LAI Conversion Tool

This tool was built specifically to align with the internal medication guidelines of the CA Department of State Hospitals and is intended for their use only.

This tool is designed to provide dosing recommendations for initial and maintenance doses of LAI based on an oral dose of antipsychotic medication. Loading doses are recommended for some medications to reduce the time to steady-state plasma levels from months to weeks. Dosing should be adjusted using measurement of trough antipsychotic plasma levels, measured 1-3 days prior to the next maintenance dose.

Oral tolerability with all medications should be verified prior to consideration of an LAI.

Select the desired oral medication and desired oral dose that the patient is receiving. The LAI dosing recommendations will populate with links to additional tips on the corresponding LAI.

Oral Antipsychotic(Required)

Oral Daily Dose(Required)

LAI Med and Dose

Initial Dose:

Partial agonists antipsychotics may worsen positive symptoms in some patients. Establishing response and tolerability should entail an 8–12-week oral trial of aripiprazole
Aristada 441 mg PLUS oral aripiprazole 10 mg x 21 days OR Aristada 441 mg PLUS Aristada Initio 675 mg PLUS oral aripiprazole 30 mg x 1

Maintenance Dose:

Aristada 441 mg every 4 weeks

Learn more about Aristada

LAI Med and Dose

Initial Dose:

Partial agonists antipsychotics may worsen positive symptoms in some patients. Establishing response and tolerability should entail an 8–12-week oral trial of aripiprazole
Abilify Maintena 300 mg PLUS oral aripiprazole 15 mg x 14 days OR Abilify Maintena 400 mg in two separate injection sites PLUS aripiprazole 20 mg x 1
Aristada 662 mg PLUS oral aripiprazole 15 mg for 21 days OR Aristada 662 mg PLUS Aristada Initio 675 mg PLUS oral aripiprazole 30 mg x 1
Aristada 882 mg PLUS oral aripiprazole 15 mg x 21 days OR Aristada 882 mg PLUS Aristada Initio 675 mg PLUS oral aripiprazole 30 mg x 1
Aristada 1064 mg PLUS oral aripiprazole 15 mg x 21 days OR Aristada 1064 mg PLUS Aristada Initio 675 mg PLUS oral aripiprazole 30 mg x 1

Maintenance Dose:

Abilify Maintena 300 mg every 4 weeks
Aristada 662 mg every 4 weeks
Aristada 882 mg every 6 weeks
Aristada 1064 mg every 8 weeks

Learn more about Abilify Maintena

Learn more about Aristada

LAI Med and Dose

Initial Dose:

Partial agonists antipsychotics may worsen positive symptoms in some patients. Establishing response and tolerability should entail an 8–12-week oral trial of aripiprazole
Abilify Maintena 400 mg PLUS oral aripiprazole 20 mg x 14 days
Abilify Maintena 400 mg in two separate injection sites PLUS oral dose of aripiprazole 20 mg x 1
Aristada 882 mg PLUS oral aripiprazole 20 mg x 21 days OR Aristada 882 mg PLUS Aristada Initio 675 mg PLUS oral aripiprazole 30 mg x 1

Maintenance Dose:

Abilify Maintena 400 mg every 4 weeks
Aristada 882 mg every 6 weeks
Aristada 1064 mg every 8 weeks

Learn more about Abilify Maintena

Learn more about Aristada

Oral Daily Dose(Required)

Please enter a number greater than or equal to 0.

Please note that the following recommendations are rounded to the nearest .25

LAI Med and Dose

Loading Dose (2.5 x oral dose weekly x 3)

Fluphenazine X mg intramuscularly each week for 3 weeks

Maintenance Dose (1.25-2.5 x oral dose every 2 weeks)

Fluphenazine X mg to X mg intramuscularly every 2 weeks

Suggestions and Tips

Conversion of oral to LAI fluphenazine is more variable than that for haloperidol
Recommend dose adjustments be made based on trough plasma levels

Learn more about Fluphenazine Decanoate

Oral Daily Dose(Required)

Please enter a number greater than or equal to 0.

