Aripiprazole: Uses, Mechanism of Action, Side Effects, Interactions, Administration and Warnings

Index

It is a drug that must be administered under the strict judgment of the physician.

It comes in four forms that you take by mouth: a tablet, an orally disintegrating tablet, a solution, and a tablet that contains a sensor (to let your doctor know if you have taken the medication).

It also comes as an injectable solution administered only by a healthcare provider.

Aripiprazole oral tablet is available as brand-name drugs Abilify (oral tablet) and Abilify MyCite (oral sensor tablet).

The regular oral tablet and the orally disintegrating tablet are also available as generic drugs. Generic drugs generally cost less than the brand name version.

Aripiprazole oral tablet can be used as part of combination therapy.

Aripiprazole oral tablet is available as a brand name drug and a generic drug.

Applications

Aripiprazole is used predominantly for the treatment of:

  • Schizophrenia.
  • Bipolar disorder

It can also be used as a complementary treatment for:

  • Major depressive disorder.
  • Tic disorders.
  • Obsessive-compulsive disorders (OCD).
  • Tourette Syndrome.
  • The irritability associated with autism.

Mechanism of action

As with other atypical antipsychotics, the exact method of action for aripiprazole is not known. The design of the drug was based on the dopamine hypothesis.

The dopamine hypothesis predicts that hyperactivity of dopamine in the brain’s mesolimbic pathways (also known as reward pathways) causes delusions, hallucinations, and disorganized thoughts.

Dopamine inactivity in the mesocortical pathways (involved in cognitive control, motivation, and emotional response) and the prefrontal cortex (an area involved in planning complex cognitive behavior and moderating social behavior) leads to impairment.

This impairment manifests itself in language ability, the inability to experience pleasure, and autism.

The effects of aripiprazole on dopamine receptors are believed to decrease dopamine production and stabilize the dopamine system.

Aripiprazole side effects

Aripiprazole oral tablet can cause mild or serious side effects. The following list contains some of the main side effects that can occur when taking aripiprazole. This list does not include all possible side effects.

Consult your doctor or pharmacist for more information on the possible side effects of aripiprazole or advice on how to treat a concerning side effect.

The more common side effects of aripiprazole can include:

  • Nausea.
  • Threw up.
  • Drowsiness.
  • Constipation.
  • Headache.
  • Dizziness.
  • Feeling agitated or distressed
  • Anxiety.
  • Trouble sleeping
  • Restlessness.
  • Fatigue.
  • Nasal congestion.
  • Weight gain.
  • Increased appetite
  • Uncontrolled movements, such as shaking.
  • Stiff muscles

If these effects are mild, they can go away in a few days to a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms are life threatening or if you think you have a medical emergency. Serious side effects and their symptoms may include the following:

Neuroleptic Malignant Syndrome (NMS)

Symptoms can include:

  • Fever.
  • Stiff muscles
  • Confusion.
  • Perspiration.
  • Changes in heart rate
  • Changes in blood pressure
  • High blood sugar level.
  • Weight gain.
  • Difficulty swallowing
Late dyskinesia

Symptoms can include:

  • Not being able to control your face, tongue, or other parts of the body
Orthostatic hypotension

This is the low blood pressure that occurs when you get up quickly from sitting or lying down.

Symptoms can include:

  • Feel dizzy.
  • Dizziness.
  • Fainting.
  • Low white blood cell count.
  • Seizures
Stroke

Symptoms can include:

  • Numbness or weakness on one side of the body.
  • Confusion.
  • Talk confused.

Interactions

Aripiprazole can interact with other medications.

Aripiprazole oral tablet can interact with several other medications. Different interactions can cause different effects. For example, some can interfere with how well a drug works, while others can cause increased side effects.

Before taking aripiprazole, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other medications that you take. Also tell them about the vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Interactions that increase your risk of side effects

Taking aripiprazole with certain medications increases the risk of aripiprazole side effects. This is because the amount of aripiprazole in your body may increase.

Examples of these medications include:

Antifungal drugs such as ketoconazole or itraconazole

Increased side effects can include nausea, constipation, dizziness, restlessness, or tiredness. They can also include tardive dyskinesia (movements you cannot control) or neuroleptic malignant syndrome (a rare but life-threatening condition). Your doctor may lower your dose of aripiprazole.

Antidepressants such as la fluoxetine or la paroxetine

Increased side effects can include nausea, constipation, dizziness, restlessness, or tiredness.

They can also include tardive dyskinesia (movements you cannot control) or neuroleptic malignant syndrome (a rare but life-threatening condition). Your doctor may lower your dose of aripiprazole.

