tobacco is safe.

Inform your doctor if you have any other medical conditions, including:

• Alzheimer's or Parkinson's disease
• Dehydration
• History of abnormal heart attack, heart rhythm, heart failure, neuroleptic malignant syndrome (NMS), or stroke.
• Heart or blood vessel conditions
• Hypotension (low blood pressure)
• Hypovolemia (low blood volume)
• Swallowing problems
• Blood or bone marrow problems
• Bone disorders such as osteodystrophy
• Certain breast cancer
• Diabetes
• Hyperprolactinemia (high blood prolactin level)
• Seizures in the past: Use cautiously.
• Kidney or liver impairment: Use cautiously.
• Phenylketonuria (PKU): Aspartame present in the orally disintegrating tablet can worsen PKU.

To use Risperdal properly, you must follow all instructions given by your doctor and do not take more, less, more frequently or for a longer duration than recommended.

Using Oral Liquid:

• Measure the exact dose using the calibrated device supplied with the container, and take all the dose with or without water.
• Clean the measuring device and place it in its case.
• Properly close the medicine container after each use.

Using Oral Disintegrating Tablet:

• Properly remove the tablet from the package.
• Keep the tablet immediately on your tongue and allow it to melt there.
• Do not break or chew the tablet.

Dosing: For best results, follow your doctor to know what amount of medicine you should take in a single dose.

The doses of a medicine can differ according to the conditions for which it is being prescribed, your age and your overall health status. Consult your doctor if you have anything to ask.

The doses of solution, tablets, or orally disintegrating tablets for:

Bipolar disorder

• Adults: Starting with 2 to 3 milligrams (mg) once a day, your doses may be modified if needed. The maximum daily dose is 6 mg.
• Older adults: Starting with 0.5 mg twice a day, your doses may be modified if needed. The maximum daily dose is 6 mg.
• Children 10 to 17 years: Starting with 0.5 mg once a day, your doses may be modified if needed. The maximum daily dose is 6 mg.
• Children below 10 years: Your doctor will decide the use and dose.

Irritability in autistic patients

• Children 5 to 16 years, weight 20 kg or more: Starting with 0.5 mg once a day, your doses may be modified if needed.
• Children 5 to 16 years of age, weight less than 20 kg: Starting with 0.25 mg once a day, your doses may be modified if needed.
• Children below 5 years: Your doctor will decide the use and dose.

Schizophrenia

• Adults: Starting with 2 mg once a day, your doses may be modified if needed. The maximum daily is 16 mg.
• Older adults: Starting with 0.5 mg twice a day, your doses may be modified if needed. The maximum daily dose is 6 mg.
• Children 13 to 17 years: Starting with 0.5 mg once a day, your doses may be modified if needed. The maximum daily dose is 6 mg.
• Children below 13 years: Your doctor will decide the use and dose.

Missed Dose: Take your missed dose once you remember but avoid it if it’s time to take your next dose, and follow your normal dosing schedule. Avoid taking double doses to make up for the missed dose. 

Storage:

• Store in a closed container at room temperature.
• Keep away from heat, moisture, and direct light.
• Do not freeze.
• Keep away from children.
• Discard any unused or expired medicines.

Before using Risperdal, there are some precautions you must take. Your progress should be regularly monitored to determine if you are responding to the treatment or dose adjustment is required.

Do not discontinue risperidone abruptly. Your doctor can recommend tapering the doses instead.

Consult your doctor before taking if you need to have alcohol or other CNS depressants such as allergy and cold medicines, sleeping pills, narcotic pain relievers, or anesthetics while you are taking risperidone.

Call your doctor IMMEDIATELY if you:

• Develop symptoms of a life-threatening condition called neuroleptic malignant syndromes (NMS), such as seizures, trouble breathing, incontinence, rapid heartbeat, stiff muscles, excessive tiredness and abnormally high or low blood pressure.
• Develop symptoms of a serious condition, tardive dyskinesia, such as rapid and involuntary movements of the limbs, tongue, and lips.
• Suspect you have acquired an infection or have symptoms of infection, such as fever or chills, cough, pain in lower back or side, or urinary problems.
• Experience worsening of depression, or have thoughts of harming self or others.
• Experience increased thirst or urination, indicating elevated blood sugar levels. If you have been diagnosed with diabetes, get your blood sugar checked on a regular basis.

Inform the concerned doctor about your intake of risperidone before any medical tests. You may feel dizzy when changing your position suddenly. Take care not to faint.

Take special care while driving, using machines or doing any activities that require alertness. It can affect the way your body cools down during exposure to high temperatures. Contact your doctor if you feel too hot. Measure your weight regularly to determine weight changes.

Call your doctor if you develop signs of elevated prolactin blood levels, such as swollen and tender breasts, inappropriate breast milk production, absent or irregular menstrual cycles, decreased sex drive or performance, and impotence.

Consult your doctor before taking any prescription or nonprescription medicines and herbal or vitamin supplements.

Make sure you meet with your doctor in using Risperdal to avoid unwanted potential side effects.

Consult your doctor immediately if you have any of the following side effects:

More common: 

• Balance problems
• Blurry vision
• Breathing or swallowing difficulties
• Cough
• Difficulty with eye movement
• Fever
• Involuntary movements of the limbs and tongue
• Masked face
• Muscle soreness
• Pain in chest
• Pain while urinating
• Restlessness
• Speech problems
• Swollen face, arms, hands, feet, legs or glands
• Tremors
• Weird facial expressions

Less common:

• Pain in back or chest
• Speech or vision difficulties
• Sudden weakness or numbness in the face or limbs

Rare: 

• Abnormal bleeding or bruising
• Confusion
• Coordination problems
• Dizziness and drowsiness
• Decreased hunger
• Headache
• Increased thirst
• Increased heart rate
• Involuntary lip or tongue movements
• Muscle cramps
• Overexcitement
• Painful, persistent erection
• Pale skin
• Puffed cheeks
• Rapid breathing
• Tremors

Mild and non-serious side effects usually go away on their own without requiring medical intervention. You may also ask your doctor to learn more about how you may prevent or reduce the side effects.

Talk to your doctor if the side effects persist or worry you, including:

More common:

• Burning in the chest
• Constipation
• Cough
• Diarrhea
• Dryness in mouth
• Excessive tiredness
• Extended sleep
• Frequent dreaming
• Headache
• Increased nasal discharge or congestion
• Nausea
• Throat pain
• Weight gain

Less common:

• Abdominal pain
• Absent or irregular menstruation
• Allergic reaction at the injection site
• Breast enlargement or soreness
• Breathing or speech problems
• Chest discomfort
• Chills
• Decreased sex drive or erectile dysfunction
• Inappropriate breast milk production
• Increased salivation
• Pain in the joint or around the eyes and cheekbones
• Skin color changes
• Uncontrolled body movements
• Vomiting

The side effects of the medicine are not limited to the ones listed above. Call your doctor immediately if you experience any side effects that are uncommon or worry you. To report side effects to the FDA, contact at 1-800-FDA-1088.