Risperidone LAI
UZEDY
Pronunciation: ris-PER-i-doen
“Choose, Eddie!” / “Sub-Q-zedy”
Spooky mascot → antipsychotic
What it isLong-acting subcutaneous D2 and 5-HT2A antagonist; schizophrenia and bipolar I maintenance.
Why this oneRapid release from the first injection — no loading, no oral overlap — with the option to stretch to a two-month interval.
What limits itOnce injected, adverse effects cannot be quickly reversed. Prolactin elevation, EPS, weight gain, and injection-site nodules matter.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Schizophrenia | Adult | SC per oral-equivalent (2 mg oral → 50 mg monthly / 100 mg q2 months; up to 5 mg oral → 125 mg monthly / 250 mg q2 months) | once monthly or once every 2 months | |
| Bipolar I disorder, maintenance (monotherapy or adjunct to lithium/valproate) | Adult | SC per oral-equivalent (2 mg → 50 mg; 3 mg → 75 mg; 4 mg → 100 mg) once monthly | once monthly |
Renal Titrate with oral risperidone up to at least 2 mg daily before initiating (not studied in renal impairment)
Hepatic Titrate with oral risperidone up to at least 2 mg daily before initiating
Available as once-monthly or (schizophrenia) once-every-2-months subcutaneous dosing.
Instructions
- Establish tolerability with oral risperidone before initiating
- Subcutaneous injection in the abdomen or upper arm by a healthcare professional; do not give by any other route
- Neither a loading dose nor supplemental oral risperidone is recommended when switching from oral therapy
- When switching from a q2-week IM risperidone LAI, start UZEDY once monthly at least 5 weeks after the last IM dose
Available strengths
- inj 50, 75, 100, 125, 150, 200, 250 mg (monthly/q2mo)
Contraindications
- Known hypersensitivity to risperidone, paliperidone, or any components of UZEDY (anaphylactic reactions and angioedema reported).
Cautions
- Increased mortality in elderly patients with dementia-related psychosis (boxed; not approved for this use)
- Cerebrovascular adverse events, including stroke, in elderly dementia patients
- Neuroleptic malignant syndrome
- Tardive dyskinesia
- Metabolic changes (hyperglycemia/diabetes, dyslipidemia, weight gain)
- Hyperprolactinemia
- Orthostatic hypotension and syncope
- Falls
- Leukopenia/neutropenia; seizures; potential for cognitive/motor impairment; dysphagia; priapism; disruption of body temperature regulation
Adverse reactions
- parkinsonism
- akathisia
- dystonia
- tremor
- sedation
- dizziness
- anxiety
- blurred vision
- nausea
- vomiting
- dyspepsia
- injection site reactions
Pregnancy Neonates exposed to antipsychotics in the third trimester are at risk for extrapyramidal and/or withdrawal symptoms after delivery. Pregnancy registry available.
Lactation Risperidone and 9-hydroxyrisperidone present in human milk (relative infant dose 2.3–4.7% of maternal); reports of sedation, failure to thrive, jitteriness, and extrapyramidal symptoms in breastfed infants.
Cost
| Strength | #/mo | generic $/unit | brand $/unit | CostPlus | |
|---|---|---|---|---|---|
| 50 mg | inj | per unit | — | $9451.01/mL | not offered |
| 75 mg | inj | per unit | — | $9358.66/mL | not offered |
| 100 mg | inj | per unit | — | $9389.09/mL | not offered |
| 125 mg | inj | per unit | — | $9329.00/mL | not offered |
| 150 mg | inj | per unit | — | not offered | |
| 200 mg | inj | per unit | — | $9346.07/mL | not offered |
| 250 mg | inj | per unit | — | not offered |
Other forms: Risperidone (RISPERDAL) · Risperidone LAI (RISPERDAL CONSTA) · Risperidone LAI (PERSERIS) · Risperidone LAI (RYKINDO)
⚠ BOXED WARNING
- Increased mortality in elderly patients with dementia-related psychosis
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMetabolic effects, extrapyramidal symptoms/tardive dyskinesia and agent-specific QT or orthostatic risk.