Quinidina

Increased side effects can include nausea, constipation, dizziness, restlessness, or tiredness. They can also include tardive dyskinesia (movements you cannot control) or neuroleptic malignant syndrome (a rare but life-threatening condition).

Your doctor may lower your dose of aripiprazole.

Interactions that can make your medications less effective

When aripiprazole is used with certain medications, it may not work as well to treat your condition. This is because the amount of aripiprazole in your body may decrease.

Examples of these medications include:

Anti-seizure medications such as phenytoin or carbamazepine

Your doctor may switch you from aripiprazole to a different antipsychotic if necessary, or increase your aripiprazole dose.

Aripiprazole dosage

The dose of aripiprazole that your doctor prescribes will depend on several factors. These include:

  • The type and severity of the condition that aripiprazole is using to treat.
  • Your age.
  • The form of aripiprazole you take.
  • Other medical conditions you may have.

Generally, your doctor will start with a low dose and adjust it over time to reach the right dose for you. Ultimately, they will prescribe the smallest dose that provides the desired effect.

The following information describes the doses that are commonly used or recommended. However, be sure to take the dose that your doctor prescribes. Your doctor will determine the best dose to meet your needs.

Dosage for schizophrenia

  • Form: oral tablet.
  • Fortalezas: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.
Adult dosage (ages 18 to 64 years)
  • Typical starting dose: 10 to 15 mg once a day.
  • Typical maintenance dose: 10 to 15 mg once a day.
  • Maximum dose: 30 mg once a day.
Infant dose (ages 13 to 17 years)
  • Typical starting dose: 2 mg once a day for two days, then 5 mg once a day for two days. Then take 10 mg once a day.
  • Dose increase: if necessary, your doctor may increase your dose by 5 mg / day at a time.
Infant dose (ages 0 to 12 years)

This medicine has not been established to be safe and effective for treating this condition in children of this age group.

Higher dose (over 65 years)

Older adults’ kidneys and liver may not work as well as they used to. This can cause your body to process medications more slowly. As a result, more of a drug stays in your body for longer. This increases your risk of side effects.

Your doctor may start with a lower dose or a different drug schedule. This can help prevent levels of this drug from building up too much in your body.

Dosage for bipolar I disorder (manic or mixed episodes or maintenance treatment)

  • Form: oral tablet.
  • Fortalezas: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.
Adult dosage (ages 18 to 64 years)

All three tablets, when used alone:

  • Typical starting dose: 15 mg once a day.
  • Typical maintenance dose : 15 mg once a day.
  • Maximum dose : 30 mg once a day.

All three tablets, when used with lithium or valproate:

  • Typical starting dose: 10 to 15 mg once a day.
  • Typical maintenance dose: 15 mg once a day.
  • Maximum dose: 30 mg once a day.
Infant dose (ages 10 to 17 years)
  • Typical starting dose: 2 mg once a day for two days, then 5 mg once a day for two days. Then take 10 mg once a day.
  • Dose increase: if necessary, your doctor may increase your dose by 5 mg / day at a time.
Infant dose (ages 0 to 9 years)

This medicine has not been established to be safe and effective for treating this condition in children of this age group.

Higher dose (over 65 years)

Older adults’ kidneys and liver may not work as well as they used to. This can cause your body to process medications more slowly.

As a result, more of a drug stays in your body for longer. This increases your risk of side effects.

Your doctor may start with a lower dose or a different drug schedule. This can help prevent levels of this drug from building up too much in your body.

Dosage for major depression in people already taking an antidepressant

  • Form: oral tablet.
  • Fortalezas: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.
Adult dosage (ages 18 to 64 years)

Oral tablet and orally disintegrating tablet:

  • Typical starting dose: 2 to 5 mg once a day.
  • Typical dosage: 2 to 15 mg once a day.
  • Dose increase: if necessary, your doctor may slowly increase your dose, up to 5 mg at a time. Your dose should not be increased more than once a week.

Tableta oral con sensor:

  • Typical starting dose: 2 to 5 mg once a day.
  • Typical dosage: 2 to 15 mg once a day.
  • Maximum dose: 15 mg once a day.
Infant dose (ages 0 to 17 years)

This medication is not prescribed to treat this condition in children.

Higher dose (over 65 years)

Older adults’ kidneys and liver may not work as well as they used to. This can cause your body to process medications more slowly.

As a result, more of a drug stays in your body for longer. This increases your risk of side effects.

