Abilify Maintena 300mg IM Dosing Window
Abilify Maintena 300mg IM given every 4 weeks can be administered up to 2 weeks late (within ±2 weeks of the scheduled injection date), meaning the maximum allowable interval is 6 weeks from the prior injection. 1
Specific Dosing Window Guidelines
The injection can be given within ±2 weeks of the scheduled 4-week (monthly) injection date, allowing flexibility for both early and late administration 1
If more than 6 weeks (42 days) have elapsed since the last injection, the dosing schedule is considered interrupted 1
Reinitiation with oral aripiprazole is only necessary if ≥14 weeks have passed since the prior injection, as this represents complete loss of therapeutic coverage 1
Practical Administration Timeline
- Earliest acceptable administration: 2 weeks before scheduled date (at week 2 from prior injection)
- Target administration: Week 4 from prior injection
- Latest acceptable administration: 2 weeks after scheduled date (at week 6 from prior injection)
- Beyond week 6: Dosing continuity is compromised but full reinitiation not required until week 14
Clinical Rationale
The ±2-week window is based on the pharmacokinetic profile of aripiprazole once-monthly formulation, which has an elimination half-life of 29.9-46.5 days 2
This extended half-life provides therapeutic coverage that extends beyond the nominal 4-week dosing interval, allowing the 2-week grace period without loss of efficacy 2
The 400mg dose formulation has the same ±2-week flexibility, indicating this is a class characteristic of the monthly aripiprazole LAI formulation 1
Critical Pitfall to Avoid
Do not restart oral overlap or reinitiation protocols if the patient presents at week 5 or 6 - simply administer the scheduled injection as this remains within the acceptable window 1
Only if ≥14 weeks have elapsed should you consider the patient as requiring full reinitiation with oral aripiprazole coverage 1