Aripiprazole, Abilify Maintena
Description: Antipsychotic, Atypical
“Alert: US Warning
Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Aripiprazole is not approved for the treatment of patients with dementia-related psychosis.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Aripiprazole, Abilify is officially indicated for acute manic or mixed episodes in bipolar disorder, adjunct for treatment-resistant major depressive disorder, or schizophrenia. It may also be prescribed off-label for use in acute severe agitation or aggression, delusional disorder, delusional infestation, Huntington disease-associated chorea, or treatment-resistant obsessive-compulsive disorder. (maybe used for other conditions not listed)
Indications For Use
Aripiprazole, Abilify is a quinolinone antipsychotic that binds various neurotransmitter receptors in the brain such as serotonin (5-HT1A, 5-HT2A, 5-HT2C, 5-HT7), dopamine (D2, D3, D4), histamine (H1), and adrenergic (Alpha1). Does not affect cholinergic receptors. Has mixed effects at the various receptors (inhibits some and activates others). Brains response to altered chemistry results in desired effects.
Before starting Aripiprazole, Abilify makes sure your physician is aware of any allergies or medications you currently take if you have cardiovascular disease, Parkinson disease, dementia, a history of seizures or are pregnant or breastfeeding. Suicidal ideation is inherent with bipolar disorder or psychotic illness so caution must be used and any major changes in personality or mood should be reported to the physician immediately.
This medication also required regular blood work and follow up with your physician to monitor for adverse reactions
Single-injection start: 400 mg once monthly (doses should be separated by ≥26 days). Continue (overlap) oral aripiprazole or another oral antipsychotic for 14 days during initiation of the ER injection.
Double injection starts Initial: Administer a single oral aripiprazole 20 mg dose, plus two 400 mg injections in separate injection sites (eg, right deltoid and left gluteal muscle). Maintenance: 400 mg once monthly (doses should be separated by ≥ 26 days).
Note: Establish tolerability with oral aripiprazole prior to initiation of ER injection; due to the prolonged half-life of oral aripiprazole, it may take up to 2 weeks to fully assess tolerability.
Pharmacist Tips On Using
How to Use:
IM: Extended-release: For IM use only; do not administer SubQ or IV. Inject slowly into the deltoid or gluteal muscle using the appropriately provided needle; for nonobese patients, use the 1-inch (25 mm) needle with deltoid administration or the 1.5-inch (38 mm) needle with gluteal administration; for obese patients, use the 1.5-inch (38 mm) needle with deltoid administration or the 2-inch (51 mm) needle with gluteal administration. Do not massage muscle after administration. Rotate injection sites between the 2 deltoid or gluteal muscles. Administer monthly (doses should be separated by ≥26 days).
Endocrine & metabolic: Decreased HDL cholesterol (14%), increased LDL cholesterol (10% to 14%), increased serum cholesterol (4% to 22%), increased serum triglycerides (7% to 27%), weight gain (17% to 22% [placebo: 7% to 9%])
Nervous system: Akathisia (dose-related; 2% to 12% [placebo: 0% to 4%]), headache (12%)
1% to 10%:
Cardiovascular: Orthostatic hypotension (3%), tachycardia (≤2%)
Endocrine & metabolic: Increased serum glucose (8%), weight loss (4%)
Gastrointestinal: Abdominal distress (2%), constipation (10%), diarrhea (3%), nausea (9%), vomiting (3%), xerostomia (4%)
Hematologic & oncologic: Neutropenia (6% [placebo: 2%])
Local: Injection site reaction (≤1%; including erythema, induration, inflammation, hemorrhage, pruritus, rash, swelling), pain at injection site (5%)
Nervous system: Anxiety (≥1%), dizziness (4% to 8%), drowsiness (7% [placebo: 4%]), dystonia (2%), extrapyramidal reaction (10%), fatigue (dose-related; 1% to 2%), insomnia (≥1%), sedated state (3% to 5%), restlessness (≥1%)
Neuromuscular & skeletal: Arthralgia (4%), back pain (4%), musculoskeletal pain (3%), myalgia (4%), tremor (dose-related; 3%)
Respiratory: Nasal congestion (2%), upper respiratory tract infection (4%)
Note this is not a complete list of side effects, only the most common.
Frequently Asked Questions
What do I do if the side effects are not tolerable?
If the side effects are causing a lot of distress speak to our physician as soon as possible to discuss options.