Palimax ER 1.5

Indications

Palimax ER is an extended-release tablet used for the treatment of:

• Schizophrenia, including both acute treatment and prevention of recurrence
• Schizoaffective disorder, as a monotherapy or in combination with antidepressants or mood stabilizers

Note: Always use under the supervision of a registered healthcare professional.

Pharmacology

Paliperidone, a benzisoxazole derivative, is a psychotropic agent and the active metabolite of Risperidone. It acts as a dopamine Type 2 (D2) antagonist, with predominant serotonin Type 2 (5-HT2A) antagonist activity. It also targets α1 and α2 adrenergic receptors as well as H1 histaminergic receptors, potentially explaining some of its effects. Notably, it does not interact with cholinergic muscarinic or β1/β2 adrenergic receptors.

Dosage

Schizophrenia

• Adults: Initial dose of 6 mg/day, with a recommended range of 3-12 mg/day. Maximum dose: 12 mg/day
• Adolescents (<51kg): Initial dose of 3 mg/day, with a range of 3-6 mg/day. Maximum dose: 6 mg/day
• Adolescents (≥51kg): Initial dose of 3 mg/day, with a range of 3-12 mg/day. Maximum dose: 12 mg/day

Schizoaffective Disorder

• Adults: Initial dose of 6 mg/day, with a recommended range of 3-12 mg/day. Maximum dose: 12 mg/day

Always follow the dosage guidance as provided by a registered healthcare professional.

Administration

Palimax ER can be taken with or without food, but should always be swallowed whole with liquids. Do not chew, divide, or crush the tablet.

Drug Interactions

• Use with caution when combined with other centrally acting drugs or alcohol
• May antagonize the effects of Levodopa and other dopamine agonists
• When co-administered with strong CYP3A4/P-glycoprotein (P-gp) inducers like carbamazepine, dose adjustments may be needed
• Co-administration with divalproex sodium can increase Cmax and AUC by approximately 50%, requiring possible dose adjustments

Side Effects

Common side effects include:

• Tachycardia
• Akathisia
• Somnolence
• Tremor
• Dystonia
• Cogwheel rigidity
• Anxiety
• Weight increase
• Dyspepsia
• Constipation
• Nasopharyngitis

Pregnancy & Lactation

Palimax ER is classified as Pregnancy Category C. There is no adequate research in pregnant women, so it should only be used if the potential benefits outweigh the risks to the fetus. It is excreted in breast milk, so caution should be exercised when breastfeeding.

Precautions & Warnings

Palimax ER should be used with caution in patients with:

• Cardiovascular diseases
• QT prolongation
• Neuroleptic malignant syndrome
• Tardive dyskinesia
• Hyperglycemia, dyslipidemia, obesity
• Hyperprolactinemia, leukopenia, neutropenia, agranulocytosis
• Seizures
• Potential cognitive and motor impairment

Use in Special Populations

• Pediatrics: Not established for the treatment of schizophrenia in patients under 12 years, and for schizoaffective disorder in those under 18 years of age.
• Overdose: There is no specific antidote for an overdose. General supportive care should be employed in the case of overdose.

Therapeutic Class

Atypical neuroleptic drugs

Storage Conditions

Store Palimax ER in a cool, dry place, away from light. Keep it out of the reach of children.