How Safe Is Risperidone for Children?

Risperidone orally disintegrating tablets, 1. Used to treat the symptoms of acute and chronic schizophrenia and various other psychotic states. 2. For patients who are effective in the acute phase treatment, in the maintenance phase treatment, Vistone can continue to exert its clinical effect. 3. Manic episodes that can be used to treat bipolar disorder, which are manifested as high mood, exaggeration or irritability, reduced sleep requirements, faster speech, distracted or poor judgment (including disorders or excessive behavior). ^[1] .

Drug Name: Risperidone orally disintegrating tablets
Hanyu Pinyin: Li Pei Tong Kou Beng Pian

Drug type: Occupational injury medical insurance
Use classification: Second-generation antipsychotics

Ingredients for risperidone orally disintegrating tablets

The main component of this product is risperidone, and its chemical name is: 3- [2- [4- (6-fluoro-1,2-benzoisoxazol-3-yl) -1-piperidinyl] Group] -6,7,8,9, -tetrahydro-2-methyl-4H-pyrido [1,2-] pyrimidin-4-one Molecular formula: C ₂₃ H ₂₇ FN ₄ O ₂
Molecular weight: 410.49.

Indications of risperidone orally disintegrating tablets

1. For the treatment of symptoms of acute and chronic schizophrenia and various other psychotic states. 2. For patients who are effective in the acute phase treatment, in the maintenance phase treatment, Vistone can continue to exert its clinical effect. 3. Manic episodes that can be used to treat bipolar disorder, which are manifested as high mood, exaggeration or irritability, reduced sleep requirements, faster speech, distracted or poor judgment (including disorders or excessive behavior).

Risperidone orally disintegrating tablets

1. For people with schizophrenia who switch from using other antipsychotics to this product: the initial use of antipsychotics should be gradually discontinued. If the patient was using a long-acting antipsychotic, risperidone can be used instead of the next course of treatment. Whether used anti-Parkinson's syndrome drugs need to be continued should be re-evaluated regularly. 1 time per day or 2 times per day. The initial measurement is 1 mg, and the dose is gradually increased to 2 to 4 mg per day within a week or so, and the amount can be gradually increased to 4 to 6 mg per day within the second week. Thereafter, this dose can be maintained unchanged or further adjusted according to personal circumstances. In general, the optimal dose is 2 to 6 mg per day. The daily dose generally does not exceed 10 mg. 2. The recommended starting dose for the treatment of bipolar disorder in manic episodes is 1 to 2 mg per day, and the dose can be adjusted according to individual needs. The increase of the dose is 1 to 2 mg per day, and the increase of the dose is performed at least every other day or more days. The ideal dose for most patients is 2 to 6 mg daily. During all symptomatic treatments, the need for continued use of this product should be continuously evaluated. 3. Patients with impaired liver and kidney function The ability of patients with impaired renal function to clear antipsychotic drugs is lower than that of healthy adults; the concentration of free risperidone in the plasma of patients with impaired liver function has increased. Regardless of the indication, the initial and maintenance doses for patients with impaired renal function or for patients with impaired liver function should be halved, and dose adjustments should be slowed. Such patients should be cautious when using this product.

Adverse reactions of risperidone orally disintegrating tablets

1. Common adverse reactions related to taking this product are: insomnia, anxiety, headache, dizziness, dry mouth.
2. Rare side effects are: drowsiness, fatigue, decreased concentration, constipation, indigestion, nausea, vomiting, abdominal pain, blurred vision, abnormal penile erection, difficulty erectile, weak ejaculation, indifferent sex, incontinence, rhinitis , Rashes, and other allergic reactions.
3. May cause extrapyramidal symptoms, such as: muscle tension, tremor, stiffness, salivation, bradykinesia, inability to sit still, and acute dystonia. Elimination can be achieved by lowering the dose or administering drugs against Parkinson's syndrome.
4. Occasionally (orthostatic) hypotension, (reflex) tachycardia, or high blood pressure.
5. There will be weight gain, edema and elevated liver enzymes
6. Occasionally, water poisoning may be caused by the patient's thirst or imbalance of antidiuretic hormone secretion (SIADH).
7. It will cause an increase in plasma prolactin concentration, and its related symptoms are: galactorrhea, male and female breasts, menstrual disorders, and amenorrhea.
8. Occasional tardive dyskinesias, malignant symptom groups, temperature disorders, and seizures.
9. A case report of a slight decrease in neutrophil and / or platelet counts.

Risperidone orally disintegrating tablets contraindications

Those who are allergic to this product are prohibited.

