Adult Dosing
Schizophrenia
- 10-15 mg/day PO; increase dose q2 wks; Max: 30 mg/day
- Periodically reassess the patients for the need to continue maintenance treatment
Bipolar I Disorder (monotherapy or as adjunctive therapy)
- 15 mg/day PO; Max: 30 mg/day
- Maintenance: 15-30 mg/day PO x 6 wks; Periodically reassess the patients for the need to continue maintenance treatment
Adjunctive Treatment of Major Depressive Disorder
- 2-5 mg/day PO; Max: 15 mg/day
- Dose adjustment up to 5 mg/day qwk
- Periodically reassess the patients for the need to continue maintenance treatment
Pediatric Dosing
Schizophrenia (13-17 yrs age)
- 10 mg/day PO
- Initial 2 mg/day PO x 2 days, then 5 mg/day PO x 2 days, then 10 mg/day
- Dose increments in 5 mg/day; Max: 30 mg/day
- Efficacy of maintenance dose has not been established, periodically reassess the patients to determine the need for maintenance treatment
Bipolar I Disorder (monotherapy or as adjunctive therapy) 10-17 yrs of age
- 10 mg/day PO
- Initial: 2 mg/day PO x 2 days, then 5 mg/day x 2 days, then 10 mg/day
- Dose increments in 5 mg/day; Max: 30 mg/day
- Efficacy of maintenance dose has not been established, periodically reassess the patients to determine the need for maintenance treatment
Irritability Associated with Autistic Disorder (6-17 yrs of age)
- Initial 2 mg/day PO
- Titer : 10-15 mg/day, dose increment upto 5 mg/day qwk
- Efficacy of maintenance dose has not been established, periodically reassess the patients to determine the need for maintenance treatment
Note Oral solution can be substituted for tablet up to 25 mg dose, for 30 mg tablet substitute 25 mg solution
[Outline]
See Supplemental Patient Information
- Aripiprazole is not approved for the treatment of dementia-related psychosis as it increases the risk of death in elderly dementia related psychosis patients [US Black box warning]
- Increases the risk of suicidal thinking and behavior in patients with major depressive disorder (MDD), both adult and pediatric [US Black box warning]
- Antipsychotic drugs cause Neuroleptic Malignant Syndrome (NMS)which is clinically manifested as hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability; immediately discontinue the drug and provide intensive symptomatic treatment and medical monitoring
- Irreversible, involuntary, dyskinetic movements develops with antipsychotic drugs more likely in elderly patients, discontinue the drug on appearance of signs and symptoms
- Hyperglycemia associated with ketoacidosis or hyperosmolar coma or deaths have occurred with atypical antipsychotics. Monitor fasting blood glucose at the baseline of the treatment and periodically during the treatment
- Aripiprazole causes orthostatic hypotension, use cautiously in cardiovascular disease, cerebrovascular disease, or conditions which would predispose patients to hypotension
- Leukopenia/neutropenia and agranulocytosis occurs with antipsychotic agents. Monitor CBC count frequently during the first few months of therapy and discontinue the drug at the first sign of low WBC
- Impairs judgment, thinking or motor skills; caution patients against the use of hazardous machinery, automobiles
- Disrupts the body's ability to reduce core body temperature, advise patients to avoid conditions which may contribute to an elevation in core body temperature
- Esophageal dysmotility and aspiration have occurred with antipsychotic drug, causing aspiration pneumonia
Cautions: use cautiously in
- Elderly patients
- Cerbrovascular diseases
- History of MI or IHD
- Heart failure
- Dehydration
- Hypovolemia
- Antihypertensive use
- Orthostatic hypotension
- History of low WBC
- Drug induced leukopenia/neutropenia
- History of seizures
- Diabetes mellitus
- Risk of diabetes mellitus
- Risk of aspiration pneumonia
- High environmental temperature
- Depression (<25 yrs patients)
Supplemental Patient Information
- Families and caregiver of the patients should be advised to be alert to the worsening of clinical symptoms of depression and suicidal behavior and immediately report to the patient's health professional
- Aripiprazole impairs judgment, thinking, or motor skills; advise patients not to drive automobiles or operate hazardous machinery
- Advise women who have become pregnant or intend to become pregnant during therapy should report to their physician
- Advise patients to avoid alcohol during therapy
- Patients should be advised to avoid overheating and dehydration
Pregnancy Category:C
Breastfeeding: Safety unknown, Limited data indicates low level of aripiprazole in milk after daily administration of 15 mg to nursing mother. Until more data are available use alternate drug especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 14th December 2010). Aripiprazole was excreted in milk of rats, manufacturer advises to discontinue breastfeeding while administering to the nursing women.
Pricing data from www.DrugStore.com in U.S.A.
- Abilify 15 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $560.01
90 mg = $1652.89 - Abilify 30 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $815.98
90 mg = $2368.9 - Abilify 10 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $584
90 mg = $1710.95 - Abilify Discmelt 10 MG TBDP [Box] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $631.3
90 mg = $1842.24 - Abilify 20 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $793.98
90 mg = $2323.88 - Abilify 2 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $570.01
90 mg = $1680.02 - Abilify 5 MG TABS [Bottle] (B-M SQUIBB U.S. (PRIMARY CARE))
30 mg = $558.02
90 mg = $1646.02
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
65 yrs of age. Patients on antidepressant therapy should be closely monitored for clinical worsening, suicidality, or unusual changes in behavior
