If you have schizophrenia or schizoaffective disorder, your doctor might suggest Invega as a treatment option for you. Knowing the possible side effects of Invega can help you and your doctor decide if it’s the best treatment for your condition.

Invega is a prescription medication that’s used long term to treat the following mental health conditions:

  • schizophrenia in adults and some children
  • schizoaffective disorder in adults

The active ingredient in Invega is paliperidone. An active ingredient is what makes a drug work. The drug comes as an extended-release tablet that you swallow.

For more information about Invega, see this in-depth article.

Like other drugs, Invega can cause mild to serious side effects. Keep reading to learn more about the side effects of Invega.

Note: This article focuses on the side effects of Invega. It doesn’t include information about the side effects of Invega Sustenna, Invega Trinza, or Invega Hafyera.

Some people may experience mild to serious side effects during their Invega treatment. The side effects of Invega can vary depending on what condition the drug is being used to treat.

More common side effects in adults taking Invega for schizophrenia include:

More common side effects in children ages 12 to 17 years taking Invega for schizophrenia include:

More common side effects in people taking Invega for schizoaffective disorder include:

  • extrapyramidal symptoms
  • sleepiness
  • indigestion
  • constipation
  • weight gain*

* To learn more about this side effect, see the “Side effects explained” section below.

Keep reading to learn about other possible mild and serious side effects of Invega.

You may have mild side effects with Invega.

Examples of mild side effects that have been reported with Invega include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And don’t stop using Invega unless your doctor recommends it.

Invega may cause mild side effects other than the ones listed above. See the Invega prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Invega, visit MedWatch.

Some people may experience serious side effects from taking Invega. Higher doses of Invega or long-term treatment with the drug may increase the risk of serious side effects. But they can occur at low doses too.

Serious side effects that have been reported with Invega include:

* Invega has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.
‡ An allergic reaction is possible after using Invega. But it’s not clear whether this side effect occurred in studies.

If you develop serious side effects while taking Invega, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Invega can be used to treat schizophrenia in children ages 12 to 17 years.

Side effects can be different in children and adults taking Invega to treat this condition. Both children and adults can experience some of these side effects, but some may be more common in one group than the other.

In studies of Invega, blurred vision was a side effect reported in children but not adults.

Anxiety, tremors, dystonia (uncontrolled repetitive muscle contractions), and cogwheel rigidity (muscle stiffness during movements) were reported more often in children than adults.

Side effects affecting the reproductive organs and breasts also occurred in children. These include changes in menstruation and breast development.

For more information about side effects of Invega in children, talk with your doctor or pharmacist.

Get answers to some frequently asked questions about Invega’s side effects.

Can stopping Invega treatment cause withdrawal symptoms?

It’s not likely. In studies, withdrawal symptoms weren’t reported in people who stopped taking Invega. Even so, it’s not recommended that you stop taking Invega without talking with your doctor first.

Note that babies born to someone taking Invega during pregnancy may have withdrawal symptoms. Symptoms of withdrawal included:

For more information about taking Invega during pregnancy, see the “Warnings for Invega” section below.

If you have questions about withdrawal symptoms and Invega, ask your doctor or pharmacist.

How do the adverse effects of Invega compare with those of paliperidone?

The adverse effects of Invega may be different from those of paliperidone. “Adverse effects” is another term for side effects.

Invega contains the active ingredient paliperidone. An active ingredient is what makes a drug work. Paliperidone is also the generic form of Invega.

In addition to the active ingredient, a generic drug can contain different ingredients from those in the brand-name version. As a result, the side effects of a drug and its generic counterpart may differ.

For more information about side effects specific to paliperidone, talk with your doctor or pharmacist.

Does Invega cause any cardiovascular side effects?

Yes, Invega can cause cardiovascular side effects, which affect the heart and blood vessels. In studies of the drug, these side effects were more common in adults than in children.

Invega can cause a fast heartbeat and long QT syndrome, a change in heart rhythm that can be serious.

Another factor that can affect your heart and blood vessels is Invega’s effect on metabolism and weight. Invega can increase blood sugar and cholesterol levels. Having high levels of blood sugar or cholesterol may increase your risk of cardiovascular disease.

During treatment, your doctor may order blood tests regularly to check your blood sugar and cholesterol levels. They may also check your weight often.

If you have cardiovascular problems, tell your doctor. They’ll discuss whether Invega is a good treatment option for you.

Will taking a higher dose of Invega increase my risk of side effects?

It’s possible. In studies of Invega, more people had certain side effects when their dose was increased.

In addition, certain side effects may happen more often with higher doses of the drug. For example, brain or spinal cord side effects occurred more frequently at doses of 6 milligrams (mg) and higher. Extrapyramidal symptoms, a type of movement disorder, also occurred more often with higher doses of Invega.

If you have concerns about how your dosage of Invega affects your risk of side effects, talk with your doctor or pharmacist.

Learn more about some of the side effects Invega may cause.

