Psych Congress NP InstituteHow to Properly Manage Missed Doses of Long-Acting Injectable Medications

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Handling missed doses of long-acting injectable (LAI) antipsychotics requires careful consideration and adherence to specific guidelines. Psychiatric nurse practitioners Desiree Matthews and Amber Hoberg emphasize the critical importance of consulting product inserts for each LAI to ensure appropriate management of delayed or missed doses in patients with schizophrenia. Their insights offer practical guidance for clinicians navigating this common challenge in psychiatric care.

Key Points:

• Consult the product insert for each specific LAI when managing missed doses
• Grace periods and procedures for missed doses vary significantly between different LAIs
• Potential interventions for missed doses may include:
  • Administering an intramuscular (IM) loading dose
  • Providing oral medication overlap
  • Restarting the entire regimen in some cases
• The approach must be tailored to each LAI and patient situation
• Timely administration and proper handling of missed doses are crucial for maintaining therapeutic efficacy

“You have to go back to the product insert of each individual long-acting injectable because each one is different in regards to the grace period, as well as what you need to do as far as retitration or, can you just give the next injection?”
– Amber Hoberg, MSN, APRN, PMHNP-BC

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