Aripiprazole Administration Timing
Aripiprazole should be administered once daily without regard to meals, meaning it can be taken at any time of day—morning or evening—based on patient preference and tolerability. 1
FDA-Approved Dosing Schedule
- The FDA label explicitly states that aripiprazole is administered "on a once-a-day schedule without regard to meals" for all approved indications including schizophrenia, with recommended starting doses of 10 or 15 mg/day 1
- The medication can be taken at any time during the day, as there is no specific requirement for morning versus evening administration 1
Pharmacokinetic Considerations Supporting Flexible Timing
- Aripiprazole has a very long elimination half-life of approximately 75 hours, and its active metabolite (dehydro-aripiprazole) has a half-life of about 94 hours 2, 3, 4
- Steady-state plasma concentrations are achieved by day 14 of continuous dosing, with the drug accumulating over this period to reach 4-fold higher levels than after the first dose 2, 3
- Peak plasma concentrations occur 3-5 hours after oral administration, with 87% oral bioavailability 2, 4
- Due to these long half-lives and the time required to reach steady state (14 days), the specific time of day for administration has minimal impact on therapeutic effect 3
Practical Timing Considerations
The choice between morning or evening dosing should be guided by individual side effect profiles:
- If the patient experiences insomnia or anxiety (the most common adverse effects), morning administration may be preferable 2
- If the patient experiences sedation or lightheadedness, evening administration may improve tolerability 4
- The full therapeutic effect may take 1-2 weeks, and sometimes up to 4 weeks, to manifest regardless of timing 3
Common Pitfall to Avoid
- Do not delay treatment initiation while trying to determine "optimal" timing—the medication's long half-life means that consistent daily administration at any chosen time is more important than the specific hour selected 2, 3
- Dosage adjustments should not be made before 2 weeks of continuous therapy, as this is the time needed to achieve steady state 1, 3