Perseris (Risperidone LAI): How This Monthly Subcutaneous Injection Works and When Telehealth Helps

Last updated: August 26, 2026

Perseris (risperidone) is a once-monthly, long-acting subcutaneous injection for schizophrenia in adults. A healthcare professional mixes a two-syringe kit and injects it under the skin of the abdomen or the back of the upper arm. It is not a daily pill. It is not intramuscular like Risperdal Consta. You establish that you tolerate oral risperidone first. The U.S. label maps oral 3 mg/day to 90 mg monthly and oral 4 mg/day to 120 mg monthly. It does not recommend a loading dose or extra oral risperidone after the first shot.

See if online depression or mood care may be a fit →

Browse Klarity condition pages →

TLDR

• Perseris is subcutaneous risperidone LAI (abdomen or back of upper arm), given by a clinician once a month.
• Labeled only for schizophrenia in adults. Not approved for dementia-related psychosis.
• DailyMed PERSERIS setid a4f21b1a; label revised January 28, 2025. Packager: Indivior Inc. DEA schedule: none. Initial U.S. approval year on the label: 1993 (risperidone as a molecule).
• Strengths: 90 mg and 120 mg kits. Do not give more than one dose per month.
• Oral 3 mg/day → 90 mg Perseris one day after the last oral dose. Oral 4 mg/day → 120 mg. People stable below 3 mg or above 4 mg may not be candidates.
• No loading dose. Supplemental oral risperidone is not recommended after start.
• Most common trial reactions (≥5% and more than twice placebo): increased weight, sedation/somnolence, musculoskeletal pain.
• Telehealth can support evaluation, oral risperidone trials, labs, and follow-up. A licensed clinician still has to mix and give the injection in person.
• Coverage may vary by plan. Verify benefits before you book. Klarity has 2,000+ licensed providers.

Table of contents

• What Perseris is
• How it works
• FDA-labeled use
• Perseris dosage
• Side effects and warnings
• Interactions
• How it compares with Uzedy and other options
• When telehealth is enough
• How a Klarity visit fits
• FAQ

What Perseris is

Perseris is risperidone for extended-release injectable suspension, for subcutaneous use. DailyMed lists it as an atypical antipsychotic kit. Packager: Indivior Inc. Marketing status: New Drug Application. It is not a controlled substance.

The molecule first reached U.S. patients as oral risperidone in 1993. Perseris is the Indivior monthly depot (also studied as RBP-7000). Indivior’s February 27, 2019 launch release describes FDA approval based on a Phase 3 program in adult schizophrenia. A 2019 review in PMC6679950 notes the 90 mg and 120 mg monthly doses as approximately matching oral risperidone 3 mg/day and 4 mg/day.

NAMI’s risperidone page lists Perseris as a long-acting injection given every month by a health professional under the skin, separate from oral Risperdal and from Uzedy.

Related Klarity guides: Risperdal (risperidone), Uzedy (risperidone LAI), and Invega (paliperidone).

This article is education. It is not a diagnosis and it is not a promise that any clinician will prescribe Perseris.

How it works

Risperidone blocks dopamine D2 and serotonin 5-HT2A receptors, among other receptor effects. That profile can reduce hallucinations, delusions, and disorganized thinking when a clinician judges it appropriate. Perseris uses a biodegradable depot so plasma risperidone stays in range between monthly clinic visits instead of depending on a daily tablet.

The medicine still carries the same class risks as other risperidone products: movement effects, metabolic change, prolactin elevation, orthostasis, and the boxed dementia-related psychosis warning. A long-acting shot does not make those risks disappear. It changes how you take the drug and how long it stays in your system if you stop.

FDA-labeled use

Per DailyMed indications, Perseris is indicated for the treatment of schizophrenia in adults. It is not approved for dementia-related psychosis. It is not labeled here for bipolar I maintenance the way the October 2025 Uzedy label is. Off-label uses require a documented clinical rationale and are not a substitute for the label.

Perseris dosage

Always follow the dose your prescriber writes. DailyMed highlights:

• Establish tolerability with oral risperidone before the first Perseris injection if you have never taken risperidone.
• A healthcare professional gives the subcutaneous injection in the abdomen or the back of the upper arm. Do not give it by any other route.
• Start at 90 mg or 120 mg once monthly. Do not give more than one dose (90 mg or 120 mg total) per month.
• Failure to fully mix the two-syringe kit can deliver the wrong dose.

Switch from oral risperidone (label table)

• Oral 3 mg/day → 90 mg Perseris one day after the last oral dose
• Oral 4 mg/day → 120 mg Perseris one day after the last oral dose

People stable on less than 3 mg/day or more than 4 mg/day may not be candidates for Perseris. Neither a loading dose nor supplemental oral risperidone is recommended after the injection. If you miss a dose, the label says give the next injection as soon as possible.

