aripiprazole, Abilify

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GENERIC NAME: aripiprazole

BRAND NAME: Abilify

DRUG CLASS AND MECHANISM: Aripiprazole is an anti-psychotic drug for treating psychotic conditions such as schizophrenia and bipolar disorder. It is also used with other medications to treat major depression in adults. The exact mechanism of action of aripiprazole is unknown. Moreover, like other anti-psychotics, it blocks several receptors on the nerves of the brain for several neurotransmitters (chemicals that nerves use to communicate with each other). It is thought that its beneficial effect is due to its effects on dopamine and serotonin receptors. Its effects on these receptors are complex, involving stimulation of the receptors but to a lesser degree than the naturally-occurring neurotransmitters (a process called partial agonism). The FDA approved aripiprazole in November 2002.

PRESCRIPTION: Yes.

GENERIC AVAILABLE: No.

PREPARATIONS:

  • Tablets: 10, 15, 20, and 30 mg.
  • Tablets (Disintegrating): 10 and 15 mg.
  • Oral solution: 1 mg/mL.
  • Injection Solution: 9.75 mg/1.3 ml.
  • Extended release Injection: 300 or 400 mg/vial

STORAGE: Tablets should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Aripiprazole is used to treat schizophrenia, bipolar mania and mixed manic/depressive episodes (as sole or adjunctive therapy) and as adjunctive (add-on) therapy for major depressive disorder. It is also used for treating irritability associated with autistic disorder and agitation associated with schizophrenia or bipolar disorder.

DOSING: Aripiprazole usually is taken once a day. The usual adult starting oral dose for schizophrenia or bipolar disorder is 10 to 15 mg once daily. The dose may be increased over time up to 30 mg daily to achieve the desired effect.

DRUG INTERACTIONS: Carbamazepine (Tegretol) can markedly decrease the amount of aripiprazole in the body by increasing the rate at which the body's enzymes (particularly the liver enzyme, CYP3A4) degrade it. The manufacturer recommends that patients on aripiprazole who are started on carbamazepine double their dose of aripiprazole, under their doctor's supervision. Other drugs that can promote the activity of CYP3A4 and decrease the body's levels of aripiprazole are phenytoin (Dilantin), rifampin (Rifadin, Rimactane, Rifadin, Rifater, Rifamate), and phenobarbital.

Ketoconazole (Nizoral) can increase the amount of aripiprazole in the body by blocking CYP3A4. The manufacturer of aripiprazole recommends reducing the dose of aripiprazole by one-half during ketoconazole therapy. Many other drugs also are known to block CYP3A4 and potentially could increase the levels of aripiprazole, but their actual effects on aripiprazole levels have not been studied. Such drugs include itraconazole (Sporanox), fluconazole (Diflucan), voriconazole (Vfend), cimetidine (Tagamet), verapamil (Calan, Isoptin), diltiazem (Cardizem, Dilacor), erythromycin, clarithromycin (Biaxin), nefazodone (Serzone), ritonavir (Norvir), saquinavir (Invirase), nelfinavir (Viracept), indinavir (Crixivan), and grapefruit juice.

Medically Reviewed by a Doctor on 7/29/2014



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