Drug Index


Mechanism :

The mechanism of action of risperidone, as with other drugs used to treat schizophrenia, is unknown. However, it has been proposed that the drugs therapeutic activity in schizophrenia is mediated through a combination of dopamine Type 2 (D2) and serotonin Type 2 (5HT2) receptor antagonism.

Indication :

  • Schizophrenia
  • Aggressive behaviour
  • Attention deficit hyperactivity disorder (ADHD)
  • Tourette syndrome
  • Bipolar Mania
  • Autism

Contraindications :

Do not use in patients with known hypersensitivity to phenothiazines. Do not use in comatose states or in the presence of large amounts of central nervous system depressants like alcohol, barbiturates and narcotics.

Dosing :

Aggressive behaviour, Tourette syndrome:
Oral: Once daily or in 2 divided doses.
2-12 years: 0.5-2 mg.
12-18 years: 1-4 mg.
<13 years: Safety and efficacy not established.
>13 years: Initially 0.5 mg/day PO in the morning/evening; may be increased in increments of 0.5-1 mg/day to recommended dose of 2.5 mg/day (dose range: 0.5-6 mg/day). In case of persistent somnolence, divide daily dose 12 hourly.
Bipolar Mania:
Same dose as in schizophrenia but can be used in children >10 years OD age.
<5 years:
Safety and efficacy not established.
5-16 years, <20 kg:
Initially 0.25 mg/day PO; after ≥4 days, it may be increased to recommended dosage of 0.5 mg/day.
5-16 years, ≥20 kg:
Initially 0.5 mg/day PO, after ≥4 days, it may be increased to recommended dosage of 1 mg/day.
In case of insufficient response, adjust dose every 2 weeks as follows:
<20 kg:
Increments of 0.25 mg/day. Maximum: 1 mg/day.
>20 kg:
Increments of 0.5 mg/day. Maximum: 2.5 mg/day.

Adverse Effect :

Somnolence, agitation, anxiety, akathisia, agitation, rhinitis, Parkinsonism, dyspepsia, constipation, dry mouth, fatigue and weight increase.

Interaction :

Fluoxetine and Paroxetine: Inhibits CYP 2D6, have been shown to increase the plasma concentration of risperidone.
Clozapine: Chronic administration of clozapine with risperidone may decrease the clearance of risperidone.
Cimetidine and Ranitidine: Increase the bioavailability of risperidone, but only marginally increased the plasma concentration of the active antipsychotic fraction.
May antagonize the effects of levodopa and dopamine agonists.
Because of its potential for inducing hypotension, may enhance the hypotensive effects of other therapeutic agents with this potential.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution.
10-20Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution.
<10Initially 0.5 mg twice daily, increasing by 0.5 mg BD to 1–2 mg twice daily. Use with caution.

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDDialysed. Dose as in GFR<10 mL/ min
HDF/High fluxDialysed. Dose as in GFR<10 mL/ min
CAV/VVHDUnlikely to be dialysed. Dose as in GFR=10–20 mL/min

Hepatic Dose :

No specific paediatric dose adjustment is given, however recommendations are based on experience with adults. Due to hepatic metabolism, in hepatic impairment the mean plasma level of free fraction of risperidone may be increased by 35%.
Mild to moderate hepatic impairment: no dosage adjustment is recommended, but reduction of dose is reasonable.
Severe hepatic impairment: Daily dose should be halved. Titrate the dose weekly.
03/13/2024 06:34:58 Risperidone
Disclaimer: The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0