Medicines

Risperidone for psychological disorders

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Do not stop giving risperidone suddenly, as your child is likely to get withdrawal symptoms

Name of medicine

Risperidone

Brand names: Risperdal®, Quicklet®

This leaflet is about the use of risperidone in autism, attention deficit hyperactivity disorder (often shortened to ADHD) bipolar disorder, Tourette’s syndrome, schizophrenia and learning disability.

Why is it important for my child to take risperidone?

Risperidone belongs to the group of medicines called antipsychotics. It works by changing the activity of chemicals in the brain called neurotransmitters and will affect your child’s mood and psychological behaviour.

What is risperidone available as?

Tablets: 500 micrograms, 1 mg, 2 mg, 3 mg, 4 mg, 6 mg; these tablets contain lactose

Orodispersible tablets: 500 micrograms, 1 mg, 2 mg, 3 mg, 4 mg; these contain aspartame

Liquid medicine: 5 mg in 5 mL

When should I give risperidone

Risperidone may be given once or twice each day. Your doctor will tell you how often to give it.

Once a day: this is usually in the evening.

Twice a day: this should be once in the morning and once in the evening. Ideally these times are 10–12 hours apart, for example some time between 7 and 8 am, and between 7 and 8 pm.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of risperidone (the dose) that is right for your child. The dose will be shown on the medicine label.

Your doctor will give your child a low dose to start with. They may then increase the dose as your child gets used to the medicine and depending on how your child responds to it.

It is important that you follow your doctor’s instructions about how much to give.

How should I give risperidone?

Tablets

  • Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablet.

Orodispersible tablets

Orodispersible tablets are designed to dissolve in the mouth. Place the tablet on your child’s tongue. It should stay there until it has dissolved (which usually takes about a minute), or your child can suck the tablet gently. Your child can then swallow the dissolved tablet.

Liquid medicine

Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

  • Shake the medicine well. Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
  • To hide the taste of the liquid medicine, you can add the dose into a small glass of juice or squash (preferably at room temperature). Your child should drink all the mixture straight away.

When should the medicine start working?

It may take a few days or weeks for risperidone to work properly, depending on what you child is being treated for, so your child may still have symptoms for a while. Continue to give the medicine to your child during this time. Your doctor will decide whether it is helping once your child has been taking it for a few weeks.

What if my child is sick (vomits)?

If your child is sick less than 30 minutes after having a dose of risperidone, give them the same dose again.

If your child is sick more than 30 minutes after having a dose of risperidone, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

Do not give the missed dose. Wait until the next normal dose, and then continue to give the medicine as usual.

Never give a double dose of risperidone.

If you have forgotten to give more than one dose, contact your doctor for advice.

What if I give too much?

If you think you may have given your child too much risperidone, contact your doctor or NHS Direct (111 in England and Scotland; 111 or 0845 4647 in parts of Wales) or take your child to hospital.

Take the medicine container or packaging with you, even if it is empty. This will be useful to the doctor. Have the medicine or packaging with you if you telephone for advice.

It can be dangerous to give too much risperidone.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).

Side effects you must do something about

If your child feels faint or dizzy, or seems to be losing consciousness, has a fever (temperature above 38°C), is cold and sweaty, has a weak or rapid heart rate (they may feel as though their heart is racing or fluttering) and stiff muscles, they may be having a rare reaction to risperidone. Contact your doctor or take your child to hospital or call an ambulance straight away.

Your child may start to have some unusual muscle movements they have not had before, such as muscle spasm, twitching in the jaw, tongue or face and body, slow movements, shaking or stiffness. Contact your doctor as soon as possible.

Other side-effects you need to know about

Contact your doctor if you are worried about any of these side-effects:

  • Your child may feel dizzy or light-headed when they stand up, or may even faint. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or lightheaded.

  • They may feel drowsy (sleepy). This will cause fewer problems if they have risperidone in the evening. If your child also takes risperidone during the day, remember that they may not be alert.

  • Your child may get stomach ache and feel sick (nausea) or constipated (difficulty doing a poo). Encourage them to drink plenty of fluid and to eat foods that contain fibre (e.g. wholemeal foods, fruit and vegetables). If this is still a problem after 2 weeks, contact your doctor.

  • They may get a headache, become anxious or have sleep disturbances such as difficulty getting to sleep. Some children find their eyesight is blurry or double.

  • They may have nosebleeds or develop a rash.

  • They may have more saliva, a dry mouth, or an increased appetite. Encourage them to eat fruit and vegetables and low calorie foods, rather than foods that contain a lot of calories (avoid crisps, cakes, biscuits and sweets) and to have plenty of physical activity. Otherwise they may put on weight.

  • Rarely, girls may find their periods become irregular or stop or that they have swelling, soreness or leakage from their breasts. Boys may also feel sore around the breast area. Tell your doctor about these symptoms at your next visit.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as risperidone?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

risperidone should not be taken with some medicines that you get on prescription. It is important to tell your doctor and pharmacist about any other medicines your child is taking before starting risperidone.

  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

Do not stop giving risperidone suddenly, as your child may get withdrawal effects and feel unwell. If you or your child wants to stop taking risperidone, discuss this with your doctor. They will explain how to reduce the dose bit by bit.

Do not change the dose of risperidone that you give your child without discussing this with your doctor.

General advice about medicines

  • Try to give medicines at about the same times each day, to help you remember.
  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight.
  • It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information?

Your doctor, pharmacist or nurse will be able to give you more information about risperidone and about other medicines used for children with autism, ADHD, bipolar disorder, Tourette’s syndrome, schizophrenia or learning disability.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

Mind (mental health support)

0300 123 3393

www.mind.org.uk

The National Autistic Society

0207 833 2299

www.autism.org.uk/

Tourettes Action

Young Minds - parent helpine

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review by June 2015.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.