Overview: Risperidone is used to treat schizophrenia, bipolar disorder, and irritability associated with autism. It comes in several dosage forms, including an oral liquid, oral tablet, orally disintegrating tablet, and long-acting injection given every two weeks. Common side effects include movement problems, restlessness, dizziness, or drowsiness. Risperidone can affect your alertness or coordination. It can also affect your body’s ability to regulate temperature. Try to avoid getting overheated, stay hydrated, and wear light and breathable clothing while you are using risperidone.

Uses

What is risperidone used for?

Risperidone is commonly used for the following conditions.

Risperidone may also be used for other conditions as determined by your health care provider.

See also: Perseris, Rykindo, and Uzedy

How does risperidone work (mechanism of action)?

Risperidone belongs to a group of medicines called second-generation (atypical) antipsychotics. It is thought to work by balancing brain chemicals called serotonin and dopamine. These chemicals are known to affect thoughts and mood.

How is risperidone supplied (dosage forms)?

Brands and other names

  • Risperdal
  • Risperdal Consta

Dosage forms and strengths

  • 1 mg/mL oral solution
  • 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg oral tablets
  • 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg orally disintegrating tablets

Risperidone is also available in an injectable form that is given by a health care provider.

How should I store risperidone?

Oral Tablet, Orally Disintegrating Tablet, and Oral Liquid. Store at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light and moisture. Do not freeze risperidone oral liquid.

Injection Liquid. Risperidone injection is usually given by a health care provider in a hospital, clinic, or pharmacy. You will not store it at home.

Side Effects

What are the most common side effects of risperidone?

The most common side effects of risperidone are listed below. These side effects may vary based on the condition being treated and the dosage form you are using. Tell your health care provider if you have any of these side effects that bother you.

  • Movement problems, including tremor
  • Restlessness (akathisia)
  • Drowsiness or tiredness
  • Dizziness
  • Blurred vision
  • Anxiety
  • Nausea or vomiting
  • Stomach discomfort, indigestion, or upper abdominal pain
  • Diarrhea or constipation
  • Excess saliva in your mouth or dry mouth
  • Infection or pain in the nose or throat, sore throat, or common cold symptoms
  • Increased appetite 
  • Weight gain
  • Rash
  • Headache (injection)
  • Pain in the arms, hands, legs, or feet (injection)

There may be other side effects of risperidone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of risperidone?

While less common, the most serious side effects of risperidone are described below, along with what to do if they happen.

Severe Allergic Reactions. Risperidone may cause allergic reactions, which can be serious. Stop using risperidone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Neuroleptic Malignant Syndrome (NMS). Antipsychotic medicines, like risperidone, may cause a rare but serious condition called neuroleptic malignant syndrome. NMS can lead to death. Stop using risperidone and contact your health care provider right away if you experience any of the following symptoms.

  • High fever
  • Muscle stiffness or rigidity, where it is hard to move
  • Confusion 
  • Changes in your breathing or heart rate
  • Increased sweating

Uncontrolled Movements. Risperidone can cause some people to have movements that they cannot control. This condition, called tardive dyskinesia (TD), can cause jerky movements of the face, tongue, or body. TD can be permanent. Call your health care provider right away if you have any of the following symptoms of TD.

  • Tongue sticking out
  • Lip smacking or puckering
  • Grimacing
  • Rapid eye blinking
  • Jerking or twisting motion of the arms, legs, or trunk

Metabolism Changes. Risperidone can cause high blood sugar levels or diabetes, high cholesterol levels, and weight gain. Keep all appointments with your health care provider to check your blood work and weight. Call your health care provider if you gain weight or develop the following symptoms of high blood sugar.

  • Thirsty more than usual
  • Peeing more than usual
  • Increase in hunger
  • Tiredness
  • Feeling sick to your stomach
  • Confusion
  • Fruity-smelling breath

High Prolactin Level (Hyperprolactinemia). Risperidone may cause an increased level of the hormone prolactin in your blood. High levels of prolactin could lead to fertility or bone problems. Contact your health care provider if you have any of the following symptoms.

  • Vaginal dryness
  • Irregular or no periods
  • Production of breastmilk when not pregnant or nursing
  • Inability to get or keep an erection
  • Enlarged breast size (gynecomastia)
  • Decreased muscle and body hair

Low Blood Pressure Upon Standing (Orthostatic Hypotension) and Falls. Risperidone may cause a sudden drop in blood pressure when standing up from a seated or lying position. This may increase your risk of falling. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your health care provider right away if you have any of the following symptoms of orthostatic hypotension.

  • Dizziness, feeling lightheaded, or fainting upon standing
  • Blurred vision
  • Confusion
  • Feeling weak

Blood Disorders. Risperidone can cause blood disorders such as low white blood cell levels (leukopenia,  neutropenia, or agranulocytosis). Keep all appointments with your health care provider to check your blood work. Stop using risperidone and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Decreased Alertness or Coordination. Risperidone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how risperidone affects you.

Seizures. Some people who have used risperidone have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop using risperidone and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Trouble Swallowing. Risperidone can cause trouble swallowing (dysphagia), which can increase your risk of choking while eating or drinking. Eat small amounts of food, and chew your food well. Get emergency help if you are choking or have food stuck in your esophagus that is not passing.