Please note that the following recommendations are rounded to the nearest whole number

LAI Med and Dose

Loading Dose (10 x oral daily dose weekly x 3)

Haloperidol Decanoate X mg intramuscularly each week for 3 weeks

Maintenance Dose (20 x oral daily dose)

Haloperidol Decanoate X mg to X mg intramuscularly every 4 weeks
Haloperidol Decanoate X mg to X mg intramuscularly every 2 weeks
Maintenance dose to begin 2 weeks after last loading dose

Suggestions and Tips

Loading dose is calculated as 10 x oral dose weekly x 3
Maintenance = 20 x oral dose every 4 weeks if less than 300 mg or every 2 weeks in divided doses if greater than 300 mg
Individual injections cannot exceed 300 mg (3 mL)
Measurement of a plasma concentration before the third loading dose will assist in determining whether the third loading dose is needed. Measurement of a plasma concentration shortly before the first maintenance dose will be helpful in [fine-tuning] ongoing dosing.

Learn more about Haloperidol Decanoate

Oral Daily Dose(Required)

LAI Med and Dose

Loading Dose(s):

Invega Sustenna 234 mg on day 1 and Invega Sustenna 156 mg on day 8. Maintenance dose is given 4 weeks after last loading dose.
Erzofri 351 mg on day 1. Maintenance dose is given 4 weeks after first dose.

Maintenance Dose:

Invega Sustenna 39 mg every 4 weeks
Erzofri 39 mg every 4 weeks

Learn more about Invega Sustenna

Learn more about Erzofri

LAI Med and Dose

Initial Dose:

Invega Sustenna 234 mg on day 1 and 156 mg Invega Sustenna on day 8. Maintenance dose is given 4 weeks after last loading dose.
Erzofri 351 mg on day 1. Maintenance dose is given 4 weeks after first dose.

Maintenance Dose:

Invega Sustenna 78 mg every 4 weeks
Erzofri 78 mg every 4 weeks
Invega Trinza 273 mg every 12 weeks (Stabilization with at least 4 months of Invega Sustenna required prior to initiation of Invega Trinza)

Learn more about Invega Sustenna

Learn more about Invega Trinza

Learn more about Erzofri

LAI Med and Dose

Initial Dose:

Invega Sustenna 234 mg on day 1 and Invega Sustenna 156 mg on day 8. Maintenance dose is given 4 weeks after last loading dose.
Erzofri 351 mg on day 1. Maintenance dose is given 4 weeks after first dose.

Maintenance Dose:

Invega Sustenna 117 mg every 4 weeks
Erzofri 117 mg every 4 weeks
Invega Trinza 410 mg every 12 weeks (Stabilization with at least 4 months of Invega Sustenna required prior to initiation of Invega Trinza)

Learn more about Invega Sustenna

Learn more about Invega Trinza

Learn more about Erzofri

LAI Med and Dose

Initial Dose:

Invega Sustenna 234 mg on day 1 and Invega Sustenna 156 mg on day 8. Maintenance dose is given 4 weeks after last loading dose.
Erzofri 351 mg on day 1. Maintenance dose is given 4 weeks after first dose.

Maintenance Dose:

Invega Sustenna 156 mg every 4 weeks
Erzofri 156 mg every 4 weeks
Invega Trinza 546 mg every 12 weeks (Stabilization with at least 4 months of Invega Sustenna required prior to initiation of Invega Trinza)
Invega Hafyera 1,092 mg every 6 months (Stabilization with at least four months of Invega Sustenna or at least one three-month cycle (1 injection) of Invega Trinza prior to initiation of Invega Hafyera.)

