Invega interactions: Alcohol, medications, and other factors

Before you start treatment with Invega, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Invega interacts with supplements, herbs, or vitamins, see the “Invega and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Invega. Keep in mind that this table doesn’t include all drugs that may interact with Invega. Some of these interactions are described in detail just below in “Drug interactions in depth.”

In some cases, factors or conditions could prevent your doctor from prescribing Invega due to the risk of harm. These are known as contraindications. Invega contains the active drug paliperidone. Contraindications of Invega include:

Having had an allergic reaction to Invega or risperidone (Risperdal)

If you have had an allergic reaction to Invega, any of its ingredients, or a similar drug called risperidone (Risperdal, others) your doctor will likely not prescribe Invega. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Invega, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Invega.

Your doctor will likely recommend that you avoid or limit alcohol consumption while taking Invega.

This is because drinking alcohol while taking the drug may worsen some of Invega side effects. For example, you may experience:

• sleepiness
• dizziness
• nausea
• vomiting
• headache

If you consume alcohol during Invega treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Invega, talk with your doctor.

Here’s a closer look at certain drug interactions of Invega.

Blood pressure medications

Invega can interact with blood pressure medications, which are used to treat high blood pressure.

Interaction result: Taking Invega with blood pressure medications can cause orthostatic hypotension. This is a sudden drop in blood pressure that happens when you get up from sitting or lying down. It can cause dizziness, lightheadedness, and fainting.

Interaction explained: One of Invega’s side effects is orthostatic hypotension. If you take Invega with medications that lower your blood pressure, you are more likely to experience this side effect.

Examples of blood pressure medications: Here are some blood pressure medications that may interact with Invega:

• atenolol (Tenormin)
• doxazosin (Cardura)
• furosemide (Lasix)
• losartan (Cozaar)
• ramipril (Altace)

Steps you or your doctor may take: Your doctor will likely check your blood pressure before prescribing Invega with blood pressure medications.

If you take Invega with blood pressure medications, take extra care when getting up from a seated or lying position. You should move slowly to give your blood pressure time to adjust. For example, when getting out of bed, sit on the edge of your bed for a few minutes before standing up slowly. It’s helpful to hold onto something in case you feel dizzy.

If you feel dizzy or lightheaded, sit or lie down until this gets better. If you have frequent episodes of orthostatic hypotension, talk with your doctor. They may adjust your dosage of Invega or your blood pressure medications.

If you have questions about taking Invega with a blood pressure medication, talk with your doctor or pharmacist.

Certain antibiotics

Invega can interact with certain antibiotics, which are drugs used to treat bacterial infections.

Interaction result: Taking Invega with certain antibiotics can cause long QT syndrome (a type of abnormal heart rhythm). Long QT syndrome can cause serious and even life threatening irregular heartbeats.

Interaction explained: Invega can cause long QT syndrome. Some other medications, including certain antibiotics, can also cause this side effect. So taking these drugs together can raise your risk of this side effect.

You may have a higher risk of long QT syndrome if you have a slow or irregular heart rhythm, or an electrolyte imbalance, such as a low potassium or magnesium level.

Examples of antibiotic drugs: Here are some antibiotics that may interact with Invega:

• azithromycin (Zithromax)
• ciprofloxacin (Cipro)
• clarithromycin
• metronidazole (Flagyl)
• moxifloxacin (Avelox)

Steps you or your doctor may take: Your doctor will usually avoid prescribing antibiotics that can cause long QT syndrome with Invega. If you need treatment for a bacterial infection while you’re taking Invega, your doctor will likely prescribe an antibiotic that doesn’t have this effect.

If you take Invega with an antibiotic that can cause long QT syndrome, your doctor may order tests to check your heart rhythm and electrolyte levels. Tell your doctor right away if you have symptoms of long QT syndrome. These can include heart palpitations, dizziness, fainting, and noisy gasping when sleeping.

If you have questions about taking an antibiotic with Invega, talk with your doctor or pharmacist.

Benzodiazepines

Invega can interact with benzodiazepines, which are drugs used to treat anxiety and insomnia.

Interaction result: Taking Invega with a benzodiazepine can increase your risk of sleepiness and dizziness, which can raise your risk of falling. The combination can also slow your thinking and reaction times.

Interaction explained: Invega and benzodiazepines can both cause sleepiness, dizziness, and slowed thinking and reaction times. So taking these drugs together can raise your risk of these side effects.

Examples of benzodiazepine drugs: Here are some benzodiazepines that may interact with Invega:

• alprazolam (Xanax)
• diazepam (Valium)
• lorazepam (Ativan)
• temazepam (Restoril)

Steps you or your doctor may take: If your doctor prescribes Invega with a benzodiazepine, they’ll likely monitor you for combined side effects of these drugs. Tell your doctor if you have bothersome sleepiness or dizziness.

