Aristada 882mg Dosing
Aristada 882 mg is administered as a single intramuscular injection into the gluteal muscle either monthly (every 4 weeks) or every 6 weeks, depending on the patient's clinical needs and prior oral aripiprazole dose. 1
Initiation Requirements
Before starting Aristada 882 mg, you must establish tolerability with oral aripiprazole, as it may take up to 2 weeks to fully assess tolerability due to the half-life of oral aripiprazole. 1
You have two initiation options:
Option 1: One-Day Initiation (Preferred for rapid start)
- Administer one injection of Aristada INITIO 675 mg (deltoid or gluteal)
- Give one dose of oral aripiprazole 30 mg on the same day
- Give the first Aristada 882 mg injection on the same day as INITIO or up to 10 days later
- Avoid injecting both INITIO and Aristada into the same muscle 1
Option 2: 21-Day Oral Supplementation
- Administer 21 consecutive days of oral aripiprazole starting with the first Aristada 882 mg injection
- The oral dose should match what the patient was taking previously (see conversion table below) 1
Dose Selection Based on Prior Oral Aripiprazole
- Oral aripiprazole 15 mg daily → Aristada 882 mg every 6 weeks
- Oral aripiprazole ≥20 mg daily → Aristada 882 mg monthly 1
Injection Site and Technique
- 882 mg must be administered in the gluteal muscle only (not deltoid)
- Administer the entire contents of the syringe
- Must be given by a healthcare professional 1
Dosing Intervals
- Monthly regimen: Every 4 weeks (28 days)
- Every 6 weeks regimen: Every 42 days
- Do not give injections earlier than 14 days after the previous injection 1
Managing Missed Doses
If a dose is missed, timing of supplementation depends on how late the patient is:
For 882 mg monthly:
- ≤8 weeks late: No supplementation needed
8 and ≤12 weeks late: Give one dose of Aristada INITIO OR 7 days of oral aripiprazole
12 weeks late: Re-initiate with Aristada INITIO + oral aripiprazole 30 mg OR 21 days of oral aripiprazole 1
Dose Adjustments for Drug Interactions
When strong CYP450 modulators are added for >2 weeks:
- Strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin): Reduce to 662 mg monthly or 441 mg monthly
- Strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine): Reduce to 662 mg monthly or 441 mg monthly
- Both CYP3A4 and CYP2D6 inhibitors together: Avoid 882 mg dose; use 441 mg only
- CYP2D6 poor metabolizers: Reduce to 662 mg or 441 mg 1
No dose adjustment needed if CYP450 modulators are used for <2 weeks. 1
Pharmacokinetic Considerations
The 882 mg dose corresponds to 600 mg of actual aripiprazole. 1 Aripiprazole is released into systemic circulation after 5-6 days, with continued release for an additional 36 days, providing steady-state concentrations within the efficacious range. 2 The elimination half-life following the last dose is approximately 55 days. 3
Common Pitfalls to Avoid
- Do not inject 882 mg into the deltoid muscle - this dose is too large for deltoid administration and must go into the gluteal muscle 1
- Do not skip oral supplementation during initiation unless using Aristada INITIO - the delayed release profile requires coverage 2
- Do not confuse dosing intervals - 882 mg can be given monthly OR every 6 weeks, but these are different regimens for different oral dose equivalents 1
- Do not give injections <14 days apart even if a dose was missed 1