Clinical Tool
LAI Antipsychotic Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Compare all 14 FDA-approved long-acting injectable antipsychotic formulations side-by-side. Dosing intervals, oral-to-LAI conversion protocols, loading doses, injection sites, and oral overlap requirements — every data point traced to its source.
14 of 14 formulations
| Formulation | Interval | Oral → LAI Dosing | Oral Overlap | Site |
|---|---|---|---|---|
| Monthly | Oral risperidoneLAI (mg ester) 2mg/day→39-78mg 4mg/day→117mg 6mg/day→156mg Oral paliperidoneLAI (mg ester) 3mg/day→39-78mg 6mg/day→117mg 9mg/day→156mg 12mg/day→234mg Loading protocol Day 1: 234mg (150mg active) in deltoid Day 8: 156mg (100mg active) in deltoid 2nd dose window: Day 4 to Day 12 (target Day 8, +/- 4 days). Both doses MUST be deltoid. | Not required if loading doses given correctly | Deltoid (loading) Deltoid/Gluteal | |
| Every 3 months | PP1M (ester)PP3M (ester) 78mg→273mg 117mg→410mg 156mg→546mg 234mg→819mg Must be stable on PP1M for at least 4 months | Not applicable -- must transition from monthly LAI | Deltoid/Gluteal | |
| Every 6 months (twice yearly) | PP1M (ester)PP6M (ester) 156mg→1092mg 234mg→1560mg Must be stable on PP1M (>=4 months) at 100mg or 150mg, or PP3M at 350mg or 525mg (>=1 cycle) | Not applicable -- must transition from monthly or 3-month LAI | Gluteal | |
| Monthly (q26d min) | 400mg standard dose 300mg if CYP2D6/3A4 issues Initiation Option 1: 400mg IM (deltoid or gluteal), + oral aripiprazole 10-20mg × 14 days Option 2: Two 400mg injections same day (different muscles), + single oral 20mg dose | REQUIRED: 14 days (Option 1) or single dose (Option 2) | Deltoid/Gluteal | |
| Every 2 months (every 8 weeks) | Maintena 400mg→960mg q2mo Strengths: 720, 960mg Switch from Maintena: give first Asimtufii in place of next scheduled Maintena dose. | New starts only: 14 days oral (not needed when switching from Maintena) | Gluteal | |
| Monthly, every 6 weeks, or every 2 months | OralLAIFreq 10mg→441mgmonthly 15mg→662mgmonthly 15mg→882mgevery 6 weeks 15mg→1064mgevery 2 months 20mg→882mgmonthly | REQUIRED: 21 days oral aripiprazole OR use Aristada Initio one-time injection | Deltoid (441mg only) or Gluteal (all doses) | |
| One-time only | 675mg one-time Initiation protocol 1. Initio 675mg IM + oral aripiprazole 30mg same day 2. First Aristada maintenance dose same day or ≤10 days later (separate muscle) | Single dose of 30mg oral aripiprazole only (NOT 21 days) | Deltoid/Gluteal (must use SEPARATE muscle from same-day Aristada injection) | |
| Every 2 weeks (biweekly) | OralLAIFreq 2mg→25mgq14d 4mg→37.5mgq14d 6mg→50mgq14d Initiation Continue oral risperidone for ≥21 days after first injection. Microsphere release is delayed ~3 weeks. | REQUIRED: 21 days minimum. Microsphere release is delayed ~3 weeks. | Deltoid/Gluteal | |
| Monthly | OralLAIFreq 3mg→90mgq28d 4mg→120mgq28d No loading dose. Therapeutic levels day 1. | NOT required. Therapeutic levels achieved within hours. | SC (abdomen) | |
| Monthly or Q2M | Monthly: 50, 75, 100, 125mg Q2M: 100, 150, 200, 250mg No loading dose. Therapeutic levels day 1. | NOT required. No loading dose needed. Initiate day after last oral dose. | SC (abdomen/arm) | |
| Every 2 weeks or monthly | OralLAIFreq 10mg→150mgq2w 10mg→300mgmonthly 15mg→210mgq2w 15mg→405mgmonthly 20mg→300mgq2w Initiation (first 8 weeks — higher doses) Oral 10mg → 210mg every 2 weeks Oral 10mg → 405mg monthly Oral 15-20mg → 300mg every 2 weeks Then reduce to maintenance doses above after 8 weeks | Not required. Plasma peaks reached within 4 days. | Gluteal (deep IM) | |
| Monthly | Maint: 117mg (range 39-234) Strengths: 39, 78, 117, 156, 234, 351mg Loading protocol Day 1: 351mg in deltoid | Not required. Previous oral antipsychotics can be gradually discontinued at time of ERZOFRI initiation. | Deltoid (Day 1) Deltoid/Gluteal | |
| Q2-6 weeks | Oral fluphenazine 20mg/day = fluphenazine decanoate 25mg every 3 weeks Starting: 12.5-25mg every 2 weeks Range: 12.5-100mg every 2-6 weeks | Not required -- sufficient plasma levels within 2-4 days | IM/SC | |
| Monthly | Dose conversion from oral to LAI: multiply oral daily dose by 10 to 20. Starting dose 50-100mg/month recommended. Range: 50-200mg/month (max 300mg/month, but efficacy above 100mg/month has been questioned) Initiation Oral overlap recommended first month. Steady state takes 2-3 months. | REQUIRED: oral haloperidol for ~1-2 weeks while depot reaches therapeutic levels | Gluteal (deep IM) |
Clinical disclaimer: LAI dosing is NOT simply the oral dose injected less frequently. Bioavailability, release kinetics, ester hydrolysis, and depot absorption all differ from oral formulations. Always follow manufacturer-specific loading protocols and prescribing information. This tool is for educational reference only.