Precautions for risperidone orally disintegrating tablets

1. People with cardiovascular diseases (such as heart failure, myocardial infarction, conduction abnormalities, dehydration, blood loss, and cerebrovascular disease) should be used with caution, starting with small doses and gradually increasing the dose.
2. Because this product has -receptor blocking activity, (orthostatic) hypotension will occur at the beginning of the medication and when the dosage is too fast. At this time, the reduction should be considered.
3. Similar to other drugs with dopamine receptor antagonist properties, causing tardive dyskinesia, which is characterized by rhythmic involuntary movements, mainly found in the tongue and face. If you have tardive dyskinesia, stop taking all antipsychotics.
4. It has been reported that taking classic antipsychotic drugs will cause malignant symptoms, which are characterized by high fever, muscle stiffness, tremors, altered consciousness, and elevated levels of creatine phosphokinase. All antipsychotics, including this product, should be discontinued at this time.
5. Patients with Parkinson's syndrome should use this product with caution, because in theory the drug will cause the disease to worsen.
6. Classic antipsychotic drugs will lower the seizure threshold, so patients with epilepsy should still use this product with caution.
7. Patients taking this product should avoid eating too much to avoid getting fat.
8. In view of the effect of this product on the central nervous system, caution should be taken when taking it at the same time as other drugs acting on the central nervous system.
9. This product has impact on activities that require alertness. Therefore, patients are advised not to drive a car or operate a machine until they understand the patient's sensitivity to the drug.

Risperidone orally disintegrating tablets for pregnant and lactating women

1. It is not clear whether this product is safe for pregnant women. 2. Animal experiments show that risperidone has no direct toxicity and no teratogenic effect on reproduction. Nevertheless, pregnant women should not take this product unless the benefits are significantly greater than the possible risks. 3. It is unclear whether this product will be excreted through human milk. Animal experiments show that risperidone and 9-hydroxy-risperidone are excreted through animal milk. Therefore, women taking this product should not breastfeed.

Risperidone orally disintegrating tablets for children

1. For schizophrenia, there is currently insufficient clinical experience for children under 15 years of age. 2. There is currently insufficient clinical experience for children under 5 years of age with respect to conduct disorders and other behavioral disorders. 3. For manic episodes of bipolar disorder, there is currently insufficient clinical experience for children and adolescents under 18 years of age.

Risperidone orally disintegrating tablets for elderly

The elderly are well tolerated by risperidone.

Risperidone orally disintegrating tablets drug interactions

1. The risk of combining this product with other drugs has not been systematically evaluated. In view of the effect of this product on the central nervous system, caution should be taken when combining it with other drugs acting on the central system.
2. This product can antagonize the effects of levodopa and other dopamine agonists.
3. Carbamazepine and other liver enzyme inducers will reduce the plasma concentration of the active ingredient of this product. Once the use of carbamazepine or other liver enzyme inducers is discontinued, the dose of this product should be re-determined, and the amount can be reduced if necessary .
4. Topiramate slightly reduces the bioavailability of risperidone and has no effect on the antipsychotic active ingredients in this product. Therefore, this interaction is essentially of no clinical significance.
5. Phenothiazine antipsychotics, tricyclic antidepressants and some -blockers will increase the blood concentration of this product, but will not increase the blood concentration of its antipsychotic active ingredients. Amitriptyline does not affect the pharmacokinetic parameters of risperidone or its antipsychotic active ingredient. Cimetidine and ranitidine can increase the bioavailability of risperidone, but have little effect on its antipsychotic active ingredients. Fluoxetine and paroxetine (CYP D6 inhibitors) can increase the blood concentration of this product, but have less effect on the required concentration of antipsychotic active ingredients. When starting or stopping co-administration with fluoxetine or paroxetine, the doctor should re-determine the dose of this product. Erythromycin (CYP 3A4 inhibitor) does not affect the pharmacokinetic parameters of risperidone or its antipsychotic active ingredient.

Pharmacology and toxicology of risperidone orally disintegrating tablets

1. This product is a benzoisoxazole derivative, which is a new generation of antipsychotics. Its active ingredient, risperidone, is a selective monoaminergic antagonist with unique properties. It has a high affinity for serotoninergic 5-HT2 receptors and dopamine D2 receptors. Risperidone can also bind to the 1-adrenergic receptor, and with a lower affinity to the H1-histaminergic receptor and the 2-adrenergic receptor.
2. Risperidone does not bind to cholinergic receptors. Risperidone is a powerful D2 antagonist that can improve the positive symptoms of schizophrenia, but it has less motor function inhibition and tonic syncope than classic antipsychotics. The balance of serotonin and dopamine antagonistic effects on the central system can reduce the possibility of extrapyramidal side effects and extend its therapeutic effect to the negative and emotional symptoms of schizophrenia.

Pharmacokinetics of risperidone orally disintegrating tablets

1. Risperidone can be completely absorbed after oral administration, and reaches the peak plasma concentration within 1-2 hours, and its absorption is not affected by food. In the body, risperidone is partially metabolized to 9-hydroxy-risperidone, which has similar pharmacological effects to risperidone.
2. This product can be quickly distributed in the body. The plasma protein binding rate of risperidone is 88%, and the plasma protein binding rate of 9-hydroxy-risperidone is 77%. The elimination half-life of the drug is about 3 hours, and the elimination half-life of the antipsychotic active ingredient is 24 hours. Most patients reach a steady state of risperidone within 1 day and a steady state of 9-hydroxy-risperidone after 4-5 days. After one week of treatment, 70% of the drug was excreted in urine, 14% of the drug was excreted in feces, and 35-45% of the excretion was risperidone and 9-hydroxy-risperidone, and the rest was inactive Thing. Elderly patients and patients with renal insufficiency have higher plasma concentrations of risperidone and slower clearance.