Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.chlorzoxazoneMonitor Closely (1)chlorzoxazone and paliperidone both increase sedation. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and paliperidone both increase sedation. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)ciprofloxacin 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.cisatracuriumMonitor Closely (3)cisatracurium 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.citalopramMonitor Closely (1)paliperidone and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.clarithromycinMonitor Closely (2)clarithromycin 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.clemastineMonitor Closely (1)clemastine and paliperidone both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (1)paliperidone, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clomipramineMonitor Closely (2)clomipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and clomipramine both increase sedation. Use Caution/Monitor.clonazepamMonitor Closely (1)clonazepam and paliperidone both increase sedation. Use Caution/Monitor.clonidineMonitor Closely (1)clonidine, paliperidone. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.clorazepateMonitor Closely (1)clorazepate and paliperidone both increase sedation. Use Caution/Monitor.clotrimazoleMonitor Closely (1)clotrimazole will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine 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.Serious - Use Alternative (1)clozapine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.codeineMonitor Closely (1)codeine and paliperidone both increase sedation. Use Caution/Monitor.crizotinibMonitor Closely (1)crizotinib and paliperidone both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.cyclizineMonitor Closely (4)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. cyclizine and paliperidone both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (4)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. cyclobenzaprine and paliperidone both increase sedation. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine and paliperidone both increase sedation. Use Caution/Monitor.dabigatranMonitor Closely (1)paliperidone 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/mindantroleneMonitor Closely (1)dantrolene and paliperidone both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)paliperidone 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. darifenacinMonitor Closely (3)darifenacin 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.dasatinibMonitor Closely (1)dasatinib and paliperidone both increase QTc interval. Use Caution/Monitor.degarelixSerious - Use Alternative (1)degarelix and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.desfluraneMonitor Closely (1)desflurane and paliperidone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desflurane and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.desipramineMonitor Closely (2)desipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and desipramine both increase sedation. Use Caution/Monitor.deutetrabenazineMonitor Closely (3)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). paliperidone 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.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and paliperidone both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (1)paliperidone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine and paliperidone both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)paliperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor Closely (1)paliperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextromethorphanMonitor Closely (1)dextromethorphan, 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).dextromoramideMonitor Closely (1)dextromoramide and paliperidone both increase sedation. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine and paliperidone both increase sedation. Use Caution/Monitor.diazepamMonitor Closely (1)diazepam and paliperidone both increase sedation. Use Caution/Monitor.dicyclomineMonitor Closely (3)dicyclomine 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.diethylpropionMonitor Closely (1)paliperidone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalinMonitor Closely (1)difelikefalin and paliperidone both increase sedation. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl and paliperidone both increase sedation. Use Caution/Monitor.dihydroergotamineMonitor Closely (1)dihydroergotamine, 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).dimenhydrinateMonitor Closely (1)dimenhydrinate and paliperidone both increase sedation. Use Caution/Monitor.diphenhydramineMonitor Closely (4)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. diphenhydramine and paliperidone both increase sedation. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl and paliperidone both increase sedation. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone and paliperidone both increase sedation. Use Caution/Monitor.disopyramideSerious - Use Alternative (1)disopyramide and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.dobutamineMonitor Closely (1)paliperidone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dofetilideMonitor Closely (1)dofetilide and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.dolasetronMonitor Closely (1)dolasetron and paliperidone both increase QTc interval. Use Caution/Monitor.donepezilSerious - Use Alternative (1)donepezil and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.dopamineMonitor Closely (1)paliperidone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)paliperidone decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.dopexamineMonitor Closely (1)paliperidone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dosulepinMonitor Closely (1)paliperidone and dosulepin both increase sedation. Use Caution/Monitor.doxepinMonitor Closely (2)doxepin and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. paliperidone and doxepin both increase sedation. Use Caution/Monitor.doxylamineMonitor Closely (1)doxylamine and paliperidone both increase sedation. Use Caution/Monitor.dronedaroneMonitor Closely (2)dronedarone 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.droperidolMonitor Closely (3)droperidol and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely. droperidol and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor. droperidol and paliperidone both increase sedation. Use Caution/Monitor.edoxabanSerious - Use Alternative (1)paliperidone will increase the level or effect of edoxaban by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. Dose adjustment may be required with strong P-gp inhibitors. DVT/PE treatment: Decrease dose to 30 mg PO once daily. NVAF: No dose reduction recommendedelagolixMonitor Closely (1)elagolix will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.eletriptanMonitor Closely (1)eletriptan, 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).eliglustatMonitor Closely (1)eliglustat 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.Serious - Use Alternative (1)eliglustat and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.encorafenibSerious - Use Alternative (1)encorafenib and paliperidone both increase QTc interval. Avoid or Use Alternate Drug. Encorafenib is associated with dose-dependent QTc interval prolongation. Avoid with drugs known to prolong QT interval.entrectinibSerious - Use Alternative (1)paliperidone and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.ephedrineMonitor Closely (1)paliperidone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.epinephrineMonitor Closely (2)epinephrine 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 racemicMonitor Closely (2)epinephrine 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.erdafitinibSerious - Use Alternative (1)erdafitinib will increase the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.ergoloid mesylatesMonitor Closely (1)ergoloid 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).ergotamineMonitor Closely (1)ergotamine, 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).eribulinSerious - Use Alternative (1)eribulin and paliperidone both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.erythromycin baseMonitor Closely (2)erythromycin 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 ethylsuccinateMonitor Closely (2)erythromycin 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 lactobionateMonitor Closely (2)erythromycin 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 stearateMonitor Closely (2)erythromycin 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.escitalopramSerious - Use Alternative (1)escitalopram increases toxicity of paliperidone by QTc interval. Avoid or Use Alternate Drug.esketamine intranasalMonitor Closely (1)esketamine intranasal, paliperidone. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.estazolamMonitor Closely (1)estazolam and paliperidone both increase sedation. Use Caution/Monitor.ethanolMonitor Closely (1)paliperidone and ethanol both increase sedation. Use Caution/Monitor.Minor (1)ethanol, paliperidone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.eucalyptusMinor (1)paliperidone and eucalyptus both increase sedation. Minor/Significance Unknown.exenatide injectable