Kidney or liver impairment: titrate oral risperidone up to at least 3 mg daily first. Then the recommended Perseris dose is 90 mg once monthly, based on response and tolerability.

Only your clinician can set your dose. Do not convert numbers yourself.

Side effects and warnings

Boxed warning: Elderly patients with dementia-related psychosis treated with antipsychotic drugs have an increased risk of death. Perseris is not approved for that use. Cerebrovascular events (stroke, TIA) are also more common in that group.

Do not use Perseris if you have known hypersensitivity to risperidone, paliperidone, or any kit component.

DailyMed also flags neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes (glucose, lipids, weight), hyperprolactinemia (Warnings and Precautions update January 2025), orthostatic hypotension, leukopenia/neutropenia/agranulocytosis, cognitive and motor impairment, seizures, and priapism. Third-trimester pregnancy exposure may cause extrapyramidal or withdrawal symptoms in newborns.

The most common adverse reactions in clinical trials (≥5% and greater than twice placebo) were increased weight, sedation/somnolence, and musculoskeletal pain. Report suspected reactions to Indivior at 1-877-782-6966 or FDA MedWatch.

Interactions

Strong CYP2D6 inhibitors (fluoxetine, paroxetine) raise risperidone levels. DailyMed says switch to the 90 mg monthly dose 2 to 4 weeks before starting a strong CYP2D6 inhibitor when that applies.

Strong CYP3A4 inducers (carbamazepine) lower risperidone levels. With Perseris 90 mg plus a strong inducer, the label says increase to 120 mg monthly and consider adding oral risperidone. People already on 120 mg may also need extra oral risperidone. When the inducer stops, re-evaluate and lower if needed.

How it compares with Uzedy and other options

Oral risperidone is the same molecule with daily pills or solution. Uzedy is another subcutaneous risperidone LAI with a wider milligram range, optional every-2-month schizophrenia dosing, and a 2025 bipolar I maintenance indication. Risperdal Consta is intramuscular and typically twice monthly. Rykindo is another intramuscular risperidone LAI. Invega products use paliperidone (risperidone’s active metabolite). Your clinician matches the molecule, interval, and injection site to your history, not to a search ranking.

When telehealth is enough

Online psychiatry can often handle history, diagnosis review, oral risperidone start or switch, metabolic labs, side-effect check-ins, and prior authorization paperwork. Klarity’s network includes 2,000+ licensed providers. Same-day visits are available in many states.

Perseris itself is a clinic injection. Telehealth does not replace the person who mixes the kit and gives the shot, or the in-person visit if you become medically unstable, suicidal, or catatonic. If you or someone you know is in crisis, call or text 988.

See if online depression or mood care may be a fit →

How a Klarity visit fits

A video visit can review whether oral risperidone is even the right molecule, whether a long-acting shot is realistic in your state, and what labs or in-person partners you would need. Coverage varies by plan. Self-pay is also an option. Patients should verify benefits before booking. CTAs that send you to /find-a-provider or /book-now are not how we route care. Start from a condition or service page instead.

Insurance and cost

Whether a plan may cover Perseris depends on the formulary, specialty pharmacy rules, site-of-care policies, and prior authorization. Coverage varies. Do not assume a commercial, Medicaid, or Medicare Advantage plan will pay the same way. Manufacturer copay cards, if any, usually exclude government plans.

FAQ

Is Perseris the same as Risperdal?

Same active ingredient (risperidone). Different product: Perseris is a monthly subcutaneous depot. Risperdal is typically an oral tablet, solution, or ODT. Do not swap them without a conversion plan.

Is Perseris the same as Uzedy?

Both are subcutaneous risperidone LAIs. Strengths, intervals, mixing, and labeled uses differ. Uzedy has more syringe strengths and an adult bipolar I maintenance indication as of October 2025. Perseris is 90 or 120 mg monthly for adult schizophrenia only on the current DailyMed highlights.

Can I inject Perseris at home?

The label says a healthcare provider administers it. It is not a self-injection product in the DailyMed highlights. Mixing errors can change the dose.

Do I need oral risperidone after the first shot?

DailyMed says supplementation with oral risperidone is not recommended after you start Perseris, and neither is a loading dose. That is different from some intramuscular risperidone products.

Will insurance cover Perseris?

It may. Plans often require prior authorization and proof you tolerated oral risperidone. Verify your benefits. This is not a coverage guarantee.

When to get urgent help

Seek emergency care for high fever with rigidity, uncontrolled movements, severe allergic reaction, prolonged erection, fainting, or thoughts of self-harm. Call 988 for a mental-health crisis. Call 911 if you are not safe.

This article is education, not personal medical advice. A licensed clinician who knows your history decides whether Perseris or another option is appropriate.

Browse Klarity condition pages →