Painful, Prolonged Erection (Priapism). Risperidone may cause an unwanted erection that is persistent, painful, and that may occur without sexual arousal. Permanent damage to the penis may occur if priapism is not treated quickly. Stop using risperidone and get emergency help right away if you have any of the following symptoms of priapism.

  • Erection lasting for more than four hours
  • Erection that is unrelated to sexual stimulation
  • Painful or tender penis

Body Temperature Regulation. Risperidone can affect your ability to regulate your body temperature. This could make you very hot, especially in hot weather or after exercising a lot. You should drink water and avoid overheating and dehydration. Call your health care provider right away if you are severely ill and have the following symptoms.

  • Excessive or no sweating
  • Dry mouth
  • Feeling very hot
  • Feeling thirsty
  • Not able to pee

Warnings & Precautions

Who should not use risperidone?

Allergies to Ingredients. People who are allergic to any of the following should not use risperidone.

  • Paliperidone
  • Risperdal
  • Risperdal Consta
  • Risperidone
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific risperidone products they stock.

What should I know about risperidone before using it?

Do not use risperidone unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share risperidone with other people, even if they have the same condition as you. It may harm them.

Keep risperidone out of the reach of children.

Because risperidone can make it hard for you to regulate your body temperature, try to avoid becoming too hot or dehydrated. Drink plenty of water, limit your exposure to the heat and sun, do not overexercise, and wear light and breathable clothing.

If you are prescribed risperidone oral liquid, use the dosing syringe that comes with your medicine to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Risperidone oral liquid can be taken on its own or mixed with water, orange juice, low-fat milk, or coffee. Do not mix it with tea or cola. Ask your pharmacist how to measure and take your medicine properly.

If you are prescribed risperidone orally disintegrating tablets, do not remove the tablet from its blister pack until you are ready to take it. You should peel back the foil to open the blister pack. Do not push the tablet through the foil because doing so could damage the tablet. Make sure your hands are dry when handling these tablets. Place the tablet on your tongue right away and let it melt. Do not chew or split.

Risperidone injection is given to you by a health care provider in a hospital, clinic, or pharmacy every two weeks in your arm or buttock muscle. You should have taken risperidone by mouth before starting the injection to make sure you tolerate the medicine. After your first dose of risperidone injection, your health care provider may have you continue to take risperidone or your current antipsychotic by mouth for three weeks. Follow your health care provider’s instructions for how to use your medicine.

People who are 65 or older can be at greater risk for some side effects from risperidone. Talk to your health care provider about your risks if you are in this age group.

If you can become pregnant, using risperidone may make this more difficult. These effects likely go away after you stop using risperidone. Talk to your health care provider if you have any concerns.

What should I tell my health care provider before using risperidone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if risperidone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Psychosis Related to Dementia. There is a higher risk of death, stroke, or ministroke in older adults who use risperidone or another antipsychotic and have memory loss or psychosis related to dementia. Risperidone is not approved to treat dementia-related psychosis.

Phenylketonuria (PKU). Risperidone orally disintegrating tablets contain phenylalanine, which can be dangerous for people with phenylketonuria (PKU). Tell your pharmacist and other health care providers if you have PKU and are prescribed risperidone orally disintegrating tablets.

Other Medicines and Supplements. Risperidone may interact with other medicines and supplements. Before using risperidone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Risperidone used later in pregnancy may lead to an increased risk of certain problems in your newborn. Tell your health care provider if you are or plan to become pregnant while using risperidone. Your health care provider will advise you if you should use risperidone while you are pregnant or trying to get pregnant. If you become pregnant while using risperidone, you can register with the National Pregnancy Registry for Atypical Antipsychotics by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry. This registry collects safety information about the use of psychiatric medicines during pregnancy.

Breastfeeding. Risperidone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should use risperidone while breastfeeding.

Interactions

Does risperidone interact with foods or drinks?

There are no known interactions between risperidone and foods or drinks.

You should avoid drinking alcohol while using risperidone. The risk of dizziness and sleepiness may be increased if you drink alcohol while using risperidone.

Does risperidone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using risperidone.

  • Methylphenidate, which is a stimulant medicine commonly used to treat attention deficit hyperactivity disorder (ADHD)
  • Clozapine, which is a medicine commonly used for mood conditions
  • Any medicine for seizures, such as carbamazepine, phenytoin, or phenobarbital
  • Paroxetine or fluoxetine, which is a medicine commonly used for anxiety and depression
  • A dopamine agonist, such as apomorphine (Apokyn), pramipexole (Mirapex ER), ropinirole, rotigotine (Neupro), which is a medicine that may be used for Parkinson’s disease or restless legs syndrome (RLS)
  • Levodopa, which is a medicine used for Parkinson’s disease
  • A medicine for high blood pressure
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Many other medicines may alter the blood levels of risperidone. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with risperidone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much risperidone?

If you or someone else has used too much risperidone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of risperidone?

If you miss a dose of oral risperidone, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

If you miss an appointment to get your injectable risperidone dose, call to make another appointment as soon as possible.