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Risperidone

Also known as: Risperdal, Perseris, Uzedy, Rykindo

Atypical Antipsychotic

Route: Oral

33 interactions on record⛔ Black Box Warning

Risperidone has 33 known drug interactions based on U.S. FDA drug labeling data. 2 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Methylphenidate Hydrochloride, Tetrabenazine, Alcohol. Patients taking Risperidone should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.

Total: 33
Major: 2
Moderate: 27
Minor: 4

Major (2)

Risperidone + Methylphenidate Hydrochloride— Combined use with dosage changes in either medication may increase risk of extrapyramidal symptoms; monitor for signs of…
Risperidone + Tetrabenazine— Antipsychotic that increases risk for Parkinsonism, NMS, and akathisia when used concomitantly with tetrabenazine.

Moderate (27)

Risperidone + Alcohol— Caution should be used due to additive CNS effects when alcohol is administered with risperidone.
Risperidone + Bupropion— CYP2D6 substrate; bupropion inhibits CYP2D6 and increases risperidone concentrations; consider dose reduction.
Risperidone + Bupropion Hcl Er— Bupropion inhibits CYP2D6 and can increase risperidone concentrations; consider dose reduction of risperidone.
Risperidone + Bupropion Hcl Er (Xl)— CYP2D6 substrate antipsychotic. Bupropion inhibits CYP2D6, increasing risperidone exposure. Dose reduction may be necess…
Risperidone + Bupropion Hydrobromide— CYP2D6 substrate antipsychotic. Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose red…
Risperidone + Bupropion Hydrochloride— CYP2D6-metabolized antipsychotic. Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose r…
Risperidone + Carbamazepine— Enzyme inducer that decreases plasma concentrations of risperidone. Increase risperidone dose up to double the patient's…
Risperidone + Carbidopa— Dopamine D2 receptor antagonists may reduce the therapeutic effects of levodopa; patients should be carefully observed f…
Risperidone + Carbidopa And Levodopa— Dopamine D2 receptor antagonists may reduce the therapeutic effects of levodopa; patients should be carefully observed f…
Risperidone + Carbidopa Tablets— Dopamine D2 receptor antagonist may reduce therapeutic effects of levodopa; patients should be carefully observed for lo…
Risperidone + Carbidopa, Levodopa And Entacapone— Dopamine D2 receptor antagonist may reduce therapeutic effects of levodopa.
Risperidone + Cimetidine— Cimetidine increases the bioavailability of risperidone by 64%, though it does not affect combined AUC of risperidone an…
Risperidone + Clozapine— Chronic administration of clozapine may decrease the clearance of risperidone.
Risperidone + Dexmethylphenidate Hydrochloride— Combined use with dosage changes in either or both medications may increase risk of extrapyramidal symptoms. Monitor for…
Risperidone + Dopamine Agonists— Risperidone may antagonize the effects of dopamine agonists.
Risperidone + Erythromycin— 7.2 Drugs Having No Clinically Important Interactions with PERSERIS Based on pharmacokinetic studies with oral risperido…
Risperidone + Fluoxetine— CYP2D6 enzyme inhibitor increases plasma concentrations of risperidone. Reduce initial dose and do not exceed 8 mg per d…
Risperidone + Foscarbidopa/Foslevodopa— Dopamine D2 receptor antagonist may reduce effectiveness of foslevodopa. Monitor for worsening Parkinson's symptoms.
Risperidone + Levodopa— Risperidone may antagonize the effects of levodopa.
Risperidone + Methylphenidate— Concomitant use with methylphenidate may increase the risk of extrapyramidal symptoms (EPS), especially with dosage chan…
Risperidone + Methylphenidate Hydrochloride Extended Release— Combined use with dosage changes may increase risk of extrapyramidal symptoms. Monitor for signs of EPS.
Risperidone + Naltrexone Hydrochloride And Bupropion Hydrochloride— Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose reduction when using with CONTRAVE.
Risperidone + Paroxetine— CYP2D6 enzyme inhibitor increases plasma concentrations of risperidone. Reduce initial dose and do not exceed 8 mg per d…
Risperidone + Paroxetine Hydrochloride— Increased exposure of CYP2D6 substrate; decrease dosage if needed.
Risperidone + Paroxetine Hydrochloride Hemihydrate— Paroxetine inhibits CYP2D6 metabolism of risperidone, potentially increasing risperidone levels.
Risperidone + Ranitidine— Ranitidine increases the bioavailability of risperidone by 26% and increases combined AUC of risperidone and 9-hydroxyri…
Risperidone + Serdexmethylphenidate And Dexmethylphenidate— Combined use with methylphenidate, especially with dosage changes, may increase the risk of extrapyramidal symptoms (EPS…

Minor (4)

Risperidone + Amitriptyline— Minor effect on risperidone exposure. Dose adjustment not needed.
Risperidone + Digoxin— Risperidone does not show clinically relevant effect on digoxin pharmacokinetics. Dose adjustment for digoxin not recomm…
Risperidone + Lithium— Risperidone does not affect lithium exposure. Dose adjustment for lithium not recommended.
Risperidone + Valproate— Risperidone increases valproate peak plasma concentration by 20%. Dose adjustment for valproate not recommended.

Risperidone + Methylphenidate Hydrochloride⚠️Major

Combined use with dosage changes in either medication may increase risk of extrapyramidal symptoms; monitor for signs of EPS.

Risperidone + Tetrabenazine⚠️Major

Antipsychotic that increases risk for Parkinsonism, NMS, and akathisia when used concomitantly with tetrabenazine.

