Risperidone

Basic Instructions

· Start at 0.25mg/day – To be taken all at once at bedtime

· Take with or without food

· Increase by 0.25mg/day every four weeks (as tolerated) until 100% better to a maximum of 2mg/day

· Take this medicine only as directed by your doctor.

· Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.

· Common side effects tend to go away within 1-2 weeks after starting or after each dose increase

· Typical baseline screening lab work includes:

1. CBC and Differential (repeat annually)

2. Electrolytes (repeat annually)

3. BUN, Creatinine (repeat annually)

4. Liver enzymes, bilirubin (repeat at one month and every 3 to 6 months)

5. Fasting Glucose, HbA1c (repeat at one month and every 3 to 6 months)

6. Fasting Lipid Profile (repeat every 6 months)

7. TSH, prolactin (repeat every 6 months)

8. Urinalysis

9. Baseline ECG (repeat every 6 to 12 months or more frequently in persons with cardiovascular disease)

10. BMI and Waist circumference monthly

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Side effects and cautions

· aggressive behavior

· agitation

· anxiety

· changes in vision, including blurred vision

· difficulty concentrating

· difficulty speaking or swallowing

· inability to move the eyes

· increase in amount of urine

· loss of balance control

· mask-like face

· memory problems

· muscle spasms of the face, neck, and back

· problems with urination

· restlessness or need to keep moving (severe)

· shuffling walk

· skin rash or itching

· stiffness or weakness of the arms or legs

· tic-like or twitching movements

· trembling and shaking of the fingers and hands

· trouble sleeping

· twisting body movements

Taking your medication with food may reduce the risk of nausea. Also, as long as your medication doesn't keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime.

Read the package insert for additional side effects, and talk to your doctor or pharmacist if you have questions.

Safety concerns

This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while using this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

This medicine may increase the amount of sugar in your blood. Check with your doctor right away if you have increased thirst or increased urination. If you have diabetes, you may notice a change in the results of your urine or blood sugar tests. If you have any questions, check with your doctor.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

Risperidone can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

This medicine may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may make it more difficult for your body to cool itself down. Use care not to become overheated during exercise or hot weather since overheating may result in heat stroke. Also, use extra care not to become too cold while you are taking risperidone. If you become too cold, you may feel drowsy, confused, or clumsy.

This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while using this medicine.

On rare occasions, exposure to atypical antipsychotics may result in a potentially life-threatening reaction known as a neuroleptic malignant syndrome (NMS). It is a condition characterized by the following symptoms:

· Altered mental state

· High fever (over 100.4 F)

· Loss of bladder control

· Muscle rigidity

· Profuse sweating

· Respiratory problem

· Seizures

· Tachycardia (rapid heartbeat)

Once symptoms appear, they tend to progress rapidly and can persist for anywhere from eight hours to over a month.

NMS is considered a medical emergency and can lead to death if left untreated. Treatment would be administered in an intensive care unit, often with mechanical ventilation, intravenous fluids, and a variety of medications used to reduce muscle rigidity, agitation, and other symptoms.

Other rare but potentially life-threatening side effects may occur with risperidone use. Most are associated with either overuse or long-term use of the drug.

They include:

· Diabetic ketoacidosis (a dangerous build-up of acids in the blood)

· Pancreatitis (inflammation of the pancreas)

· Pulmonary embolism (the formation of a blood clot in the lungs)

· Stroke

· Sudden cardiac death

Stopping the medication:

Do not stop taking this drug abruptly as it may increase the intensity of withdrawal symptoms. Consult with your doctor before reducing or stopping this medication. You may reduce withdrawal symptoms by slowly tapering off of this medication. Possible symptoms of withdrawal include:

· Insomnia

· Irritability

· Delusions

· Hallucinations