Drug & supplement interaction

Manganese + Paliperidone

Paliperidone brand name: Invega.

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

Manganese has a moderate interaction with Paliperidone. Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.

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

Manganese and Paliperidone

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

Moderate

ANTIPSYCHOTIC DRUGS

Why this applies to Paliperidone

Paliperidone falls under ANTIPSYCHOTIC DRUGS — the group Manganese interacts with.

Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.
Severity Moderate Likelihood Possible Evidence D

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 Invega (paliperidone) and manganese. This isn't about manganese changing how your body breaks the medication down. Instead, the worry runs the other way: taking extra manganese alongside an antipsychotic may, in theory, make manganese itself harder for your body to handle and raise the odds of manganese building up. Too much manganese can affect the nervous system and cause symptoms like tremor, stiffness, or mood and behavior changes, which can muddy the picture when you're already managing schizophrenia.

I want to be honest that this is very thin evidence, basically one report in a person with liver disease on a different antipsychotic. A normal diet won't be the issue; concentrated supplement doses are the concern. Before adding a manganese supplement, please check with your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. 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

Manganese Also Interacts With Other Medications

Manganese has 82 moderate known drug interactions in our database — the Paliperidone one above is one of them. If you take anything else, check it against the full list below.

Moderate 82 No known interaction 2,748 (incl. Paliperidone)
Taking anything else?

Check Another of Your Medications Against Manganese

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

From our Q&A

Questions About Manganese or Paliperidone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Manganese or Paliperidone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Paliperidone

This page covers Manganese only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Paliperidone page lists 64 supplements it has a documented interaction with, worst first, each one explained.

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

By severity: 9 major · 44 moderate · 11 minor.

From our pharmacist’s overview on the Paliperidone page

“Paliperidone (Invega) is an antipsychotic for schizophrenia and related conditions that can stretch the heart's QT interval on its own, so this list warrants real vigilance. Nine of the 64 ingredients on file carry a major rating, and most either prolong that QT interval further (grapefruit in large amounts is one of them) or intensify…”

Reviewed by 2 · Jul 18, 2026

Open the Paliperidone interaction page

One more smart check

Taking Manganese as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,006 real supplement products containing Manganese, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Manganese. Your product may carry other ingredients that interact with Paliperidone too, on top of Manganese — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Manganese and Paliperidone 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 Manganese
Top 5%

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

29 days ago today
Medication Paliperidone
Top half

#949 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 Manganese

What is Manganese?

Manganese
  • Bone health support
  • Antioxidant and enzyme support
  • Filling dietary gaps
  • Metabolism support
  • Wound healing

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements may help if you have a genuine deficiency, but too much can be harmful—especially to the nervous system—so do not take high doses without guidance from a pharmacist or doctor.

Read the full Manganese monograph & all interactions
Medication

About Paliperidone

What Is Paliperidone Used For?

Brand name: Invega

Paliperidone treats schizophrenia and schizoaffective disorder. The extended-release tablets (Invega and generic paliperidone) are approved for schizophrenia in adults and adolescents ages 12–17, and for schizoaffective disorder in adults.

Several injectable formulations are also available, each with specific roles. Invega Sustenna and Erzofri extended-release are once-monthly injections approved for schizophrenia and schizoaffective disorder in adults. Invega Trinza is a once-every-3-month injection for schizophrenia in adults who have already been stabilized on a once-monthly paliperidone palmitate injection for at least four months. Invega Hafyera is a once-every-6-month injection for schizophrenia in adults already stabilized on a once-monthly or every-3-month paliperidone palmitate injection.

See full Paliperidone drug information
Keep checking

Other Drugs & Manganese

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

0Major
82Moderate
0Minor
2,747No known interaction
82 Moderate 2,747 No interaction
Moderate

82 interactions

Showing 60 of 82 moderate interactions — see all 82 on the Manganese page.

No interaction 2,747 drugs checked — show the list

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

Showing the 60 most looked-up of 2,747 medications checked with no known interaction — see the full Manganese list.

See the full Manganese interactions page
See every supplement checked against Paliperidone, 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
Manganese monograph › Uses, safety, and every drug interaction in one place Paliperidone supplement interactions › Every supplement checked against Paliperidone, ranked by severity Paliperidone 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 Manganese and Paliperidone Together: Common Questions

Can you take Manganese with Paliperidone?
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 Manganese and Paliperidone 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 and Manganese?

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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.