Can Abilify (aripiprazole) be administered via a Percutaneous Endoscopic Gastrostomy (PEG) tube?

Administration of Abilify (Aripiprazole) via PEG Tube

Abilify (aripiprazole) can be safely administered through a PEG tube by using the liquid formulation or by crushing the tablet and mixing it with water, as long as proper administration techniques are followed to prevent tube occlusion.

Appropriate Formulations for PEG Tube Administration

When administering Abilify through a PEG tube, consider the following options:

• Preferred option: Use the liquid formulation of aripiprazole when available

  • Liquid formulations are generally preferred for enteral administration 1
  • This avoids the need for crushing and potential issues with modified-release formulations

• Alternative option: Crush immediate-release tablets

  • Standard immediate-release aripiprazole tablets can be crushed and mixed with water
  • Do not crush extended-release formulations as this would alter drug delivery

Proper Administration Technique

To administer aripiprazole via PEG tube safely:

1. Preparation:

   • If using tablets, crush them to a fine powder
   • Mix with 15-30 mL of warm water until fully dissolved 1
   • Use a mortar and pestle for complete pulverization

2. Administration:

   • Stop enteral feeding before medication administration
   • Flush the tube with at least 15 mL of water
   • Administer the medication suspension using a syringe
   • Flush again with 15-30 mL of water after administration

3. Timing considerations:

   • Hold enteral feeding for at least 30 minutes before and after administration
   • This helps prevent potential drug-nutrient interactions and ensures proper absorption

Important Considerations

• Tube size: PEG tubes typically have larger diameters (≥15 French) which reduces the risk of clogging compared to smaller tubes 2

• Avoid direct addition to formula: Never add medications directly to enteral formula as this can cause incompatibilities and altered drug efficacy 1

• Prevent tube occlusion: Proper flushing before and after medication administration is essential to prevent tube blockage 2, 1

• Monitoring: Monitor for therapeutic efficacy and side effects as bioavailability might differ slightly from oral administration

Special Precautions

• Patients with liver disease: Exercise caution when using PEG tubes in patients with liver cirrhosis, especially those with ascites or varices, as PEG placement carries higher risks in these patients 2

• Hypertonic preparations: Be aware that some liquid medications may be hypertonic or contain sorbitol, which could cause gastrointestinal side effects 1

• Separate administration: If multiple medications are being administered, give each separately with appropriate flushes in between to prevent interactions

By following these guidelines, aripiprazole can be effectively and safely administered through a PEG tube while minimizing the risk of complications such as tube occlusion or reduced drug efficacy.