days, adjusted according to response; usual dose 1 mg
once daily; maximum 1. 5 mg per day
Short-term treatment of severe aggression in autism
(under expert supervision)
▶BY MOUTH
▶Child 5–17 years (body-weight 15–20 kg):Initially
250 micrograms daily for at least 4 days, then increased
if necessary to 500 micrograms daily, then increased in
steps of 250 micrograms daily, dose to be increased at
intervals of 2 weeks, review effectiveness and any side-
effects after 3 – 4 weeks; stop if no response at 6 weeks;
maximum 1 mg per day
▶Child 5–17 years (body-weight 20–45 kg):Initially
500 micrograms daily for at least 4 days, then increased
if necessary to 1 mg daily, then increased in steps of
500 micrograms daily, dose to be increased at intervals
of 2 weeks, review effectiveness and any side-effects
after 3 – 4 weeks; stop if no response at 6 weeks;
maximum 2. 5 mg per day
▶Child 5–17 years (body-weight 45 kg and above):Initially
500 micrograms daily for at least 4 days, then increased
if necessary to 1 mg daily, then increased in steps of
500 micrograms daily, dose to be increased at intervals
of 2 weeks, review effectiveness and any side-effects
after 3 – 4 weeks; stop if no response at 6 weeks;
maximum 3 mg per daylUNLICENSED USENot licensed for use in children for
psychosis, mania, or autism.IMPORTANT SAFETY INFORMATION
SAFE PRACTICE
Risperidone has been confused with ropinirole; care
must be taken to ensure the correct drug is prescribed
and dispensed.lCAUTIONSAvoid in Acute porphyrias p. 603 .cataract
surgery (risk of intra-operativefloppy iris syndrome).
dehydration.family history of sudden cardiac death
(perform ECG).prolactin-dependent tumours
lINTERACTIONS→Appendix 1 : risperidone
lSIDE-EFFECTS
▶Common or very commonAnaemia.anxiety.appetite
abnormal.asthenia.chest discomfort.conjunctivitis.
cough.depression.diarrhoea.dyspnoea.epistaxis.fall.
fever.gastrointestinal discomfort.headache.
hypertension.increased risk of infection.joint disorders.
laryngeal pain.muscle spasms.nasal congestion.nausea.
oedema.oral disorders.pain.sedation.skin reactions.
sleep disorders.urinary disorders.vision disorders.
vomiting.weight decreased
▶UncommonAlopecia.arrhythmias.breast abnormalities.
cardiac conduction disorders.cerebrovascular
insufficiency.chills.coma.concentration impaired.
consciousness impaired.cystitis.diabetes mellitus.
dizziness postural.dry eye.dysarthria.dysphagia.
dysphonia.ear pain.eye disorders.feeling abnormal.
flushing.gait abnormal.gastrointestinal disorders.
malaise.menstrual cycle irregularities.mood altered.
muscle weakness.palpitations.polydipsia.postural
hypotension.posture abnormal.respiratory disorders.
sensation abnormal.syncope.taste altered.thirst.
thrombocytopenia.tinnitus.vaginal discharge.vertigo
▶Rare or very rareAngioedema.dandruff.eyelid crusting.
glaucoma.head titubation.hypoglycaemia.hypothermia.
jaundice.pancreatitis.peripheral coldness.
rhabdomyolysis.SIADH.sleep apnoea.water intoxication
.withdrawal syndrome
▶Frequency not knownCardiac arrest
lPREGNANCYUse only if potential benefit outweighs risk.lBREAST FEEDINGUse only if potential benefit outweighs
risk—small amount present in milk.
lHEPATIC IMPAIRMENT
Dose adjustmentsInitial and subsequent oral doses should
be halved.
lRENAL IMPAIRMENT
Dose adjustmentsInitial and subsequent oral doses should
be halved.
lDIRECTIONS FOR ADMINISTRATIONOrodispersible tablets
should be placed on the tongue, allowed to dissolve and
swallowed. Oral liquid may be diluted with any non-
alcoholic drink, except tea.
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer risperidone
orodispersible tablets and oral liquid (counselling on use
of dose syringe advised).
Medicines for Children leaflet: Risperidone for psychological
disorderswww.medicinesforchildren.org.uk/risperidone-for-
psychological-disorderslMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral solution
Oral solution
CAUTIONARY AND ADVISORY LABELS 2
▶Risperidone (Non-proprietary)
Risperidone 1 mg per 1 mlRisperidone 1 mg/ml oral solution sugar
free sugar-free| 100 mlP£ 58. 22 DT = £ 3. 87
▶Risperdal(Janssen-Cilag Ltd)
Risperidone 1 mg per 1 mlRisperdal 1 mg/ml oral solution sugar-
free| 100 mlP£ 37. 01 DT = £ 3. 87
Orodispersible tablet
CAUTIONARY AND ADVISORY LABELS 2
EXCIPIENTS:May contain Aspartame
▶Risperidone (Non-proprietary)
Risperidone 500 microgramRisperidone 500 microgram
orodispersible tablets sugar free sugar-free| 28 tabletP£ 23. 88
DT = £ 23. 86
Risperidone 1 mgRisperidone 1 mg orodispersible tablets sugar free
sugar-free| 28 tabletP£ 23. 51 DT = £ 22. 99
Risperidone 2 mgRisperidone 2 mg orodispersible tablets sugar free
sugar-free| 28 tabletP£ 42. 95 DT = £ 42. 40
Risperidone 3 mgRisperidone 3 mg orodispersible tablets sugar free
sugar-free| 28 tabletP£ 43. 50 DT = £ 43. 50
Risperidone 4 mgRisperidone 4 mg orodispersible tablets sugar free
sugar-free| 28 tabletP£ 50. 35 DT = £ 50. 35
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Risperidone (Non-proprietary)
Risperidone 500 microgramRisperidone 500 microgram tablets|
20 tabletP£ 6. 95 DT = £ 0. 40
Risperidone 1 mgRisperidone 1 mg tablets| 20 tabletP£ 0. 84
DT = £ 0. 41 | 60 tabletP£ 1. 23 – £ 25. 07
Risperidone 2 mgRisperidone 2 mg tablets| 60 tabletP£ 60. 10
DT = £ 1. 36
Risperidone 3 mgRisperidone 3 mg tablets| 60 tabletP£ 88. 38
DT = £ 1. 57
Risperidone 4 mgRisperidone 4 mg tablets| 60 tabletP
£ 116. 67 DT = £ 1. 83
Risperidone 6 mgRisperidone 6 mg tablets| 28 tabletP£ 82. 50
DT = £ 2. 76
▶Risperdal(Janssen-Cilag Ltd)
Risperidone 500 microgramRisperdal 500 microgram tablets|
20 tabletP£ 5. 08 DT = £ 0. 40
Risperidone 1 mgRisperdal 1 mg tablets| 20 tabletP£ 8. 36 DT
=£ 0. 41 | 60 tabletP£ 17. 56
Risperidone 2 mgRisperdal 2 mg tablets| 60 tabletP£ 34. 62 DT
=£ 1. 36
Risperidone 3 mgRisperdal 3 mg tablets| 60 tabletP£ 50. 91 DT
=£ 1. 57
Risperidone 4 mgRisperdal 4 mg tablets| 60 tabletP£ 67. 20 DT
=£ 1. 83
Risperidone 6 mgRisperdal 6 mg tablets| 28 tabletP£ 67. 88 DT
=£ 2. 76254 Mental health disorders BNFC 2018 – 2019
Nervous system4