If you take Invega with a benzodiazepine, you should avoid driving and other activities that require you to be alert until you know how the combination affects you. Only drive if you are certain the drugs are not affecting your ability to do so safely.

If you have questions about taking Invega with a benzodiazepine, talk with your doctor or pharmacist.

Invega may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Invega.

Invega interactions with supplements

Before you start treatment with Invega, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Invega interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Invega. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort may speed up the activity of an enzyme in your body called cytochrome P450 3A4 (CYP3A4). It may also speed up the action of another protein in your body called P-glycoprotein (P-gp). CYP3A4 and P-gp help clear Invega from your system.

By speeding up these proteins, St. John’s wort can cause Invega to be cleared from your system more quickly. And this may lead to a low level of Invega in your system. If the level of Invega in your system is too low, the drug may not work to treat schizophrenia or schizoaffective disorder.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Invega and vitamins

There are no specific reports of vitamins interacting with Invega. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Invega.

Invega interactions with food

There were no reports of food interactions with Invega. If you’d like to learn more about eating certain foods during treatment with Invega, talk with your doctor.

Invega interactions with vaccines

There aren’t any known interactions between Invega and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Invega interactions with lab tests

Invega isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

INVEGA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Invega.

Using cannabis with Invega may raise your risk of sleepiness, dizziness, and slowed thinking and reaction times. Your doctor will likely recommend that you avoid using cannabis or cannabis products while taking Invega.

Before you start treatment with Invega, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Invega. Before you take this drug, be sure to talk with your doctor about your health history. Invega may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Invega include:

• Psychosis related to dementia: Invega has a boxed warning for an increased risk of death if Invega is used in older adults with psychosis related to dementia. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For more information, see the boxed warning at the start of this article.
• Low blood pressure: Invega can cause orthostatic hypotension (drop in blood pressure upon getting up). If you have low blood pressure, you may have a higher risk of this side effect. Talk with your doctor about whether Invega is right for you.
• Heart problems: Invega can cause long QT syndrome (a type of abnormal heart rhythm). You may have a higher risk of this side effect if you have certain heart problems, such as heart failure or a slow or irregular heartbeat. Invega can also cause orthostatic hypotension, which may be dangerous if you have a heart problem. If you have a heart problem, talk with your doctor about whether Invega is right for you.
• Electrolyte imbalance: If you have an electrolyte imbalance, such as a low potassium or magnesium level, you may have a raised risk of long QT syndrome with Invega. Your doctor may prescribe medication to correct the imbalance before you start Invega.
• Kidney problems: Your kidneys help clear Invega from your body. If you have kidney problems, Invega can build up in your body. This can raise your risk of Invega side effects. Due to this risk, your doctor may prescribe a dosage of Invega that’s lower than usual.
• Diabetes: Invega can increase your blood sugar levels. If you have diabetes, this could make your blood sugar harder to manage. Your doctor may monitor your blood sugar levels more closely during Invega treatment.
• Swallowing or digestive problems: If you have trouble swallowing, narrowing in your digestive system, or other digestive problems, Invega may not be right for you. This is because the drug comes as an extended-release tablet that must be swallowed whole. Extended-release means the drug is slowly released into your body over a long period of time. The tablet could block your intestine if you have certain digestive problems. If you have a swallowing or digestive problem, your doctor can advise if Invega is safe for you.
• Seizure disorders: Invega may raise your risk of seizures. If you have a disorder that causes seizures, such as epilepsy, talk with your doctor about whether Invega is right for you.
• Low levels of white blood cells: Invega can lower your white blood cell levels. If you already have low levels of white blood cells or you’ve had this problem with other medications, talk with your doctor about whether Invega is right for you. If your doctor prescribes Invega, they may check your white blood cells during your first few months of treatment.
• Parkinson’s disease or Lewy body dementia: If you have Parkinson’s disease or Lewy body dementia, you may have a raised risk of side effects with Invega. Talk with your doctor about whether this medication is right for you.
• Allergic reaction: If you’ve had an allergic reaction to Invega, any of its ingredients, or a similar drug called risperidone (Risperdal, others), your doctor will likely not prescribe Invega. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use Invega while breastfeeding. The drug may pass into breast milk, but there isn’t enough information to determine what effects Invega may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor about nursing considerations before using Invega. They can talk with you about treatment options, ways to feed your child, and side effects to watch for if you breastfeed while taking Invega.
• Pregnancy: There haven’t been enough clinical trials to determine whether Invega is safe to use while pregnant. However, taking Invega during the last 3 months of pregnancy may cause certain side effects in the baby after they are born. Examples of these side effects include withdrawal symptoms and movement problems. If you’re pregnant or planning to become pregnant, tell your doctor before starting Invega. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Invega. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Invega label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Invega doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Invega by taking it exactly as your doctor prescribes.

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.