Increased risk of death in older adults with dementia-related psychosis

Invega has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Antipsychotic drugs such as Invega may increase the risk of death in people ages 65 years and older who have dementia-related psychosis. Dementia involves declining memory, and psychosis refers to losing touch with reality.

Studies of Invega have not shown an increased risk of death in older adults with dementia-related psychosis. But Invega is an antipsychotic drug, and this side effect is known to occur with other drugs of this kind.

What might help

Due to an increased risk of death, doctors usually will not prescribe Invega to adults 65 years and older with dementia-related psychosis.

If you’re 65 years or older and have dementia-related psychosis, your doctor will likely discuss safer treatments with you.

Weight gain

Weight gain is a common side effect of antipsychotics such as Invega. Usually, weight gain occurs quickly when starting the drug. But this side effect can occur at any time throughout treatment. Children who take antipsychotics such as Invega experience weight gain more often than adults taking these drugs.

Invega may cause changes in your metabolism, which can also affect your weight.

What might help

While you’re taking Invega, your doctor will monitor your weight. They can also suggest ways to help you maintain a moderate weight.

If you experience weight gain that’s bothersome, do not stop taking Invega before talking with your doctor. They may recommend that you switch to another antipsychotic drug.

High prolactin levels

If you take Invega long term, your prolactin levels may increase and stay high. This side effect occurs with many antipsychotics, including Invega.

Prolactin is a hormone that controls breast development, breast milk production, and other processes.

In both males and females,* having high prolactin levels can affect fertility. Long-term effects of high prolactin levels include bone loss.

The effects of high prolactin may occur in both males and females, though some people may not have any symptoms. High prolactin symptoms in females include:

Males with high prolactin levels from Invega may have:

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

What might help

If you notice symptoms of high prolactin levels, talk with your doctor immediately. They may have you stop taking Invega and can recommend another drug for your condition.

Your prolactin levels should return to what they usually are once you stop taking the drug. But do not stop taking Invega before talking with your doctor.

Your doctor may prescribe medications to help manage symptoms of high prolactin levels if you need to take Invega long term.

If you’re considering pregnancy, talk with your doctor before taking Invega. They may recommend a different treatment to manage your condition, as this drug can affect fertility. Stopping treatment with the drug should reverse its effects on your fertility.

Neuroleptic malignant syndrome

Neuroleptic malignant syndrome is a serious side effect of antipsychotic medications such as Invega. It can cause severe symptoms and even be fatal. Symptoms of neuroleptic malignant syndrome include:

What might help

If you have symptoms of neuroleptic malignant syndrome, call 911 or your local emergency number immediately.

If you have neuroleptic malignant syndrome, your doctor will have you stop taking Invega. They’ll also closely monitor and treat your symptoms.

For more information about neuroleptic malignant syndrome and Invega, talk with your doctor or pharmacist.

Allergic reaction

Like most drugs, Invega can cause an allergic reaction in some people. But it’s not clear whether this side effect occurred in studies. People have reported allergic reactions to paliperidone, the active ingredient in Invega. An active ingredient is what makes a drug work.

Paliperidone is similar to risperidone, another antipsychotic drug that’s available under the brand name Risperdal. People who are allergic to risperidone can also be allergic to paliperidone. If you’ve had an allergic reaction to risperidone, Invega may not be the right drug for you.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

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. Examples include:

  • an over-the-counter antihistamine that you take by mouth, such as Benadryl (diphenhydramine)
  • a product that you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Invega, they’ll decide if you should continue using it.

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, they will have you switch to a different treatment.

Before starting treatment with Invega, tell your doctor about allergic reactions you may have had to any drugs in the past.

The active ingredient in Invega, paliperidone, is similar to another drug, risperidone. If you’ve had an allergic reaction to risperidone, Invega may not be the right medication for you.

Keeping track of side effects

During your Invega treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Invega affects you. They can then use this information to adjust your treatment plan if needed.

Invega comes with several warnings, including a boxed warning.

Boxed warning: Increased risk of death in older adults with dementia-related psychosis

Invega has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Antipsychotic drugs such as Invega may increase the risk of death in people ages 65 years and older who have dementia-related psychosis.

To learn more, see the “Side effects explained” section above.

Other warnings

Invega may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Invega. The list below includes factors to consider.

Seizures. Invega may cause seizures. If you have a history of seizures or take medications that increase your risk of seizures, Invega may not be right for you. If you’re 65 years or older, you may be more sensitive to drugs that increase your risk of having a seizure. Your doctor can discuss with you whether Invega is a safe treatment option.

Long QT syndrome. Invega can cause long QT syndrome. If you have a condition or take medication that affects how your heart beats, Invega may not be right for you. Your doctor may recommend a medication other than Invega for your condition.

Allergic reaction. If you’ve had an allergic reaction to Invega or any of its ingredients, your doctor will likely not prescribe Invega. If you’ve had an allergic reaction to the antipsychotic drug risperidone, Invega may also not be right for you. Tell your doctor about any drug allergies you have before taking Invega. And ask them what other medications are better options for you.

