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 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.
The long-acting doses of Aripiprazole (Abilify) are not explicitly mentioned in the provided text. The text only discusses the dosage for tablet formulation, not long-acting doses. 1
From the Research
Aripiprazole long-acting injectable formulations are available in two main options: Abilify Maintena (monthly) and Aristada (monthly, every 6 weeks, or every 2 months). For Abilify Maintena, the recommended dose is 400 mg once monthly by intramuscular injection, with a lower 300 mg dose available for patients who experience adverse effects or have CYP2D6 poor metabolizer status. Prior to starting the long-acting injection, patients should be stabilized on oral aripiprazole for at least 2 weeks. For the first injection, continue oral aripiprazole for 14 days afterward to maintain therapeutic levels. Aristada offers more flexible dosing options: 441 mg, 662 mg, or 882 mg monthly; 882 mg every 6 weeks; or 1064 mg every 2 months. When initiating Aristada, patients can either be stabilized on oral aripiprazole first or use the Aristada Initio one-time 675 mg injection plus a single 30 mg oral aripiprazole dose to achieve rapid therapeutic levels. These long-acting formulations help improve medication adherence in patients with schizophrenia or bipolar I disorder by maintaining steady drug levels and reducing the need for daily dosing. Common side effects include injection site reactions, weight gain, akathisia, and sedation, so regular monitoring is essential, as noted in studies such as 2.
Some key points to consider when prescribing aripiprazole long-acting injectable formulations include:
- The importance of stabilizing patients on oral aripiprazole before initiating long-acting injections, as discussed in 3
- The need for careful monitoring of patients for potential side effects, such as injection site reactions and weight gain, as mentioned in 4
- The flexibility of dosing options with Aristada, which can be tailored to individual patient needs, as described in 2
- The potential benefits of improved medication adherence and reduced risk of relapse with long-acting injectable formulations, as highlighted in 5.
Overall, aripiprazole long-acting injectable formulations offer a valuable treatment option for patients with schizophrenia or bipolar I disorder, and can help improve medication adherence and reduce the risk of relapse, as supported by the evidence from studies such as 4, 5, 2.