subdermal implantbuprenorphine subdermal implant and paliperidone both increase sedation. Use Caution/Monitor.buprenorphine transdermalbuprenorphine transdermal and paliperidone both increase sedation. Use Caution/Monitor.buprenorphine, long-acting injectionpaliperidone increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.buprenorphine, long-acting injection and paliperidone both increase sedation. Use Caution/Monitor.butabarbitalbutabarbital and paliperidone both increase sedation. Use Caution/Monitor.butalbitalbutalbital and paliperidone both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and paliperidone both increase sedation. Use Caution/Monitor.caffeinepaliperidone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.captoprilpaliperidone, captopril. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.carbamazepinecarbamazepine will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Paliperidone dose may need to be increased when coadministered with strong inducers of both CYP3A4 and P-gpcarbinoxaminecarbinoxamine and paliperidone both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and paliperidone both increase sedation. Use Caution/Monitor.cenobamatecenobamate, paliperidone. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibpaliperidone increases levels of ceritinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.chloral hydratechloral hydrate and paliperidone both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and paliperidone both increase sedation. Use Caution/Monitor.chloroquinechloroquine increases toxicity of paliperidone by QTc interval. Use Caution/Monitor.chlorpheniraminechlorpheniramine and paliperidone both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.chlorpromazine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.chlorpromazine and paliperidone both increase sedation. Use Caution/Monitor.chlorpropamidepaliperidone, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.chlorzoxazonechlorzoxazone and paliperidone both increase sedation. Use Caution/Monitor.cinnarizinecinnarizine and paliperidone both increase sedation. Use Caution/Monitor.ciprofloxacinciprofloxacin and paliperidone both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.cisatracuriumcisatracurium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cisatracurium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.citaloprampaliperidone and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clarithromycinclarithromycin will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.clarithromycin and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.clemastineclemastine and paliperidone both increase sedation. Use Caution/Monitor.clobazampaliperidone, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineclomipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and clomipramine both increase sedation. Use Caution/Monitor.clonazepamclonazepam and paliperidone both increase sedation. Use Caution/Monitor.clonidineclonidine, paliperidone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateclorazepate and paliperidone both increase sedation. Use Caution/Monitor.clotrimazoleclotrimazole will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.clozapineclozapine and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.clozapine and paliperidone both increase sedation. Use Caution/Monitor.codeinecodeine and paliperidone both increase sedation. Use Caution/Monitor.crizotinibcrizotinib and paliperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyclizinecyclizine and paliperidone both increase sedation. Use Caution/Monitor.cyclizine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cyclizine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyclobenzaprinecyclobenzaprine and paliperidone both increase sedation. Use Caution/Monitor.cyclobenzaprine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.cyclobenzaprine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.cyproheptadinecyproheptadine and paliperidone both increase sedation. Use Caution/Monitor.dabigatranpaliperidone will increase the level or effect of dabigatran by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Atrial fibrillation: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <30 mL/min. DVT/PE treatment: Avoid coadministering dabigatran with P-gp inhibitors if CrCl <50 mL/mindantrolenedantrolene and paliperidone both increase sedation. Use Caution/Monitor.daridorexantpaliperidone and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacindarifenacin decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.darifenacin decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.dasatinibdasatinib and paliperidone both increase QTc interval. Use Caution/Monitor.desfluranedesflurane and paliperidone both increase sedation. Use Caution/Monitor.desipraminedesipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazinepaliperidone and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.paliperidone and deutetrabenazine both increase sedation. Use Caution/Monitor.paliperidone and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexchlorpheniraminedexchlorpheniramine and paliperidone both increase sedation. Use Caution/Monitor.dexfenfluraminepaliperidone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidinedexmedetomidine and paliperidone both increase sedation. Use Caution/Monitor.dexmethylphenidatepaliperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetaminepaliperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromethorphandextromethorphan, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dextromoramidedextromoramide and paliperidone both increase sedation. Use Caution/Monitor.diamorphinediamorphine and paliperidone both increase sedation. Use Caution/Monitor.diazepamdiazepam and paliperidone both increase sedation. Use Caution/Monitor.dicyclominedicyclomine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.dicyclomine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.diethylpropionpaliperidone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalindifelikefalin and paliperidone both increase sedation. Use Caution/Monitor.difenoxin hcldifenoxin hcl and paliperidone both increase sedation. Use Caution/Monitor.dihydroergotaminedihydroergotamine, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).dimenhydrinatedimenhydrinate and paliperidone both increase sedation. Use Caution/Monitor.diphenhydraminediphenhydramine and paliperidone both increase sedation. Use Caution/Monitor.diphenhydramine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.diphenhydramine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.diphenoxylate hcldiphenoxylate hcl and paliperidone both increase sedation. Use Caution/Monitor.dipipanonedipipanone and paliperidone both increase sedation. Use Caution/Monitor.dobutaminepaliperidone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dofetilidedofetilide and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.dolasetrondolasetron and paliperidone both increase QTc interval. Use Caution/Monitor.dopaminepaliperidone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopexaminepaliperidone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinpaliperidone and dosulepin both increase sedation. Use Caution/Monitor.doxepindoxepin and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and doxepin both increase sedation. Use Caution/Monitor.doxylaminedoxylamine and paliperidone both increase sedation. Use Caution/Monitor.dronedaronedronedarone will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.dronedarone and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.droperidoldroperidol and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.droperidol and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.droperidol and paliperidone both increase sedation. Use Caution/Monitor.elagolixelagolix will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.eletriptaneletriptan, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).eliglustateliglustat increases levels of paliperidone by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.ephedrinepaliperidone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineepinephrine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrine racemicepinephrine racemic and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ergoloid mesylatesergoloid mesylates, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).ergotamineergotamine, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).erythromycin baseerythromycin base will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.erythromycin base and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.erythromycin ethylsuccinateerythromycin ethylsuccinate will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.erythromycin ethylsuccinate and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.erythromycin lactobionateerythromycin lactobionate will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.erythromycin lactobionate and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.erythromycin stearateerythromycin stearate will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.erythromycin stearate and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.esketamine intranasalesketamine intranasal, paliperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.estazolamestazolam and paliperidone both increase sedation. Use Caution/Monitor.ethanolpaliperidone and ethanol both increase sedation. Use Caution/Monitor.exenatide injectable solutionpaliperidone, exenatide injectable solution. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.exenatide injectable suspensionpaliperidone, exenatide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.ezogabineezogabine, paliperidone. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.felodipinefelodipine will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.fenfluraminepaliperidone increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.paliperidone decreases effects of fenfluramine by pharmacodynamic antagonism. Use Caution/Monitor. Potent serotonin receptor antagonists may decrease fenfluramine efficacy. If coadministered, monitor appropriately.fentanylfentanyl, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics