and paliperidone both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.mefloquinemefloquine increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.methyldopapaliperidone decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.metoclopramide intranasalpaliperidone, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.paliperidone increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome.mirtazapinemirtazapine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.mobocertinibmobocertinib and paliperidone both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.olanzapineolanzapine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.olopatadine intranasalpaliperidone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. ondansetronpaliperidone and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.oxaliplatinoxaliplatin will increase the level or effect of paliperidone by Other (see comment). Avoid or Use Alternate Drug. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.oxaliplatin and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.panobinostatpaliperidone and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.pentamidinepaliperidone and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pimavanserinpaliperidone and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug. Coadministration may increase the risk of QT prolongation and cardiac arrhythmia.pimozidepaliperidone and pimozide both increase QTc interval. Avoid or Use Alternate Drug.pitolisantpaliperidone and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pomalidomidepaliperidone increases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.pramipexolepaliperidone decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.primaquineprimaquine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.procainamidepaliperidone and procainamide both increase QTc interval. Avoid or Use Alternate Drug.quinidinequinidine will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.quinidine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.ribociclibribociclib and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.riociguatpaliperidone will increase the level or effect of riociguat by decreasing metabolism. Avoid or Use Alternate Drug. Coadministration of riociguat (substrate of CYP isoenzymes 1A1, 2C8, 3A, 2J2) with strong CYP inhibitors may require a decreased initial dose of 0.5 mg PO TID; monitor for signs of hypotension and reduce dose if neededromidepsinpaliperidone and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.ropinirolepaliperidone decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.safinamidepaliperidone decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.saquinavirsaquinavir, paliperidone. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Increased risk of QT prolongation and cardiac arrhythmias.selinexorselinexor, paliperidone. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sertralinesertraline and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.sevofluranesevoflurane and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.siponimodsiponimod and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.sodium oxybatepaliperidone, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.solifenacinsolifenacin and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.sotalolpaliperidone and sotalol both increase QTc interval. Avoid or Use Alternate Drug.sotorasibsotorasib will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If use is unavoidable, refer to the prescribing information of the P-gp substrate for dosage modifications.sufentanil SLsufentanil SL, paliperidone. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.sunitinibsunitinib and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.tacrolimustacrolimus and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.tepotinibtepotinib will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If concomitant use unavoidable, reduce the P-gp substrate dosage if recommended in its approved product labeling.tetrabenazinetetrabenazine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.triptorelintriptorelin increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.umeclidinium bromide/vilanterol inhaledpaliperidone increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vandetanibpaliperidone, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.vemurafenibvemurafenib and paliperidone both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.venetoclaxpaliperidone will increase the level or effect of venetoclax by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If a P-gp inhibitor must be used, reduce the venetoclax dose by at least 50%. Monitor more closely for signs of venetoclax toxicities.vilanterol/fluticasone furoate inhaledpaliperidone increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.vorinostatvorinostat and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (388)abobotulinumtoxinAabobotulinumtoxinA increases effects of paliperidone by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.acarbosepaliperidone, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.aclidiniumaclidinium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.acrivastineacrivastine and paliperidone both increase sedation. Use Caution/Monitor.albiglutidepaliperidone, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.albuterolpaliperidone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.albuterol and paliperidone both increase QTc interval. Use Caution/Monitor.alfentanilalfentanil and paliperidone both increase sedation. Use Caution/Monitor.alfuzosinpaliperidone and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan, 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).alprazolamalprazolam and paliperidone both increase sedation. Use Caution/Monitor.amifostineamifostine, paliperidone. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor. Due to its alpha adrenergic antagonism, atypical antipsychotic agents has the potential to enhance the effect of certain antihypertensive agents. Monitor blood pressure and adjust dose accordingly.amiodaroneamiodarone will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.amitriptylineamitriptyline and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and amitriptyline both increase sedation. Use Caution/Monitor.amobarbitalamobarbital and paliperidone both increase sedation. Use Caution/Monitor.amoxapinepaliperidone and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.amoxapine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and amoxapine both increase sedation. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/sedative combos decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.anticholinergic/sedative combos decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.apomorphinepaliperidone and apomorphine both increase sedation. Use Caution/Monitor.arformoterolpaliperidone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.arformoterol and paliperidone both increase QTc interval. Use Caution/Monitor.aripiprazolearipiprazole and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.aripiprazole and paliperidone both increase sedation. Use Caution/Monitor.armodafinilpaliperidone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.artemether/lumefantrineartemether/lumefantrine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.asenapineasenapine and paliperidone both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and paliperidone both increase sedation. Use Caution/Monitor.atorvastatinatorvastatin will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.atracuriumatracurium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atracurium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropineatropine decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atropine decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IMpaliperidone increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.atropine IV/IM decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.atropine IV/IM decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.avapritinibavapritinib and paliperidone both increase sedation. Use Caution/Monitor.azelastineazelastine and paliperidone both increase sedation. Use Caution/Monitor.baclofenbaclofen and paliperidone both increase sedation. Use Caution/Monitor.bedaquilinepaliperidone and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closelybelladonna alkaloidsbelladonna alkaloids decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.belladonna alkaloids decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.belladonna and opiumbelladonna and opium and paliperidone both increase sedation. Use Caution/Monitor.belladonna and opium decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.belladonna and opium decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.paliperidone increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.benazeprilpaliperidone increases toxicity of benazepril by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benazepril increases toxicity of paliperidone by pharmacodynamic synergism. Use Caution/Monitor. Increases risk of hypotension.benperidolbenperidol and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.benperidol and paliperidone both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen and paliperidone both increase sedation. Use Caution/Monitor.benzphetaminepaliperidone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.berotralstatberotralstat will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Monitor or titrate P-gp substrate dose if coadministered.betrixabanpaliperidone increases levels of betrixaban by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Decrease betrixaban dose to 80 mg PO once, then 40 mg PO qDay if coadministered with a P-gp inhibitor.bosutinibbosutinib increases levels of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.brexanolonebrexanolone, paliperidone. Either increases toxicity of the other by sedation. Use Caution/Monitor.brexpiprazolebrexpiprazole and paliperidone both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and paliperidone both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and paliperidone both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and paliperidone both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and paliperidone both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and paliperidone both increase sedation. Use Caution/Monitor.buprenorphine