Can a Patient Take Two 5mg Abilify Tablets Instead of One 10mg Tablet?
Yes, a patient can take two 5mg aripiprazole (Abilify) tablets instead of one 10mg tablet—the total daily dose of 10mg is what matters for therapeutic efficacy, not whether it comes from one or two tablets.
Pharmacological Equivalence
- Taking two 5mg tablets delivers the same total dose (10mg) as one 10mg tablet, making them therapeutically equivalent 1
- The bioavailability and pharmacokinetics are determined by the total milligram dose administered, not the number of tablets 1
- Aripiprazole is typically dosed once daily (q24h), and the guideline recommendation is to give the full daily dose together rather than splitting it throughout the day 1
Practical Considerations
When this approach makes sense:
- Dose titration flexibility: Using 5mg tablets allows easier adjustment when starting at lower doses (particularly in older or frail patients who may need 2.5-5mg initially) and titrating upward 1
- Supply availability: If only 5mg tablets are available in the pharmacy or formulary, two tablets achieve the target 10mg dose 1
- Cost considerations: Sometimes smaller-strength tablets may be more readily available or covered by insurance
Important Caveats
- Medication adherence risk: Taking two tablets instead of one increases the pill burden, which can negatively impact adherence, especially in patients already on polypharmacy 2
- Patient understanding: Ensure clear instructions that both tablets should be taken together at the same time, not split throughout the day—misunderstanding of dosing frequency is common and occurs in approximately 38.5% of patients 2
- Avoid splitting the daily dose: The full 10mg dose (whether as one or two tablets) should be administered once daily, not divided into multiple administrations throughout the day 1, 3
Counseling Recommendations
- Use explicit language when instructing patients: "Take both 5mg tablets together once daily" rather than vague instructions 4
- Provide written instructions accompanying the prescription to reinforce verbal counseling 2
- Patients with limited literacy are at higher risk for misinterpreting instructions and may benefit from additional counseling 4