Last update June 14, 2022

Paliperidone

Compatible

Safe substance and/or breastfeeding is the best option.

Atypical or second-generation antipsychotic indicated for the treatment of schizophrenia. It is the active metabolite of Risperidone. Oral (or intramuscular) administration once daily.

Risperidone and its active metabolite (paliperidone) are excreted in breastmilk in very small amounts.(Weggelaar 2011, Aichhorn 2005, Ilett 2004, Hill 2000).

No problems have been observed in infants whose mothers were taking Risperidone. (Viguera 2022, Aichhorn 2005, Ilett 2004, Ratnayake 2002)

The paliperiden plasma levels of these infants were undetectable or very low. (Aichhorn 2005, Ilett 2004)

May be a cause of hyperprolactinemia and galactorrhea. (Zhu 2021, Ray 2020, Skopek 2010)

Expert authors consider this medication possible with caution during breastfeeding. (Hale, Uguz 2021), although other alternatives, such as olanzapine or quetiapine, may be preferable. (Hale, LactMed, Klinger 2013)

Thera are two types of Paliperidone: oral and intramuscular (Depo). Depo type (Paliperidone Palmitate) requires intramuscular administration with a TMax (Time to peak plasma level) of 13 days and a T1/2 (Elimination half-life) of 25 to 50 days. That would be a reason to use during breastfeeding a non-depot (oral) medication like Risperidone or any suggested alternative, as a safer choice.


See below the information of these related products:

Alternatives

  • Olanzapine (Safe substance and/or breastfeeding is the best option.)
  • Quetiapine Fumarate (Safe substance and/or breastfeeding is the best option.)
  • Risperidone (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.
DONATE NOW

Other names

Paliperidone is also known as


Paliperidone in other languages or writings:

Groups

Paliperidone belongs to these groups or families:

Tradenames

Main tradenames from several countries containing Paliperidone in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 28 %
Molecular weight 427 daltons
Protein Binding 74 %
VD 7 l/Kg
pKa 13.74 -
Tmax 24; Depot: 312 hours
T½ 23; Depot: 312 hours
Relative Dose 1 - 4.7 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. Viguera AC, Vanderkruik R, Gaccione P, Caplin PS, Kobylski LA, Freeman MP, Cohen LS. Breastfeeding practices among women taking second-generation antipsychotics: findings from the National Pregnancy Registry for Atypical Antipsychotics. Arch Womens Ment Health. 2022 Apr;25(2):511-516. Consulted on April 7, 2022 Abstract
  4. Zhu Y, Zhang C, Siafis S, Zhuo K, Zhu D, Wu H, Liu D, Jiang K, Wang J, Leucht S, Li C. Prolactin levels influenced by antipsychotic drugs in schizophrenia: A systematic review and network meta-analysis. Schizophr Res. 2021 Nov;237:20-25. Abstract
  5. Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Abstract
  6. Ray I, Jones RM. A 30-year-old woman with galactorrhea. CMAJ. 2020 Apr 14;192(15):E397-E398. Abstract
  7. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013 Mar-Apr;10(3):308-17. Review. Abstract
  8. Weggelaar NM, Keijer WJ, Janssen PK. A case report of risperidone distribution and excretion into human milk: how to give good advice if you have not enough data available. J Clin Psychopharmacol. 2011 Feb;31(1):129-31. Abstract
  9. Skopek M, Manoj P. Hyperprolactinaemia during treatment with paliperidone. Australas Psychiatry. 2010 Jun;18(3):261-3. Abstract
  10. Aichhorn W, Stuppaeck C, Whitworth AB. Risperidone and breast-feeding. J Psychopharmacol. 2005 Mar;19(2):211-3. Abstract
  11. Ilett KF, Hackett LP, Kristensen JH, Vaddadi KS, Gardiner SJ, Begg EJ. Transfer of risperidone and 9-hydroxyrisperidone into human milk. Ann Pharmacother. 2004 Feb;38(2):273-6. Epub 2003 Dec 30. Abstract
  12. Ratnayake T, Libretto SE. No complications with risperidone treatment before and throughout pregnancy and during the nursing period. J Clin Psychiatry. 2002 Jan;63(1):76-7. No abstract available. Abstract
  13. Hill RC, McIvor RJ, Wojnar-Horton RE, Hackett LP, Ilett KF. Risperidone distribution and excretion into human milk: case report and estimated infant exposure during breast-feeding. J Clin Psychopharmacol. 2000 Apr;20(2):285-6. No abstract available. Abstract

Total visits

7,305

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2015 of United States of America

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM