Classifications: psychotherapeutic; antipsychotic, atypical; dopamine system stabilizer; Therapeutic: atypical antipsychotic
Pregnancy Category: C
10 mg, 15 mg, 20 mg, 30 mg tablets; 1 mg/mL oral solution
Efficacy of aripiprazole may be mediated through a combination of partial agonist activity at D2 and 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
Partial dopaminergic agonist property of aripiprazole accounts for antipsychotic treatment of schizophrenic and bipolar
Treatment of schizophrenia, bipolar mania, maintenance in bipolar 1 disorder.
Depression with psychotic features.
Hypersensitivity to aripiprazole; dementia in elderly; QT prolongation; lactation; pregnancy (category C).
History of seizures or conditions that lower seizure threshold (e.g., Alzheimer's dementia); suicidal ideation; brain tumor;
dementia; diabetes mellitus; patients with known cardiovascular disease (history of MI or ischemic heart disease, heart
failure, or conduction abnormalities), cerebrovascular disease, or conditions that predispose to hypotension (dehydration,
hypovolemia, and treatment with antihypertensive medications); dysphagia; ethanol intoxication; hyperglycemia, hypothermia;
obesity, elderly, children <18 y.
Route & Dosage
Adult: PO 1015 mg once daily, may increase at 2-wk intervals to max of 30 mg/d if needed
Adult: PO 30 mg once daily, may reduce to 15 mg/d
- Note that dose should be reduced by 50% with concurrent treatment with ketoconazole, quinidine, fluoxetine, or paroxetine.
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)Body as a Whole: Headache,
asthenia, fever, flu-like symptoms, peripheral edema, chest pain, neck pain, neck rigidity. CNS: Anxiety, insomnia, lightheadedness, somnolence, akathisia,
tremor, extrapyramidal symptoms, depression
, nervousness, increased salivation, hostility, suicidal thought, manic reaction,
abnormal gait, confusion, cogwheel rigidity. CV:
Hypertension, tachycardia, hypotension, bradycardia. Risk of stroke in elderly with dementia-related psychosis. GI: Nausea, vomiting, constipation,
Ecchymosis, anemia. Metabolic:
Weight gain, weight loss, hyperglycemia, diabetes
mellitus, increased creatine kinase. Musculoskeletal:
Muscle cramp. Respiratory:
Rhinitis, cough. Skin:
Rash. Special Senses:
Interactions Drug: Carbamazepine
will decrease aripiprazole levels (may need to double aripiprazole dose); ketoconazole, quinidine, fluoxetine, paroxetine
may increase aripiprazole levels (reduce dose by ?); may enhance effects of antihypertensive agents
. Herbal: St. John's wort
may decrease aripiprazole levels. Food:
High fat meals may delay time to peak plasma levels.
87% bioavailable. Peak:
35 h. Metabolism:
In liver by CYP3A4 and 2D6. Major metabolite, has some activity. Elimination:
55% in feces, 25% in urine. Half-Life:
75 h (94 h for metabolite).
Assessment & Drug Effects
- Monitor diabetics for loss of glycemic control.
- Monitor cardiovascular status. Assess for and report orthostatic hypotension. Take BP supine then in sitting position. Report
systolic drop of >1520 mm Hg. Patients at increased risk are those who are dehydrated, hypovolemic, or receiving concurrent
- Monitor body temperature in situations likely to elevate core temperature (e.g., exercising strenuously, exposure to extreme
heat, receiving drugs with anticholinergic activity, or being subject to dehydration).
- Monitor for and report signs of tardive dyskinesia.
- Monitor for and immediately report S&S of neuroleptic malignant syndrome (NMS) that include: hyperpyrexia, muscle rigidity,
altered mental status, irregular pulse or blood pressure, tachycardia, diaphoresis, and cardiac dysrhythmia. Withhold drug
if NMS is suspected.
- Lab tests: Monitor periodically Hct & Hgb. Monitor periodically blood glucose. Monitor for elevated CPK and myoglobinuria
if NMS is suspected.
Patient & Family Education
- Carefully monitor blood glucose levels if diabetic.
- Do not drive or engage in other potentially hazardous activities until reaction to drug is known.
- Avoid situations where you are likely to become overheated or dehydrated.
- Notify physician if you become pregnant or intend to become pregnant while taking this drug.