Your doctor may start with a lower dose or a different drug schedule. This can help prevent levels of this drug from building up too much in your body.

Dosage for irritability caused by autistic disorder

  • Form : oral tablet.
  • Fortalezas: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.
Adult dosage (over 18 years)

This drug is not prescribed to treat this condition in adults.

Child dosage (ages 6 to 17 years)
  • Typical starting dose: 2 mg per day.
  • Ongoing dosage range: 5 to 15 mg once daily.
  • Increasing the dose: If necessary, your child’s doctor may increase the dose as needed.
Infant dose (ages 0 to 5 years)

This medicine has not been established to be safe and effective for treating this condition in children of this age group.

Dosage for Tourette syndrome

  • Form: oral tablet.
  • Fortalezas: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg.
  • Form: orally disintegrating tablet.
  • Fortalezas: 10 mg, 15 mg, 20 mg, 30 mg.
Adult dosage (over 19 years)

This drug is not prescribed to treat this condition in adults.

Infant dose (ages 6 to 18 years)
  • Typical starting dose (for children weighing <110 lbs. [50 kg]): 2 mg once daily.
  • Target dosage: 5 to 10 mg once a day.
  • Typical starting dose (for children weighing ≥110 pounds [50 kg]): 2 mg once daily.
  • Daily dose: 10 to 20 mg once a day.

Warnings about aripiprazole

FDA warnings

This drug has black box warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Black box warnings alert doctors and patients to potentially dangerous drug effects.

Increased risk of death in older people with dementia warning: The use of this drug increases the risk of death in older people (over 65 years) with dementia-related psychosis.

Warning about the risk of suicide in children: The use of antidepressants in children, adolescents and young adults can increase thoughts of suicide and suicidal behavior.

Talk to your doctor about whether this medicine is safe for your child. The potential benefit must outweigh the risk of using this drug.

Neuroleptic Malignant Syndrome Warning

In rare cases, this drug can cause a serious reaction called neuroleptic malignant syndrome (NMS).

Symptoms can include low blood pressure, increased heart rate, muscle stiffness, confusion, or elevated body temperature. If you have any or all of these symptoms, call 911 right away.

Metabolic changes warning

This medicine can cause changes in the way your body works. These changes can lead to high blood sugar or diabetes, high cholesterol or triglyceride levels, or weight gain.

Tell your doctor if you notice an increase in your weight or blood sugar level. You may need to change your diet or medication doses.

Dysphagia warning

This medicine can cause dysphagia (difficulty swallowing). If you are at risk for aspiration pneumonia, talk to your doctor about whether this medicine is safe for you.

Allergy warning

This medicine can cause a severe allergic reaction.

Symptoms can include:

  • Hives (itchy welts).
  • Itch.
  • Swelling of the face, eyes, or tongue.
  • Difficulty breathing.
  • Wheezing
  • Chest tightness.
  • Fast and weak heart rate.
  • Nausea or vomiting

If you develop these symptoms, call 911 or go to the nearest emergency room.

Do not take this medicine again if you have ever had an allergic reaction. Taking it again could be fatal (cause death).

Alcohol Interaction Warning

Do not drink alcohol while you are taking this drug. Aripiprazole causes drowsiness, and alcohol can make this side effect worse. It also increases your risk of liver damage.

Warnings for people with certain health conditions.

For people with heart conditions: This drug has not been established to be safe and effective for use in people with certain heart conditions.

These conditions include unstable heart disease or a recent history of stroke or heart attack. Tell your doctor if you have a heart condition before starting this medicine.

For people with epilepsy: If you have a history of seizures, talk to your doctor about whether this drug is safe for you. Also talk to your doctor if you have conditions that increase the risk of seizures, such as Alzheimer’s dementia.

For people with a low white blood cell count: This drug may cause a low white blood cell count. Your doctor will monitor you for symptoms of this problem. They will also do regular blood tests.

If you develop a low white blood cell count while taking this medicine, your doctor will stop this treatment. Tell your doctor if you have a history of low white blood cell count before starting treatment with this medicine.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. Not enough human studies have been done to be sure how the drug might affect the fetus.

Talk to your doctor if you are pregnant or planning to become pregnant. This medication should be used only if the potential benefit justifies the potential risk.

If you become pregnant while taking this medicine, call your doctor immediately.

If you use the oral sensor tablet during pregnancy, consider enrolling in the National Pregnancy Registry for Atypical Antipsychotics. Your doctor can tell you more.

For women who are breastfeeding: This drug passes into breast milk and may cause side effects in a child who is breastfed.

