From the Research
Patients should be stable on oral aripiprazole for at least 14 days before switching to Abilify Maintena (aripiprazole). This recommendation is based on the need to establish tolerability with oral aripiprazole before initiating the long-acting injectable formulation, as noted in the context of treating schizophrenia and other conditions 1.
Key Considerations for Switching to Abilify Maintena
- The recommended starting and maintenance dose of Abilify Maintena is 400 mg administered once monthly as a deep intramuscular injection in the gluteal or deltoid muscle.
- After the first injection, patients should continue oral aripiprazole (10-20 mg daily) for 14 days to maintain therapeutic levels during the initial absorption phase.
- Dose reductions to 300 mg monthly are appropriate for patients who are CYP2D6 poor metabolizers, experience adverse reactions at 400 mg, or take strong CYP3A4 inhibitors or CYP2D6 inhibitors.
- For patients taking strong CYP3A4 inducers, the dose may need to be increased.
Administration and Monitoring
- The injection should be administered by a healthcare professional, alternating between the two gluteal or deltoid muscles each month.
- Missed doses should be addressed promptly - if 4-5 weeks have elapsed since the last dose, administer as soon as possible; if more than 5 weeks have elapsed, restart concurrent oral supplementation for 14 days.
- This regimen ensures consistent blood levels of aripiprazole, which is important for maintaining its dopamine and serotonin receptor modulating effects in treating conditions like schizophrenia and bipolar disorder.
While other studies discuss the pharmacokinetics and use of antipsychotics like risperidone and paliperidone 2, 3, 4, 5, the specific guidance for switching to Abilify Maintena is most directly informed by the principles of establishing tolerability and maintaining therapeutic drug levels, as outlined in the context of aripiprazole treatment 1.