Drug & supplement interaction

Manganese + Paliperidone Palmitate

Paliperidone Palmitate brand name: Invega Trinza.

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

Manganese has a moderate interaction with Paliperidone Palmitate. 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 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 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 for your Invega Trinza shot: this isn't about manganese changing how your medicine is broken down. Both manganese and antipsychotics like paliperidone can build up in the same brain regions, so the worry is that taking concentrated manganese supplements alongside this drug might raise your risk of manganese-related problems in the nervous system. That can look like tremor, stiffness, slowed movement, or mood and thinking changes, which honestly overlap with some side effects paliperidone can already cause.

I want to be honest about how thin this evidence is. It comes from a single case in someone with liver disease on a different antipsychotic, so it's largely theoretical. The manganese you get from a normal diet is not a concern. If you're considering a high-dose supplement, run it by your pharmacist or prescriber 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 Palmitate 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 Palmitate)
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.

Everything else you take

See Every Supplement That Interacts With Paliperidone Palmitate

This page covers Manganese 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

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 Palmitate 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 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 Manganese
Top 5%

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

29 days ago today
Medication Paliperidone Palmitate
Top half

#906 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 Injection

What Is Paliperidone Injection Used For?

Brand name: Invega Trinza

Paliperidone injection is used to treat schizophrenia and schizoaffective disorder in adults. Different branded products are approved for specific treatment situations.

Invega Sustenna (once-monthly injection) treats both schizophrenia and schizoaffective disorder. Invega Trinza (every-three-month injection) and Invega Hafyera (every-six-month injection) treat schizophrenia in adults who have already been stabilized on a paliperidone palmitate injectable. Erzofri extended-release is a once-monthly injectable for schizophrenia and schizoaffective disorder in adults.

See full Paliperidone Injection 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 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
Manganese 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 Manganese and Paliperidone Palmitate Together: Common Questions

Can you take Manganese 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 Manganese 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 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.