From the Guidelines
Aripiprazole dosing typically starts at 5 mg p.o. or i.m. (immediate-release) stat, with a scheduled dosing of q24h if required, and may need to be reduced in older patients and in poor metabolisers of cytochrome P450 2D6. The dosing of aripiprazole is crucial in managing its potential side effects, such as headache, agitation, anxiety, insomnia, dizziness, and drowsiness 1. When considering the use of aripiprazole, it's essential to be aware of potential drug-drug interactions, particularly with cytochrome P450 2D6 and 3A4, and to consult pharmacist/pharmacy references for further details 1.
Key Considerations
- The starting dose of aripiprazole is 5 mg p.o. or i.m. (immediate-release) stat, which may be adjusted based on patient response and tolerability 1.
- Scheduled dosing is typically q24h if required, allowing for a consistent and controlled management of symptoms 1.
- Dose reduction is necessary in older patients and in poor metabolisers of cytochrome P450 2D6 to minimize the risk of adverse effects 1.
Potential Side Effects and Interactions
- Aripiprazole may cause headache, agitation, anxiety, insomnia, dizziness, and drowsiness, which should be monitored and managed accordingly 1.
- Potential drug-drug interactions, particularly with cytochrome P450 2D6 and 3A4, should be considered and addressed through consultation with pharmacist/pharmacy references 1.
From the FDA Drug Label
2. 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 Aripiprazole tablets have been systematically evaluated and shown to be effective in a dose range of 10 to 30 mg/day, when administered as the tablet formulation; however, doses higher than 10 or 15 mg/day were not more effective than 10 or 15 mg/day. Adolescents The recommended target dose of aripiprazole tablets is 10 mg/day. Aripiprazole was studied in adolescent patients 13 to 17 years of age with schizophrenia at daily doses of 10 mg and 30 mg
The doses of aripiprazole (Abilify) are:
- Adults: 10 or 15 mg/day, with a dose range of 10 to 30 mg/day
- Adolescents: 10 mg/day, with a studied dose range of 10 mg and 30 mg/day 2
From the Research
Doses of Aripiprazole
- The recommended dose range for aripiprazole is 10-30 mg/day for schizophrenia and 15-30 mg/day for manic or mixed states associated with bipolar I disorder 3.
- Aripiprazole 10 or 15 mg once daily is effective and well tolerated in patients with schizophrenia or schizoaffective disorder 4.
- The recommended starting and target dose for aripiprazole is 10 or 15 mg/day administered on a once-a-day schedule without regard to meals 5.
- In the treatment of a manic episode, aripiprazole may be initiated at 15 mg/day and adjusted as required (down to 5-10 mg/day or up to 30 mg/day) 6.
- The optimum dose for aripiprazole is 10 mg/day, and doses above 20 mg/day do not appear to provide any additional benefit and may be associated with a smaller change in symptom scores 7.
Dosage Adjustments
- Dosage increases should not be made before 2 weeks of continuous therapy, the time needed to achieve steady state 5.
- When switching to aripiprazole, it is frequently advisable to maintain the therapeutic dose of current medication, add aripiprazole 5, 10 or 15 mg/day, and adjust between 10 and 30 mg/day depending on response and tolerability 6.
- Dosage adjustment of aripiprazole is necessary when it is coadministered with CYP3A4 and CYP2D6 inhibitors (since aripiprazole concentration is increased) and with inducers of CYP3A4 (since aripiprazole concentration is decreased) 4.