risperidone, Risperdal; Risperdal Consta (cont.)

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Medical and Pharmacy Editor:

Serotonin reuptake inhibitors such as paroxetine (Paxil), Sertraline (Zoloft), and fluoxetine (Prozac) when taken with risperidone causes the metabolism (breakdown) of risperidone by the liver to be inhibited, which in turn causes elevated blood levels of risperidone and may increase the risk of adverse reactions from risperidone.

Antifungal drugs such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral) when taken with risperidone also cause the metabolism (breakdown) of risperidone by the liver to be inhibited, which in turn causes elevated blood levels and may increase the risk of adverse reactions from risperidone.

PREGNANCY: There are no adequate studies of risperidone in pregnant women. Some unwanted effects have been reported in animal studies. Risperidone can be used in pregnancy if the physician feels that the benefits outweigh the potential but unknown risks.

NURSING MOTHERS: Risperidone is excreted in human breast milk. Women receiving risperidone should not breastfeed.

SIDE EFFECTS: The most commonly-noted side effects associated with risperidone are insomnia, headache, dizziness, hyperactivity, drowsiness, abdominal pain, fatigue, fever, and nausea. Extrapyramidal effects (sudden, often jerky, involuntary motions of the head, neck, arms, body, or eyes) also occur. Risperidone may cause a condition called orthostatic hypotension during the early phase of treatment (the first week or two). Patients who develop orthostatic hypotension have a drop in their blood pressure when they rise from a lying position and may become dizzy or even lose consciousness.

Studies involving risperidone suggest an increased risk of hyperglycemia-related adverse reactions as seen in people with diabetes. Although there is no clear link between risperidone and diabetes, patients should be tested during treatment for elevated blood sugars. Additionally, persons with risk factors for diabetes, including obesity or a family history of diabetes, should have their fasting levels of blood sugar tested before starting treatment and periodically throughout treatment to detect the onset of diabetes. Any patient developing symptoms that suggest diabetes during treatment should be tested for diabetes.

Reference: FDA Prescribing Information


Last Editorial Review: 2/21/2014



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