Diabetes and high blood sugar. Invega can cause changes in metabolism, such as increased blood sugar. If you are at risk of diabetes, taking Invega can increase your risk. And if you already have diabetes, Invega can worsen it. Your doctor will monitor your blood sugar often during Invega treatment.

Digestive tract disorders. In people with diseases that narrow the digestive tract, such as cystic fibrosis or small bowel inflammatory disease, Invega can cause digestive tract blockages. If you have a medical condition affecting your digestive tract, tell your doctor before starting Invega treatment. Your doctor can determine whether Invega is safe for you to take.

Kidney problems. If you have kidney problems, your doctor may need to prescribe lower doses of Invega. During treatment, your doctor may order frequent blood tests to check how well your kidneys are working. Before you start taking Invega, tell your doctor if you have any kidney problems.

Heart problems. Invega can cause a sudden drop in blood pressure that occurs when you stand up or change position. If you have a heart or blood vessel condition or other factors that can also cause your blood pressure to drop, tell your doctor. They’ll check your heart function and blood pressure often while you’re taking this drug.

Parkinson’s disease or Lewy body dementia. If you have Parkinson’s disease or Lewy body dementia, you may have a higher risk of certain Invega side effects. Examples include extrapyramidal symptoms and neuroleptic malignant syndrome. Before taking Invega, tell your doctor if you have either of these conditions. They’ll discuss with you whether the drug is safe for you to take.

Alcohol and Invega

You should not drink alcohol while taking Invega. Alcohol acts on the brain, so combining it with a medication that acts on the brain, such as Invega, may be unsafe.

Both alcohol and Invega can make you feel more sleepy than usual. So, drinking alcohol while taking Invega can increase the risk of sleepiness.

Talk with your doctor about consuming alcohol while taking Invega. They can recommend an amount of alcohol, if any, that’s safe for you to drink during Invega treatment.

Pregnancy and breastfeeding while taking Invega

It’s unknown whether it’s safe to take Invega during pregnancy or breastfeeding. Talk with your doctor about the risks and benefits of taking Invega while pregnant or breastfeeding. Below are some factors to consider.

Pregnancy

If you’re planning a pregnancy, it’s important to know that Invega may affect your fertility. The drug increases prolactin levels, which can make it more difficult for you to become pregnant. (For more information about high prolactin levels, see the “Side effects explained” section.) Before starting Invega treatment, talk with your doctor if you are considering pregnancy.

If you become pregnant during Invega treatment, tell your doctor immediately. Babies born to someone taking Invega during pregnancy may have withdrawal symptoms and extrapyramidal symptoms.

Extrapyramidal symptoms affect muscle movements. These may include uncontrolled muscle contractions and repetitive movements.

Withdrawal symptoms that a newborn may have include:

Note that untreated schizophrenia is a concern during pregnancy because it may lead to increased hospitalization, suicide, and preterm birth. If you’re pregnant, your doctor will help you find the safest treatment for your condition during this time.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Pregnancy registry

If you become pregnant during Invega treatment, consider enrolling in the drug’s pregnancy registry.

A pregnancy registry collects information from people taking certain drugs while pregnant, such as side effects they experienced. Reporting side effects of Invega during this time helps researchers better understand its risks related to pregnancy.

To enroll, contact the National Pregnancy Registry for Atypical Antipsychotics at 866-961-2388.

Breastfeeding

Paliperidone, the active ingredient in Invega, passes into breast milk. (An active ingredient is what makes a drug work.) But it’s unclear what the effects are in children who are breastfed by someone taking the drug.

The following side effects have been reported in infants exposed to risperidone through breastmilk. Risperidone is similar to paliperidone.

If you’re breastfeeding or considering breastfeeding while taking Invega, talk with your doctor. Your doctor will discuss with you the safety of breastfeeding your child during Invega treatment.

Invega can cause mild or serious side effects in some people. Ask your doctor or pharmacist about the side effects of this drug. This information can help you decide whether Invega is a good treatment option for you.

Here are a few questions to get you started:

Q:

What should I do if I have tardive dyskinesia from taking Invega?

Anonymous

A:

Tardive dyskinesia is a movement disorder that may occur in people taking antipsychotic medications such as Invega. It can be irreversible. People with tardive dyskinesia have uncontrolled and irregular movements of the face, arms, legs, or torso.

The chances of tardive dyskinesia occurring from taking Invega increase with long-term treatment. Some people may develop this side effect even if they’ve been taking the drug for a short time. It can also happen with smaller doses of the drug or after stopping treatment.

If you notice irregular and uncontrolled muscle movements while taking Invega, talk with your doctor immediately. But don’t stop taking Invega without speaking to your doctor. Your doctor will let you know if you should continue taking Invega or switch to another drug.

If you need long-term treatment, your doctor may prescribe Invega at a low dose and for the shortest possible time. In certain situations, some people may continue taking Invega despite having tardive dyskinesia.

For more information about the risk of tardive dyskinesia from taking Invega, talk with your doctor or pharmacist.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.