From the Guidelines
Abilify (aripiprazole) should be prescribed at a starting dose of 5 mg p.o. or i.m. (immediate-release) stat, with a scheduled dosing of q24h, and reduced dose in older patients and in poor metabolisers of cytochrome P450 2D6. When considering the use of Abilify, it's crucial to weigh the benefits against potential side effects, which may include headache, agitation, anxiety, insomnia, dizziness, and drowsiness 1.
Key Considerations
- The dosage may need to be adjusted based on the patient's response and tolerability.
- Abilify is less likely to cause extrapyramidal side effects (EPSEs) compared to other antipsychotics, making it a preferable option for certain patients 1.
- It's essential to monitor for potential drug-drug interactions, particularly with cytochrome P450 2D6 and 3A4, and consult a pharmacist or pharmacy references for further guidance 1.
Patient-Specific Factors
- Older patients and those with hepatic impairment may require lower doses, starting with 5 mg and titrating gradually as needed.
- Patients with severe renal impairment should be closely monitored due to the potential for increased exposure to aripiprazole.
- The medication can be taken with or without food, but it's recommended to take it at the same time each day to maintain consistent drug levels.
Side Effects and Monitoring
- Common side effects include weight gain, restlessness, and dizziness, which should be monitored and addressed promptly.
- Patients should not stop taking Abilify abruptly without medical supervision to avoid potential withdrawal symptoms. Given the potential benefits and risks, the recommended use and dosage of Abilify should be individualized based on the patient's condition, response, and tolerability, with careful consideration of potential side effects and drug interactions 1.
From the FDA Drug Label
- 1 Schizophrenia Adults The recommended starting and target dose for aripiprazole tablets is 10 or 15 mg/day administered on a once-a-day schedule without regard to meals Adolescents The recommended target dose of aripiprazole tablets is 10 mg/day.
- 7 Dosage Adjustments for Cytochrome P450 Considerations Dosage adjustments are recommended in patients who are known CYP2D6 poor metabolizers and in patients taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors or strong CYP3A4 inducers
The recommended use and dosage of Abilify (aripiprazole) is as follows:
- Schizophrenia in Adults: The recommended starting and target dose is 10 or 15 mg/day, administered once a day.
- Schizophrenia in Adolescents: The recommended target dose is 10 mg/day.
- Dosage Adjustments: May be necessary for patients who are known CYP2D6 poor metabolizers or taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors or strong CYP3A4 inducers, as outlined in Table 2 2.
From the Research
Recommended Use of Abilify (Aripiprazole)
- Abilify (aripiprazole) is an atypical antipsychotic drug used for the treatment of schizophrenia and bipolar I disorder 3, 4, 5, 6, 7.
- It is effective in treating the positive and negative symptoms of schizophrenia, as well as manic or mixed states associated with bipolar I disorder 3, 4, 5, 7.
Dosage of Abilify (Aripiprazole)
- The recommended dose of aripiprazole for schizophrenia is 10-30 mg/day 4, 5.
- For manic or mixed states associated with bipolar I disorder, the recommended dose is 15-30 mg/day 4, 7.
- Dosage titration is not necessary, and the drug is effective in the first few weeks of treatment 5.
- A revised dosing strategy, based on weight, may be indicated for children and adolescents 3.
Administration and Pharmacology
- Aripiprazole is rapidly absorbed after oral administration, with a mean time to peak plasma concentration of 3 hours 5.
- It has extensive extravascular distribution and is highly bound to plasma protein 5.
- The drug is primarily eliminated hepatically, with a mean elimination half-life of about 75 hours 5.
- Intramuscular aripiprazole is also available for the treatment of agitation associated with schizophrenia or bipolar I disorder 6.