Talk to your doctor if you are breastfeeding your child. You may need to decide whether to stop breast-feeding or to stop taking this medicine.

For older people: Your kidneys and liver may not work as well as they used to. This can cause your body to process medications more slowly.

As a result, more of a drug stays in your body for longer. This increases your risk of side effects.

For children : For children, this drug is only used to treat:

  • Schizophrenia in children older than 13 years.
  • Manic or mixed episodes caused by bipolar I disorder in children 10 years of age and older.
  • Irritability caused by an autistic disorder in children 6 years and older
  • Tourette syndrome in children 6 years of age and older.

This medicine has not been established to be safe and effective for use in children with certain conditions that this medicine can treat in adults. These conditions include major depressive disorder.

Take as indicated

Aripiprazole oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the medicine suddenly or do not take it at all: You should not suddenly stop taking this medicine or change your dose without consulting your doctor. Stopping this drug suddenly can cause unwanted side effects.

These can include symptoms such as facial tics or uncontrolled speech. They can also include uncontrolled tremors such as the tremor caused by Parkinson’s disease.

If you do not take this medicine, your symptoms may not improve.

If you miss a dose or don’t take the medicine on time: Your medicine may not work as well or it may stop working altogether.

For this medicine to work well, a certain amount must be in your body at all times. If you take too much: you could have dangerous levels of the drug in your body.

Symptoms of an overdose of this drug may include:

  • Barf.
  • Temblor.
  • Drowsiness.

If you think you have taken too much of this medicine, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose

take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take just one dose. Never try to catch up by taking two doses at the same time. This could result in dangerous side effects.

How to tell if the medicine is working: Your symptoms should improve. Your doctor will examine you to see if your symptoms are improving.

Considerations

Keep these considerations in mind if your doctor prescribes aripiprazole for you.

General

  • Take this medicine with or without food.
  • Take this medicine at the time (s) recommended by your doctor.
  • You can cut or crush the oral tablet or oral disintegrating tablet. But do not cut, crush, or chew the oral sensor tablet.
  • Avoid getting overheated or dehydrated (low fluid levels) while taking this medicine. Aripiprazole can make it harder for your body to maintain a normal temperature. This can cause your temperature to rise too high.

Storage

For all tablets

Do not store these items in damp or wet areas, such as bathrooms.

For the oral tablet and orally disintegrating tablet:

Store these tablets at room temperature between 59 ° F and 86 ° F (15 ° C and 30 ° C).

For the oral tablet with sensor

Store the tablet at a temperature between 68 ° F and 77 ° F (20 ° C and 25 ° C). You can store it for short periods at temperatures between 59 ° F and 86 ° F (15 ° C and 30 ° C).

Refills

A prescription for this drug is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Self-management

When using the oral sensor tablet:

Your doctor will explain how to use this tablet.

You will need to download an application on your smartphone that will track your medication use.

The tablet comes with a patch that you will need to wear on your skin. The phone app will tell you when and where to apply the patch.

Do not apply the patch to skin that is scraped, cracked, or irritated. You can keep the patch on when bathing, swimming, or exercising.

You will need to change the patch every week, or sooner as needed.

Trip

When traveling with your medication:

Always carry your medicine with you. When flying, never put it in a checked suitcase. Store it in your handbag.

Don’t worry about the X-ray machines at the airport. They cannot harm your medication.

You may need to show the airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.

Do not put this medicine in the glove compartment of your car or leave it in the car. Make sure to avoid doing this when the weather is very hot or very cold.

Clinical follow-up

During your treatment with this medicine, your doctor will monitor you for side effects.

They will also monitor your symptoms and do regular blood tests to check your:

  • Glycemia.
  • Cholesterol levels
  • Kidney function.
  • Liver function
  • Blood cell count.
  • Thyroid function

Availability

Not all pharmacies stock this drug. When you fill your prescription, be sure to call ahead to make sure your pharmacy carries it.

Is there an alternative?

There are other medications available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about other drug options that may work for you.

recommendations

It is recommended that you wait to drive or operate machinery until you know how the medicine affects you.

Report important side effects to your doctor right away, which may include: seizures, chest pain, fever, uncontrollable body movements, vision changes, irregular changes or changes in your heartbeat, hives, sweating, confusion, muscle stiffness , itching, swelling, trouble breathing or swallowing.

Adolescents who take the medication may be at high risk of developing suicidal thoughts.

Disclaimer

This article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication.

The drug information in this document is subject to change and is not intended to cover all possible uses, instructions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.

The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.