| Schizophrenia
Invega Sustenna vs Aristada & Aristada Initio
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Invega Sustenna vs Aristada with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsAristada has a higher rate of injection site reactions vs Invega Sustenna based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Aristada but not Invega Sustenna, including UnitedHealthcare
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Category
Invega Sustenna
Aristada
At A Glance
IM injection
Every 4 weeks
D2/5HT2A antagonist
IM injection
Monthly to every 2 months
Dopamine D2 partial agonist
Indications
- Schizophrenia
- Schizoaffective Disorder
- Schizophrenia
Dosing
Schizophrenia Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; recommended monthly maintenance 117 mg (range 39-234 mg) in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Schizoaffective Disorder Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; monthly maintenance 78-234 mg adjusted for tolerability and/or efficacy in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Mild renal impairment (creatinine clearance >=50 mL/min) Initiation: 156 mg deltoid on Day 1, 117 mg deltoid on Day 8; monthly maintenance 39-156 mg; maximum monthly dose 156 mg.
Schizophrenia 441 mg, 662 mg, or 882 mg monthly, 882 mg every 6 weeks, or 1064 mg every 2 months via IM injection into the deltoid (441 mg only) or gluteal muscle; initiate with ARISTADA INITIO 675 mg plus a single 30 mg oral aripiprazole dose, or supplement with 21 consecutive days of oral aripiprazole concomitant with the first injection.
Contraindications
- Known hypersensitivity to paliperidone, risperidone, or any excipient in the INVEGA SUSTENNA formulation
- Known hypersensitivity reaction to aripiprazole (reactions have ranged from pruritus/urticaria to anaphylaxis)
Adverse Reactions
Most common (>=5%) Injection site reactions, somnolence/sedation, dizziness, akathisia, extrapyramidal disorder
Serious Increased mortality in elderly patients with dementia-related psychosis, cerebrovascular adverse reactions, neuroleptic malignant syndrome, QT prolongation, tardive dyskinesia, metabolic changes, orthostatic hypotension and syncope, leukopenia/neutropenia/agranulocytosis, hyperprolactinemia, seizures
Postmarketing Angioedema, anaphylactic reaction, catatonia, ileus, somnambulism, swollen tongue, thrombotic thrombocytopenic purpura, urinary incontinence, urinary retention
Most common (>=5%) Akathisia
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, seizures, orthostatic hypotension
Postmarketing Anaphylactic reaction, angioedema, pathological gambling, drug reaction with eosinophilia and systemic symptoms (DRESS), oculogyric crisis, fecal incontinence
Pharmacology
Paliperidone palmitate is hydrolyzed to paliperidone, the major active metabolite of risperidone; its therapeutic effect in schizophrenia may be mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism, with additional antagonist activity at histamine H1 and alpha-1/alpha-2 adrenergic receptors.
Aripiprazole lauroxil is a prodrug of aripiprazole that, following IM injection, undergoes enzyme-mediated hydrolysis to yield aripiprazole, which exerts its effects through partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at serotonin 5-HT2A receptors.
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Most Common Insurance
Anthem BCBS
Invega Sustenna
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (11/12)
Aristada
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (4/12) · Qty limit (11/12)
UnitedHealthcare
Invega Sustenna
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Aristada
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Invega Sustenna
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Aristada
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/fillfill
Aristada Co-pay Savings ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.