Switching from Aripiprazole Tablet to Solution
The oral solution can be directly substituted for tablets on a mg-per-mg basis up to 25 mg, with patients on 30 mg tablets receiving 25 mg of solution instead. 1
Direct Substitution Protocol
Perform a 1:1 dose conversion for all doses up to 25 mg (e.g., 10 mg tablet = 10 mg solution, 15 mg tablet = 15 mg solution, 20 mg tablet = 20 mg solution). 1
For patients taking 30 mg tablets, switch to 25 mg of oral solution rather than attempting a 30 mg equivalent, as this is the FDA-approved conversion strategy. 1
No titration period or cross-tapering is required when switching between these formulations of the same medication, unlike switches between different antipsychotic agents. 1
Administration Considerations
Administer the solution once daily without regard to meals, maintaining the same timing as the previous tablet regimen to preserve steady-state pharmacokinetics. 1
Ensure accurate measurement using calibrated oral dosing syringes or cups provided with the solution to prevent dosing errors, particularly important given that liquid formulations carry higher risk of measurement inaccuracy compared to fixed-dose tablets. 1
Monitoring Parameters
Monitor for any changes in symptom control during the first 2-4 weeks post-switch, though bioequivalence between formulations makes significant clinical changes unlikely. 1
Assess adherence and patient preference between formulations, as some patients may prefer liquid formulations due to swallowing difficulties while others may find tablets more convenient. 2, 3
Common Pitfalls to Avoid
Do not attempt to give 30 mg of oral solution to match a 30 mg tablet dose - the FDA label explicitly states that 25 mg solution is the appropriate conversion for 30 mg tablets. 1
Avoid assuming the solution requires different dosing intervals - once-daily administration remains appropriate for the solution formulation. 1
Do not initiate new dose adjustments simultaneously with the formulation switch, as this makes it impossible to determine whether any clinical changes are due to the formulation change or the dose modification. 1
Special Populations
For patients with cytochrome P450 considerations (CYP2D6 poor metabolizers or those on CYP3A4/2D6 inhibitors or inducers), maintain the same adjusted dose when converting to solution - the pharmacokinetic interactions remain identical across formulations. 1
Adolescent patients (13-17 years) can be switched using the same mg-per-mg conversion, as the solution formulation does not alter the established dosing recommendations for this age group. 1