Drug Interaction of INVEGA - QT Prolongation

Summary

• As stated in the WARNINGS AND PRECAUTIONS section of the INVEGA (paliperidone) Extended-Release Tablets Prescribing Information, paliperidone causes a modest increase in the corrected QT (QTc) interval.¹
• The use of paliperidone should be avoided in combination with other drugs that are known to prolong QTc including Class 1A (e.g. quinidine, procainamide) or Class III (e.g. amiodarone, sotalol) antiarrhythmic medications, antipsychotic medications (e.g. chlorpromazine, thioridazine), antibiotics (e.g. gatifloxacin, moxifloxacin), or any other class of medications known to prolong the QTc interval. Paliperidone should also be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias.¹
• Certain circumstances may increase the risk of the occurrence of torsade de pointes and/or sudden death in association with the use of drugs that prolong the QTc interval, including (1) bradycardia; (2) hypokalemia or hypomagnesemia; (3) concomitant use of other drugs that prolong the QTc interval; and (4) presence of congenital prolongation of the QT interval.¹
• The potential for QT-prolonging effects of other drugs should be considered before co-administration with INVEGA.

LITERATURE SEARCH

A literature search of MEDLINE^®, Embase^®, BIOSIS Previews^®, and Derwent Drug File (and/or other resources, including internal/external databases) pertaining to this topic was conducted on 14 July 2025.