Drug Action
Aripiprazole is a dopamine D2 partial agonist with weak 5-HT1a partial agonism and 5-HT2A receptor antagonism.
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Drug reference
Aripiprazole is a dopamine D2 partial agonist with weak 5-HT1a partial agonism and 5-HT2A receptor antagonism.
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Maintenance of schizophrenia in patients stabilised with oral aripiprazole (CYP2D6 poor metabolisers) ▶BY INTRAMUSCULAR INJECTION ▶Adult: 300 mg every month, to be injected into the gluteal or deltoid muscle, minimum of 26 days between injections, treatment with 10–20 mg oral aripiprazole daily should be continued for 14 consecutive days after the first injection, for dose adjustment due to side- effects and for advice on missed doses, consult product literature Maintenance of schizophrenia in patients stabilised with oral aripiprazole ▶BY INTRAMUSCULAR INJECTION ▶Adult: 400 mg every month, to be injected into the gluteal or deltoid muscle, minimum of 26 days between injections, treatment with 10–20 mg oral aripiprazole daily should be continued for 14 consecutive days after the first injection, for dose adjustment due to side- effects and for advice on missed doses, consult product literature Schizophrenia ▶BY MOUTH ▶Adult: 10–15 mg once daily; usual dose 15 mg once daily (max. per dose 30 mg once daily) Treatment and recurrence prevention of mania ▶BY MOUTH ▶Adult: 15 mg once daily, increased if necessary up to 30 mg once daily Control of agitation and disturbed behaviour in schizophrenia ▶BY INTRAMUSCULAR INJECTION ▶Adult: Initially 5.25–15 mg for 1 dose, alternatively usual dose 9.75 mg for 1 dose, followed by 5.25–15 mg after 2 hours if required, maximum 3 injections daily; maximum daily combined oral and parenteral dose 30 mg
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DUE TO INTERACTIONS ▶With oral use Manufacturer advises double the dose with concurrent use of potent inducers of CYP3A4. Manufacturer advises reduce dose by half with concurrent use of potent inhibitors of CYP3A4 or CYP2D6. ▶With intramuscular use For dose adjustments due to concurrent use of interacting drugs—consult product literature.
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CNS depression. comatose state. phaeochromocytoma
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Nervous system GENERAL CAUTIONS Cerebrovascular disease. elderly (reduce initial dose) SPECIFIC CAUTIONS ▶With intramuscular use When transferring from oral to depot therapy, the dose by mouth should be reduced gradually
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When prescribing, dispensing, or administering, check that the correct preparation is used—the preparation usually used in hospital for the rapid control of an acute episode (solution for injection containing aripiprazole 7.5 mg/mL) should not be confused with depot preparations (aripiprazole 400-mg vial with solvent), which are usually used in the community or clinics for maintenance treatment.
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→Appendix 1: aripiprazole
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▶Common or very common Anxiety. appetite abnormal. diabetes mellitus. fatigue. gastrointestinal discomfort. headache. hypersalivation. nausea. vision disorders ▶Uncommon Depression. hiccups. hyperglycaemia. sexual dysfunction ▶Frequency not known Aggression. alopecia. cardiac arrest. chest pain. diabetic hyperosmolar coma. diabetic ketoacidosis. diarrhoea. dysphagia. generalised tonic- clonic seizure. hepatic disorders. hyperhidrosis. hypertension. hyponatraemia. laryngospasm. musculoskeletal stiffness. myalgia. oropharyngeal spasm. pancreatitis. pathological gambling. peripheral oedema. photosensitivity reaction. pneumonia aspiration. rhabdomyolysis. serotonin syndrome. speech disorder. suicidal tendencies. syncope. temperature regulation disorder. thrombocytopenia. urinary incontinence. weight decreased
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Use only if potential benefit outweighs risk.
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Manufacturer advises avoid—present in milk.
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Manufacturer advises caution in severe impairment (oral treatment preferred to intramuscular administration; limited information available).
