Invega Hafyera (paliperidone palmitate) is a prescription drug that’s used to treat schizophrenia. It’s given as an injection into your muscle by your doctor or another healthcare professional.
Invega Hafyera basics
Invega Hafyera contains the active ingredient paliperidone palmitate. It belongs to a group of drugs called antipsychotics.
Invega Hafyera is a brand-name medication. A generic version of the drug isn’t currently available.
Invega Hafyera has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should be considered before receiving Invega Hafyera?” section.
Invega Hafyera is used to treat schizophrenia in adults.
Schizophrenia is a mental health condition that affects emotions, thoughts, and behaviors. It may cause symptoms such as difficulty with speech, flat affect (an inability to express emotions), and hallucinations.
Invega Hafyera is used after you’ve received another injection for schizophrenia that contains paliperidone palmitate (the same active ingredient found in Invega Hafyera). This injection may be Invega Sustenna or Invega Trinza.
Your doctor can help you decide whether switching to Invega Hafyera is right for you.
It’s not fully known how Invega Hafyera works to treat schizophrenia. It’s thought that the drug affects the levels of certain brain chemicals and that, as a result, it may help manage symptoms of schizophrenia.
Like most drugs, Invega Hafyera may cause mild to serious side effects. The lists below contain some of the more common side effects Invega Hafyera may cause, but they don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Invega Hafyera. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects that Invega Hafyera can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Invega Hafyera’s prescribing information.
Mild side effects of Invega Hafyera that have been reported include:
- mild infection, such as urinary tract infection (UTI) and upper respiratory infection
- injection site reactions, such as pain or swelling
- headache
- back pain
- diarrhea
- musculoskeletal pain
- insomnia or sleepiness
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Invega Hafyera can occur, but they aren’t common. If you have serious side effects from Invega Hafyera, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Invega Hafyera that have been reported include:
- seizures
- difficulty swallowing
- difficulty with thinking or muscle coordination, which may affect your ability to drive
- difficulty managing your body temperature
- priapism (long-lasting and painful erection)
- high prolactin levels
- low level of white blood cells
- orthostatic hypotension (a sudden drop in blood pressure when standing up)
- QT prolongation (a type of irregular heart rhythm)
- neuroleptic malignant syndrome (a rare reaction to medication that affects your nervous system)
- changes in mental health, which may include psychosis and anxiety
- changes in metabolism (chemical processes in your body), which may lead to:
- extrapyramidal symptoms (a group of movement disorders), which may include:
- parkinsonism (repetitive movements that typically affect your whole body)
- tardive dyskinesia (repetitive movements that typically affect your face)
- akathisia (restlessness)
- boxed warning: increased risk of death in older adults with dementia-related psychosis*
* For more information, see the “What should be considered before receiving Invega Hafyera?” section.
ALLERGIC REACTIONFor some people, Invega Hafyera can cause an allergic reaction. But it’s not clear whether this side effect occurred in the drug’s studies.
In general, symptoms of allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Invega Hafyera.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Invega Hafyera, they may have you switch to a different treatment.
Whether you have health insurance or not, cost may be a factor when you’re considering Invega Hafyera. What you’ll pay for Invega Hafyera may depend on several factors, including your treatment plan.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Janssen CarePath may also be available.
Learn more about saving on your prescriptions.
Your doctor will recommend the dosage of Invega Hafyera that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Form and strengths
Invega Hafyera comes as an extended-release liquid suspension. (“Extended-release” means the drug is slowly released into your body over a long period of time.) Your doctor or another healthcare professional will give the drug as an injection into your muscle.
Invega Hafyera is available in two strengths:
- 1,092 milligrams in 3.5 milliliters of solution (mg/mL)
- 1,560 mg/5 mL
Recommended dosages
Invega Hafyera is used for adults with schizophrenia. It’s given after you’ve received at least four monthly doses of Invega Sustenna or one dose of Invega Trinza, which is given every 3 months.
You’ll receive one injection of Invega Hafyera every 6 months. Your starting dose depends on whether you’re switching from Invega Sustenna or Invega Trinza. Your doctor will determine the dosage of Invega Hafyera that you’ll receive.
Note: Invega Sustenna and Invega Trinza are other injections for schizophrenia that contain paliperidone palmitate (the same active ingredient that’s in Invega Hafyera).
About Invega Hafyera’s administration
Your doctor will explain how Invega Hafyera will be given to you. They’ll also explain how much you’ll receive and how often.
Invega Hafyera is given as an injection into your buttock muscle. You’ll receive these injections at your doctor’s office or a clinic.
To learn more about how you’ll receive Invega Hafyera, talk with your doctor.
Questions about receiving Invega Hafyera
Below are some common questions about receiving Invega Hafyera.
- What if I miss a dose of Invega Hafyera? What you’ll do for a missed dose of Invega Hafyera depends on the amount of time since your last injection. If you miss an appointment to receive Invega Hafyera, call your doctor’s office. They’ll help you reschedule your appointment and recommend next steps.
- Will I need to receive Invega Hafyera long term? Invega Hafyera is typically used as a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely receive it long term.
- How long does Invega Hafyera take to work? Invega Hafyera starts working after your first injection. It’s used after you’ve already received Invega Sustenna or Invega Trinza. These drugs contain the same active ingredient as Invega Hafyera, so the drug should continue to work as Invega Sustenna or Invega Trinza did. If you have questions about what to expect from treatment with Invega Hafyera, talk with your doctor.