Learn more about Invega Sustenna

Learn more about Invega Trinza

Learn more about Invega Hafyera

Learn more about Erzofri

LAI Med and Dose

Initial Dose:

Invega Sustenna 234 mg on day 1 and Invega Sustenna 156 mg on day 8. Maintenance dose is given 4 weeks after last loading dose.
Erzofri 351 mg on day 1. Maintenance dose is given 4 weeks after first dose.

Maintenance Dose:

Invega Sustenna 234 mg every 4 weeks
Erzofri 234 mg every 4 weeks
Invega Trinza 819 mg every 12 weeks (Stabilization with at least 4 months of Invega Sustenna required prior to initiation of Invega Trinza)
Invega Hafyera 1,560 mg every 6 months (Stabilization with at least four months of Invega Sustenna or at least one three month cycle (1 injection) of Invega Trinza prior to initiation of Invega Hafyera.)

Learn more about Invega Sustenna

Learn more about Invega Trinza

Learn more about Invega Hafyera

Learn more about Erzofri

Oral Daily Dose(Required)

LAI Med and Dose

Initial Dose:

Risperdal Consta 12.5 mg PLUS oral risperidone 1 mg x 21 days

Maintenance Dose:

Risperdal Consta 12.5 mg every 2 weeks

Learn more about Risperdal Consta

LAI Med and Dose

Uzedy 50 mg every 4 weeks or Uzedy 100 mg every 8 weeks

Learn more about Uzedy

LAI Med and Dose

Initial Dose:

Risperdal Consta 25 mg PLUS oral risperidone 2-3 mg x 21 days

Maintenance Dose:

Risperdal Consta 25 mg every 2 weeks

Learn more about Risperdal Consta

LAI Med and Dose

Uzedy 75 mg every 4 weeks or Uzedy 150 mg every 8 weeks

Learn more about Uzedy

LAI Med and Dose

Initial Dose:

Risperdal Consta 37.5 mg plus oral risperidone 3-5 mg x 21 days

Maintenance Dose

Risperdal Consta 37.5 mg every 2 weeks

Learn more about Risperdal Consta

LAI Med and Dose

Initial Dose:

Uzedy 100 mg every 4 weeks or Uzedy 200 mg every 8 weeks

Learn more about Risperdal Consta

LAI Med and Dose

Initial Dose:

Risperdal Consta 50 mg plus oral risperidone 4-5 mg x 21 days

Maintenance Dose

Risperdal Consta 50 mg every 2 weeks

Learn more about Risperdal Consta

LAI Med and Dose

Uzedy 125 mg every 4 weeks or Uzedy 250 mg every 8 weeks

Learn more about Uzedy

Disclaimer: This LAI Conversion tool and the information it presents are not meant to serve as a guideline for individual patient management. It should not be considered as statement of the standard of care or inclusive of all considerations relevant to care. Any action suggested by this tool should not be used by a clinician without independent evaluation; ultimate treatment decisions must always be made by the treating clinician, including in light of each individual patient’s specific conditions and possible contraindications or dangers in use, applicable manufacturer product information, the psychiatric and medical evidence, recommendations of relevant authorities, other relevant clinical data, and diagnostic and treatment options available for such patient. APA provides the tool and all information on this site on an “as is” basis and makes no warranties, expressed or implied, regarding the tool, including that the information contained within it is free from error. APA assumes no responsibility and fully disclaims all liability for any injury or damage to persons or property arising out of or related to any use of this tool, including for any errors or omissions.

Some information presented within this Center of Excellence was created in collaboration with the California Department of State Hospitals (DSH). This includes that the content has been specifically aligned to the DSH’s medication guidelines (DSH Psychotropic Medication Operational Procedures, appended to DSH Policy Directive 3400). These medication guidelines are applicable only to the DSH settings and inclusion within this resource does not indicate that they must be followed in any non-DSH settings. The medication guidelines included in this resource are those of DSH and do not necessarily represent the views, policy(ies), and/or position(s) of the American Psychiatric Association (APA).