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▶Aripiprazole does not affect blood pressure to the same extent as other antipsychotic drugs and so blood pressure monitoring is not mandatory for this drug. ▶With intramuscular use Treatment requires careful monitoring for optimum effect.
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▶With oral use Orodispersible tablets should be placed on the tongue and allowed to dissolve, or be dispersed in water and swallowed. ▶With intramuscular use Correct injection technique (including the use of z-track technique) and rotation of injection sites are essential.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral solution Tablet CAUTIONARY AND ADVISORY LABELS 2 ▶Aripiprazole (Non-proprietary) Aripiprazole 5 mg Aripiprazole 5mg tablets | 28 tablet P £96.04 DT = £1.36 Aripiprazole 10 mg Aripiprazole 10mg tablets | 28 tablet P £96.04 DT = £1.36 Aripiprazole 15 mg Aripiprazole 15mg tablets | 28 tablet P £96.04 DT = £1.57 Aripiprazole 30 mg Aripiprazole 30mg tablets | 28 tablet P £192.08 DT = £13.94 ▶Arpoya (Torrent Pharma (UK) Ltd) Aripiprazole 5 mg Arpoya 5mg tablets | 28 tablet P £96.04 DT = £1.36 Aripiprazole 10 mg Arpoya 10mg tablets | 28 tablet P £96.04 DT = £1.36 Aripiprazole 15 mg Arpoya 15mg tablets | 28 tablet P £96.04 DT = £1.57 Aripiprazole 30 mg Arpoya 30mg tablets | 28 tablet P £192.08 DT = £13.94 Solution for injection ▶Abilify (Otsuka Pharmaceuticals (U.K.) Ltd) Nervous system Aripiprazole 7.5 mg per 1 ml Abilify 9.75mg/1.3ml solution for injection vials | 1 vial P £3.43 Oral solution CAUTIONARY AND ADVISORY LABELS 2 ▶Aripiprazole (Non-proprietary) Aripiprazole 1 mg per 1 ml Aripiprazole 1mg/ml oral solution sugar free sugar-free | 150 ml P £101.20 Aripiprazole 1mg/ml oral solution | 150 ml P £102.90 DT = £99.55 ▶Abilify (Otsuka Pharmaceuticals (U.K.) Ltd) Aripiprazole 1 mg per 1 ml Abilify 1mg/ml oral solution | 150 ml P £102.90 DT = £99.55 Powder and solvent for suspension for injection ▶Abilify Maintena (Otsuka Pharmaceuticals (U.K.) Ltd) Aripiprazole 400 mg Abilify Maintena 400mg powder and solvent for prolonged-release suspension for injection pre-filled syringes | 1 pre-filled disposable injection P £220.41 DT = £220.41 Abilify Maintena 400mg powder and solvent for prolonged-release suspension for injection vials | 1 vial P £220.41 DT = £220.41 Orodispersible tablet CAUTIONARY AND ADVISORY LABELS 2 EXCIPIENTS: May contain Aspartame ▶Aripiprazole (Non-proprietary) Aripiprazole 10 mg Aripiprazole 10mg orodispersible tablets sugar free sugar-free | 28 tablet P £96.04 DT = £65.69 Aripiprazole 15 mg Aripiprazole 15mg orodispersible tablets sugar free sugar-free | 28 tablet P £96.04 DT = £65.69 eiiii F 401
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▶With oral use Patients or carers should be given advice on how to administer aripiprazole orodispersible tablets.
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300 mg every month, to be injected into the
First-line fragment. Read the complete Indications and Dose section above.
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400 mg every month, to be injected into the
First-line fragment. Read the complete Indications and Dose section above.
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10–15 mg once daily; usual dose 15 mg once
First-line fragment. Read the complete Indications and Dose section above.
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15 mg once daily, increased if necessary up to
First-line fragment. Read the complete Indications and Dose section above.
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Initially 5.25–15 mg for 1 dose, alternatively
First-line fragment. Read the complete Indications and Dose section above.
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