Drug & supplement interaction

Khat + Paliperidone Palmitate

Paliperidone Palmitate brand name: Invega Trinza.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Khat has a moderate interaction with Paliperidone Palmitate. Khat may affect response to antipsychotic treatment.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Khat and Paliperidone Palmitate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIPSYCHOTIC DRUGS

Why this applies to Paliperidone Palmitate

Paliperidone Palmitate falls under ANTIPSYCHOTIC DRUGS — the group Khat interacts with.

Khat may affect response to antipsychotic treatment. In a large retrospective study of adults with newly diagnosed schizophrenia, chewing khat was associated with a decreased retention rate with the initial antipsychotic agent when compared with non-chewers, and lack of efficacy was the most commonly reported reason for switching antipsychotic agents among khat users. Until more is known, avoid khat in patients taking antipsychotic agents.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with your Invega Trinza shot: this medicine is meant to calm the brain signaling that drives symptoms of schizophrenia. Khat does the opposite. Its main ingredient, cathinone, acts a lot like an amphetamine and floods the brain with dopamine and norepinephrine. That stimulant push can work against what your paliperidone injection is trying to do, so symptoms like racing thoughts, agitation, or paranoia may creep back even though you're getting your dose on schedule.

One large study of people newly diagnosed with schizophrenia found that khat chewers were more likely to have their antipsychotic stop working well and need a switch. That's real-world evidence, not just lab theory. On top of that, khat is illegal in the U.S. and hard on the heart. Please don't change your shots on your own. Talk with your doctor or pharmacist if khat is part of the picture.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Hakami T, Mahmoud M, Mohammed B, El-Setouhy M. Effects of khat use on response to antipsychotic medications in patients with newly diagnosed schizophrenia: a retrospective study. East Mediterr Health J 2021;27(4):353-360. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Khat Also Interacts With Other Medications

Khat has 4 major, 400 moderate known drug interactions in our database — the Paliperidone Palmitate one above is one of them. If you take anything else, check it against the full list below.

Major 4 Moderate 400 No known interaction 2,426 (incl. Paliperidone Palmitate)
Taking anything else?

Check Another of Your Medications Against Khat

Covers the 2,830 medications we’ve checked against Khat. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Paliperidone Palmitate

This page covers Khat only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paliperidone Palmitate page lists 27 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: American Hellebore (major), Arsenic (major), Cesium (major), Ephedra (major) and Grapefruit (major).

By severity: 8 major · 18 moderate · 1 minor.

From our pharmacist’s overview on the Paliperidone Palmitate page

“Paliperidone palmitate (Invega Trinza), a long-acting injection for schizophrenia, can lengthen the heart's QT interval on its own, so the supplements on this page deserve real care rather than casual curiosity. Nearly half of the interacting ingredients can stretch that interval further and raise the risk of a dangerous heart rhythm,…”

Reviewed by 2 · Jul 18, 2026

Open the Paliperidone Palmitate interaction page

How much people look this up

Where Khat and Paliperidone Palmitate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Khat
Top half

#607 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Paliperidone Palmitate
Top half

#1,155 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Khat

What is Khat?

Khat
  • Stimulant for energy and alertness
  • Euphoria and mood elevation
  • Reducing fatigue
  • Appetite suppression
  • Social and traditional ceremonies

Khat is a plant chewed for its amphetamine-like stimulant effects, but it carries serious risks including high blood pressure, heart problems, mental health effects, and dependence. It is a controlled substance and illegal in the United States and many other countries, so it should not be used.

Read the full Khat monograph & all interactions
Medication

About Paliperidone Injection

What Is Paliperidone Injection Used For?

Brand name: Invega Trinza

Paliperidone injections are used for schizophrenia in adults. Invega Hafyera is an every-six-month injection. It is for adults who have already been adequately treated with a once-a-month paliperidone injection (such as Invega Sustenna) for at least four months, or an every-three-month injection (such as Invega Trinza) for at least one three-month cycle.

Invega Sustenna dosing also covers schizoaffective disorder in adults. Erzofri and Invega Trinza are also in this group, but the supplied evidence does not state their specific uses.

See full Paliperidone Injection drug information
Keep checking

Other Drugs & Khat

Browse every other medication we’ve checked against Khat — both the ones with a known interaction and the ones without. Select any drug for the full detail.

4Major
400Moderate
0Minor
2,425No known interaction
4 Major 400 Moderate 2,425 No interaction
Major

4 interactions

Moderate

400 interactions

Showing 60 of 400 moderate interactions — see all 400 on the Khat page.

No interaction 2,425 drugs checked — show the list

We also checked Khat against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,425 medications checked with no known interaction — see the full Khat list.

See the full Khat interactions page
See every supplement checked against Paliperidone Palmitate, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Khat monograph › Uses, safety, and every drug interaction in one place Paliperidone Palmitate supplement interactions › Every supplement checked against Paliperidone Palmitate, ranked by severity Paliperidone Injection drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Khat and Paliperidone Palmitate Together: Common Questions

Can you take Khat with Paliperidone Palmitate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Khat and Paliperidone Palmitate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Paliperidone Palmitate and Khat?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.