Abilify Maintena Dosage, forms & strengths
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Get started todayAbilify Maintena is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Otsuka America Pharmaceutical, Inc. Abilify Maintena contains aripiprazole, which is classed as an atypical antipsychotic treatment. It is used for the treatment of schizophrenia, and the maintenance monotherapy treatment of bipolar I disorder in adults.
Abilify Maintena forms and strengths
Abilify Maintena is available as a long-acting injectable suspension formulation, in the following doses: 300-mg and 400-mg strength lyophilized powder for reconstitution in single-use pre-filled, dual-chamber syringe, or single-dose vials.
You should use the correct aseptic techniques for reconstitution at room temperature. If the injection is not used immediately keep the vial at room temperature. Shake the vial for at least 60 seconds to re-suspend before injection.
How does Abilify Maintena work?
Aripiprazole’s mechanism of action is not fully understood. It is thought that aripiprazole improves the action of dopamine and serotonin receptors but also blocks 5HT2A receptors. Aripiprazole may also affect other receptors resulting in orthostatic hypotension.
Abilify Maintena dosage chart
Indication
Initial dose
Maintenance dose
Schizophrenia
400 mg monthly by intramuscular injection
400 mg monthly by intramuscular injection
Maintenance Monotherapy of Bipolar I Disorder
400 mg monthly by intramuscular injection
400 mg monthly by intramuscular injection
Abilify Maintena dosage for adults
Abilify Maintena is to be given by intramuscular injection in the deltoid or gluteal muscle only by a healthcare professional. If you are new to aripiprazole, your tolerability must be established with oral aripiprazole before commencing treatment.
The recommended starting and maintenance dose is 400 mg monthly (no sooner than 26 days after the previous injection) as a single injection. If you have adverse reactions with Abilify Maintena, your dose can be reduced to a 300 mg dose. You must take 14 consecutive days of concurrent oral aripiprazole (10 mg to 20 mg) or current oral antipsychotic with your first dose. If you are known to be a CYP2D6 poor metabolizer your recommended starting and maintenance treatment dose will be 300 mg monthly as a single injection.
Abilify Maintena boxed warning
Elderly patients with dementia-related psychosis being treated with antipsychotic drugs are at an increased risk of death. Abilify Maintena is not FDA-approved for the treatment of patients with dementia-related psychosis.
Abilify Maintena dosage restrictions
Abilify Maintena may cause problems if you have certain medical conditions. Contraindications include having known hypersensitivity to the active ingredient aripiprazole, having an allergy to any of the other ingredients in Abilify Maintena, or if you are an older adult with dementia-related psychosis.
Other medical conditions may require closer monitoring for side effects. Conditions include heart disease, if you have had a heart attack or stroke, having high or low blood pressure, having diabetes or a family history of diabetes, if you suffer from seizures, having low white blood cells, if you are pregnant or are planning to become pregnant, or are breastfeeding or are planning to breastfeed.
How to take Abilify Maintena
Abilify Maintena is given as a shot directly into a muscle once every 4 to 8 weeks, depending on what you are being treated for. Your doctor may want you to take oral doses for a short period before your first shot, and for up to 3 weeks after your first injection. You should follow your doctor’s instructions carefully and not stop using any medications. Abilify Maintena can make you become dehydrated, so make sure you drink plenty of water. Your recommended dose will depend on the condition you are being treated for, your age, weight, and your renal function.
Please see the full prescribing information, including the medication guide and boxed warning for full drug information, and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.
Abilify Maintena dosage FAQs
How long does it take Abilify Maintena to work?
Injectable aripiprazole has a much longer half-life than oral aripiprazole, and Abilify Maintena should only be prescribed after you have reached an effective dosing regimen of oral aripiprazole. It may take two weeks to notice improvements in symptoms (this is when plasma concentrations reach a steady level in the body). This is also the reason dose adjustments are not made more than every two weeks. Your symptoms will continue to improve after a two-week period but it will still take a few months to reach the full benefit of taking Abilify Maintena.
What happens if I miss a dose of Abilify Maintena
You should not miss a dose of Abilify Maintena. If you miss a dose call your healthcare provider right away to discuss what you should do next. Dosage adjustments are required for missed doses.
How do I stop taking Abilify Maintena?
Discontinuation of Abilify suddenly may cause withdrawal symptoms in some patients. Only stop taking Abilify under the medical advice of a healthcare professional.
What interacts with Abilify Maintena?
Drug interactions can change how Abilify Maintena and other medications work. It can even increase the likelihood and severity of some side effects. Medications that are known or thought to interact with Abilify Maintena include:
- Strong CYP3A4 inhibitors (ketoconazole)
- CYP3A4 inducers (carbamazepine)
- Strong CYP2D6 inhibitors (quinidine, paroxetine, fluoxetine)
- Opioid painkillers – alfentanil, buprenorphine, codeine, morphine, tramadol
- Other treatments for schizophrenia – clozapine
- Anesthetics – ketamine
- Antiemetics to prevent sickness – metoclopramide
Tell your prescribing physician about all drugs you’re taking, including over-the-counter medication, vitamins, and dietary supplements.
What are the side effects of Abilify Maintena
Common side effects of Abilify Maintena in clinical trials compared to placebo include:
- Somnolence, sedation
- Injection site reaction
- Weight gain
- Constipation, dry mouth, diarrhea, vomiting, abdominal discomfort
Serious side effects include:
- Risk of extrapyramidal symptoms (EPS) (eg, pseudoparkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesia
- Hyperglycemia (high blood sugar)
- Anemia (low red blood cells)
- Serotonin syndrome especially in cases of concomitant use with other serotonergic medicinal products, such as SSRI/SNRI, or with medicinal products that are known to increase aripiprazole concentrations
- Dysphagia
- Seizures
- Elevated hepatic enzymes
- Cerebrovascular adverse reactions in elderly patients with dementia-related psychosis. Increased incidence of stroke, transient ischemic attack, including fatalities
- Neuroleptic malignant syndrome (NMS)
- High cholesterol
- High blood sugar
- High blood pressure
- Fast or slow heart rate
- Orthostatic hypotension
- Suicidal thoughts, or worsening of depression
- Dyslipidemia
- Leukopenia, neutropenia, and agranulocytosis – check blood counts in patients with a history of low white blood cell count (WBC)
- Cognitive and motor impairment
Your doctor will assess the benefits of using Abilify Maintena against your risk of adverse events. You are encouraged to report negative side effects or adverse reactions to the FDA, or visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
What happens when you mix Abilify Maintena and alcohol?
Alcohol can increase the side effects of aripiprazole such as dizziness, drowsiness, and difficulty concentrating. You may also experience impairment in thinking and judgment. Abilify Maintena with alcohol should be avoided.
Is it safe to take Abilify Maintena during pregnancy or when breastfeeding?
Women who are pregnant or breastfeeding are advised to be cautious when taking Abilify Maintena, especially during the third trimester. Babies have been born with extrapyramidal symptoms or withdrawal symptoms when Abilify is taken in the third trimester.
Abilify Maintena can pass into your breast milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you use Abilify Maintena.