A longer-acting formulation of risperidone has recently been added to the Pharmaceutical Benefits Scheme (PBS). Risvan® is a modified-release injection that is indicated for the treatment of schizophrenia in adults for whom oral risperidone has been effective and well-tolerated.
Risvan® is intended for monthly administration. Risvan® should be initiated around 24 hours after the last oral risperidone dose or two weeks after the last fortnightly injection. Risvan® is available in two strengths: 75mg and 100mg. To maintain a similar steady-state exposure, patients previously receiving 3mg oral risperidone daily or the 37.5mg fortnightly injection can be initiated on Risvan® 75mg. The 100mg Risvan® injection is recommended for patients who have previously taken 4mg orally per day or the 50mg fortnightly injection. Supplemental oral risperidone doses are not recommended during therapy with Risvan®.
Risvan® is supplied as a pre-filled powder syringe that must be reconstituted immediately before use with the accompanying pre-filled diluent syringe. The product information should be referred to for detailed reconstitution instructions. Incorrect preparation can lead to a higher initial peak of risperidone (and potentially signs of overdose) followed by lower plasma levels (and poorer efficacy) over the rest of the dosing period.
A comparison of oral and injectable risperidone products can be seen in Table 1.
Table 1. Overview of risperidone preparations
Oral | Risperdal Consta® | Risvan® | |
Type | Immediate release |
Modified release |
|
Strengths | 0.5mg, 1mg, 2mg, 3mg, 4mg tabs
1mg/ml liquid |
25mg
37.5mg 50mg |
75mg
100mg |
Administration | Oral |
Intramuscular (gluteal or deltoid) |
|
Usual dosing frequency | Daily to twice daily | Every two weeks | Every 28 days |
Approved indications | Schizophrenia (+ related psychoses)
Behaviour disorders Acute mania (bipolar 1) Behavioural symptoms of dementia (≤ 12 weeks) |
Schizophrenia (+ related psychoses)
Bipolar 1 disorder |
Schizophrenia |
References:
- Risperdal Consta® (Risperidone) Australian approved product information. Macquarie Park: Janssen-Cilag. Approved April 2023.
- Risperdal® (Risperidone) Australian approved product information. Macquarie Park: Janssen-Cilag. Approved August 2021.
- Risvan® (Risperidone) Australian approved product information. Burnley: Servier Laboratories. Approved July 2024.
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