Risperidone oral tablet interactions: A detailed guide

This article describes possible interactions with risperidone oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

Risperidone comes as an oral tablet. It’s also available as an oral liquid solution, an oral disintegrating tablet, a liquid solution that’s injected into your muscle, and a liquid solution that’s injected under your skin. Interactions are expected to be the same across all forms of the drug.

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Boxed warning: Increased risk of death in older adults with dementia-related psychosis

Risperidone has a boxed warning for the increased risk of death in older adults with dementia-related psychosis. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

See the end of this article for more information about this warning.

Other drugs and risperidone

The drugs in the list below may interact with risperidone oral tablet. This article doesn’t include all drugs that may interact with risperidone.

Drug classes or drugs that may interact with risperidone oral tablet include:

• certain antibiotics:
  • drug examples: clarithromycin, azithromycin
  • what might happen: can increase the risk of side effects of risperidone and the antibiotic
• certain antidepressants:
  • drug examples: paroxetine (Paxil, Brisdelle), fluoxetine (Prozac)
  • what might happen: can increase the risk of side effects of risperidone and their severity
• certain antiepileptic drugs:
  • drug examples: carbamazepine (Tegretol, others), phenytoin (Dilantin)
  • what might happen: can make risperidone less effective
• certain antifungal drugs:
  • drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
  • what might happen: can increase the risk of side effects of risperidone and the antifungal drug
• drugs that slow activity in the central nervous system:
  • drug examples: opioids, such as oxycodone (Oxycontin, others), benzodiazepines, such as alprazolam (Xanax)
• drugs that lower blood pressure:
  • drug examples: lisinopril (Zestril), carvedilol (Coreg)
  • what might happen: can enhance the effect of the blood pressure drug and increase the risk of low blood pressure as a side effect
• clozapine (Clozaril, Versacloz):
  • what might happen: can increase the risk of side effects of risperidone and clozapine
• levodopa and treatments that contain it:
  • drug example: carbidopa/levodopa (Sinemet, others)
  • what might happen: can make levodopa or risperidone less effective
• methylphenidate (Ritalin, others):
  • what might happen: can increase the risk of side effects of risperidone
• metoclopramide (Reglan):
  • what might happen: can increase the risk of side effects of risperidone and metoclopramide

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When to avoid risperidone

Certain health conditions or other factors could increase some risks with risperidone oral tablet. Because of this, doctors may not prescribe risperidone in these cases. These health conditions or other factors are called contraindications.

Here’s a list of contraindications for risperidone oral tablet:

• Past allergic reaction to risperidone: If you’ve ever had an allergic reaction to risperidone oral tablet, taking it again may cause another allergic reaction.
• Past allergic reaction to paliperidone: If you’ve ever had an allergic reaction to the drug paliperidone, taking risperidone oral tablet may cause another allergic reaction. This is because when your body breaks down risperidone, it creates paliperidone as a byproduct. So, if you’ve had an allergic reaction to paliperidone, it’s likely you’ll have an allergic reaction to risperidone.

Before you start taking risperidone, tell your doctor if anything listed above relates to you. They can recommend whether you should take risperidone.

Other interactions and risperidone

Interactions can occur with foods, supplements, vaccines, and some lab tests. Below you can learn whether risperidone oral tablet has these interactions. 

The information below doesn’t include all other possible interactions with risperidone.

Risperidone interactions and food

Risperidone oral tablet isn’t known to interact with foods. But this doesn’t mean interactions with foods can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking risperidone oral tablet.

Risperidone and supplements

Before taking risperidone oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Risperidone interactions and herbs

Risperidone oral tablet isn’t known to interact with any herbs. But this doesn’t mean interactions with herbs can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before using any of these products while taking risperidone oral tablet.

Risperidone interactions and vitamins

Risperidone oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, ask your doctor or pharmacist before using any of these products while taking risperidone oral tablet.

Risperidone and vaccines

Risperidone oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking risperidone oral tablet.

Risperidone and lab tests

Risperidone oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, talk with your doctor or pharmacist before having any tests while taking risperidone oral tablet.

Risperidone and cannabis or CBD

Reports have shown cannabis (commonly called marijuana) and cannabis products may interact with risperidone. Cannabidiol (CBD) is an example of a cannabis product.

Taking risperidone and using cannabis may raise your risk of certain side effects, including problems with balance, coordination, and thinking.

Before you take risperidone, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Alcohol and risperidone

Risperidone oral tablet is known to interact with alcohol.

Taking risperidone oral tablet and drinking alcohol raises the risk of certain side effects of risperidone, including:

• problems with thinking or concentration
• difficulty with balance or movement, which can lead to falls and other injuries
• low blood pressure, including when sitting or standing up

If you have additional questions about risperidone interactions with alcohol, talk with your doctor. They can advise on whether it’s safe to consume alcohol while taking risperidone oral tablet.

Health factors and risperidone

Certain medical conditions or other health factors may increase the risk of interactions with risperidone oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking risperidone, tell your doctor about your health history. They’ll determine whether risperidone is right for you.

These health conditions or other factors might interact with risperidone oral tablet:

• blood cell conditions, such as low neutrophil count
• heart conditions, such as heart failure or past heart attack
• high blood pressure
• high cholesterol
• type 1 or type 2 diabetes
• long-term exposure to heat or hot environments, such as working outdoors
• kidney conditions, such as chronic kidney disease
• liver conditions, such as cirrhosis
• epilepsy or seizures
• low blood pressure, including when sitting or standing
• pregnancy or breastfeeding
• past allergic reaction to risperidone

Preventing risperidone interactions

You may be able to help avoid certain interactions with risperidone oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you’re prescribed a new drug while taking risperidone oral tablet.

Taking risperidone exactly as prescribed can also help prevent interactions.

What to ask your doctor

If you have questions about risperidone and possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Do other drugs that could treat my condition have similar interactions?
• Does my risk of interactions depend on my dosage of risperidone?
• Do I need to take my medications at different times throughout the day to avoid interactions?

Boxed warning for risperidone

Risperidone has a boxed warning for the increased risk of death in older adults with dementia-related psychosis. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Risperidone and other antipsychotic drugs should not be used to treat dementia-related psychosis in older adults (age 65 years and older). In studies, these drugs increased the risk of death when used for this purpose.

Risperidone is not approved for treating dementia-related psychosis in people of any age. Instead, doctors will prescribe other safer options to treat dementia-related psychosis in older adults.

To learn more, talk with your doctor.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.