Below is important information you should consider before receiving Invega Hafyera.
Interactions
Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.
Invega Hafyera can interact with several other medications and certain supplements. But the drug is not known to interact with any foods.
Before starting Invega Hafyera treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you take. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
Drug interactions
Below is a list of medications that can interact with Invega Hafyera. This list does not contain all drugs that may interact with Invega Hafyera. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
| Drug group or drug name | Drug examples |
|---|---|
| certain antibiotics | • levofloxacin • azithromycin (Zithromax) |
| certain irregular heart rhythm drugs | • sotalol (Betapace, Sotylize, others) • amiodarone (Nexterone, Pacerone) |
| certain Parkinson’s drugs | • levodopa (Inbrija) • carbidopa/levodopa (Rytary, Sinemet, others) |
| certain seizure drugs | • phenytoin (Dilantin, Phenytek) • carbamazepine (Carbatrol, Tegretol, others) |
| benzodiazepines | • lorazepam (Ativan, Loreev XR) • alprazolam (Xanax) |
| blood pressure drugs | • metoprolol (Lopressor, Toprol XL, others) • amlodipine (Norliqva, Norvasc, others) |
| muscle relaxers | • metaxalone • carisoprodol (Soma) |
| certain other antipsychotic drugs | • chlorpromazine • thioridazine |
Invega Hafyera and alcohol
It may not be safe to consume alcohol during your Invega Hafyera treatment. This is because alcohol may worsen certain side effects of the drug. Examples include sleepiness, difficulty with thinking, or difficulty with muscle coordination.
For this reason, your doctor may advise you to avoid alcohol during your Invega Hafyera treatment.
Other interactions
Invega Hafyera may interact with St. John’s wort. This supplement is used to ease symptoms of depression and other conditions. Taking St. John’s wort with Invega Hafyera could make Invega Hafyera less effective.
Your doctor will likely recommend that you avoid taking this supplement during your Invega Hafyera treatment.
Pregnancy and breastfeeding
It’s not known whether Invega Hafyera is safe to receive during pregnancy or while breastfeeding.
Receiving Invega Hafyera during the last 3 months of pregnancy may increase the risk of side effects in infants after birth. Examples include difficulty breathing, difficulty feeding, and agitation.
If your doctor prescribes Invega Hafyera during pregnancy, they may recommend joining the drug’s pregnancy registry. This registry monitors the safety of Invega Hafyera during pregnancy. To learn more, visit the registry website or call 866-961-2388.
Boxed warning
Invega Hafyera has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.
Receiving Invega Hafyera may increase the risk of death in adults ages 65 years and older who have dementia-related psychosis. Dementia is a condition that affects thinking, memory, and communication. Psychosis is a mental health condition that may lead to a loss of touch with reality.
This risk was not reported in Invega Hafyera’s studies. But this is a known risk of antipsychotic drugs such as Invega Hafyera.
Treatment with antipsychotic drugs may also increase the risk of stroke in older adults with dementia-related psychosis. In some cases, a stroke can be fatal. Stroke symptoms may include difficulty with speech, vision changes, and weakness on one side of your body.
If you have symptoms of a stroke after receiving Invega Hafyera, call 911 or your local emergency number immediately.
Due to these risks, doctors typically will not prescribe Invega Hafyera for older adults with dementia-related psychosis. They can recommend other treatments for this condition.
Other warnings
Invega Hafyera can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Invega Hafyera is a good treatment option for you.
Talk with your doctor about your health history before you start treatment with Invega Hafyera. Be sure to tell them if any of the following factors apply to you:
- cerebrovascular disease (a group of conditions that affect blood flow to your brain)
- seizures
- heart or blood pressure problems
- low blood levels of potassium or magnesium
- high blood sugar or diabetes
- high levels of triglycerides or cholesterol
- Parkinson’s disease or Lewy body dementia
- kidney or liver problems
- previous allergic reaction to Invega Hafyera
- pregnancy
- breastfeeding
Find answers to some commonly asked questions about Invega Hafyera.
Can Invega Hafyera be given with a COVID-19 vaccine?
Yes, it’s generally safe to receive Invega Hafyera and a COVID-19 vaccine together. There are no reported interactions or safety concerns with receiving both at the same time.
For more information about Invega Hafyera and vaccines, talk with your doctor or pharmacist.
Can I switch to Invega Hafyera from other forms of Invega?
Yes, if your doctor recommends it.
Invega Hafyera is typically used after you’ve received Invega Sustenna or Invega Trinza. These are other injections for schizophrenia that contain the same active ingredient (paliperidone palmitate) as Invega Hafyera.
However, your doctor likely won’t switch you directly from an oral form of Invega to Invega Hafyera. You’ll first switch to a different injectable form.
If you have questions about the different forms of Invega, talk with your doctor. They can help you determine which option is right for you.
Other drugs are available that can treat schizophrenia. If you’d like to explore an alternative to Invega Hafyera, talk with your doctor. They can tell you about other medications that might work well for you.
The following drugs are similar to Invega Hafyera:
- other forms of paliperidone (Erzofri, Invega, others)
- risperidone (Risperdal Consta, Rykindo, others)
- aripiprazole (Abilify Maintena, Aristada, others)
- olanzapine (Zyprexa)
Disclaimer: Healthline 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.