Risperidone + Alcohol🟡Moderate

Caution should be used due to additive CNS effects when alcohol is administered with risperidone.

Risperidone + Bupropion🟡Moderate

CYP2D6 substrate; bupropion inhibits CYP2D6 and increases risperidone concentrations; consider dose reduction.

Risperidone + Bupropion Hcl Er🟡Moderate

Bupropion inhibits CYP2D6 and can increase risperidone concentrations; consider dose reduction of risperidone.

Risperidone + Bupropion Hcl Er (Xl)🟡Moderate

CYP2D6 substrate antipsychotic. Bupropion inhibits CYP2D6, increasing risperidone exposure. Dose reduction may be necessary.

Risperidone + Bupropion Hydrobromide🟡Moderate

CYP2D6 substrate antipsychotic. Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose reduction of risperidone when used with bupropion.

Risperidone + Bupropion Hydrochloride🟡Moderate

CYP2D6-metabolized antipsychotic. Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose reduction.

Risperidone + Carbamazepine🟡Moderate

Enzyme inducer that decreases plasma concentrations of risperidone. Increase risperidone dose up to double the patient's usual dose and titrate slowly.

Risperidone + Carbidopa🟡Moderate

Dopamine D2 receptor antagonists may reduce the therapeutic effects of levodopa; patients should be carefully observed for loss of therapeutic response.

Risperidone + Carbidopa And Levodopa🟡Moderate

Dopamine D2 receptor antagonists may reduce the therapeutic effects of levodopa; patients should be carefully observed for loss of response.

Risperidone + Carbidopa Tablets🟡Moderate

Dopamine D2 receptor antagonist may reduce therapeutic effects of levodopa; patients should be carefully observed for loss of therapeutic response.

Risperidone + Carbidopa, Levodopa And Entacapone🟡Moderate

Dopamine D2 receptor antagonist may reduce therapeutic effects of levodopa.

Risperidone + Cimetidine🟡Moderate

Cimetidine increases the bioavailability of risperidone by 64%, though it does not affect combined AUC of risperidone and 9-hydroxyrisperidone.

Risperidone + Clozapine🟡Moderate

Chronic administration of clozapine may decrease the clearance of risperidone.

Risperidone + Dexmethylphenidate Hydrochloride🟡Moderate

Combined use with dosage changes in either or both medications may increase risk of extrapyramidal symptoms. Monitor for EPS signs.

Risperidone + Dopamine Agonists🟡Moderate

Risperidone may antagonize the effects of dopamine agonists.

Risperidone + Erythromycin🟡Moderate

7.2 Drugs Having No Clinically Important Interactions with PERSERIS Based on pharmacokinetic studies with oral risperidone, no dosage adjustment of PERSERIS is required when administered concomitantly with amitriptyline, cimetidine, ranitidine, clozapine, topiramate and moderate CYP3A4 inhibitors (erythromycin).

Risperidone + Fluoxetine🟡Moderate

CYP2D6 enzyme inhibitor increases plasma concentrations of risperidone. Reduce initial dose and do not exceed 8 mg per day of risperidone.

Risperidone + Foscarbidopa/Foslevodopa🟡Moderate

Dopamine D2 receptor antagonist may reduce effectiveness of foslevodopa. Monitor for worsening Parkinson's symptoms.

Risperidone + Levodopa🟡Moderate

Risperidone may antagonize the effects of levodopa.

Risperidone + Methylphenidate🟡Moderate

Concomitant use with methylphenidate may increase the risk of extrapyramidal symptoms (EPS), especially with dosage changes. Monitor for EPS symptoms.

Risperidone + Methylphenidate Hydrochloride Extended Release🟡Moderate

Combined use with dosage changes may increase risk of extrapyramidal symptoms. Monitor for signs of EPS.

Risperidone + Naltrexone Hydrochloride And Bupropion Hydrochloride🟡Moderate

Bupropion inhibits CYP2D6 and can increase risperidone concentrations. Consider dose reduction when using with CONTRAVE.

Risperidone + Paroxetine🟡Moderate

CYP2D6 enzyme inhibitor increases plasma concentrations of risperidone. Reduce initial dose and do not exceed 8 mg per day of risperidone.

Risperidone + Paroxetine Hydrochloride🟡Moderate

Increased exposure of CYP2D6 substrate; decrease dosage if needed.

Risperidone + Paroxetine Hydrochloride Hemihydrate🟡Moderate

Paroxetine inhibits CYP2D6 metabolism of risperidone, potentially increasing risperidone levels.

Risperidone + Ranitidine🟡Moderate

Ranitidine increases the bioavailability of risperidone by 26% and increases combined AUC of risperidone and 9-hydroxyrisperidone by 20%.

Risperidone + Serdexmethylphenidate And Dexmethylphenidate🟡Moderate

Combined use with methylphenidate, especially with dosage changes, may increase the risk of extrapyramidal symptoms (EPS).

Risperidone + Amitriptyline🟢Minor

Minor effect on risperidone exposure. Dose adjustment not needed.

Risperidone + Digoxin🟢Minor

Risperidone does not show clinically relevant effect on digoxin pharmacokinetics. Dose adjustment for digoxin not recommended.

Risperidone + Lithium🟢Minor

Risperidone does not affect lithium exposure. Dose adjustment for lithium not recommended.

Risperidone + Valproate🟢Minor

Risperidone increases valproate peak plasma concentration by 20%. Dose adjustment for valproate not recommended.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.