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Abilify (aripiprazole)

Abilify (aripiprazole)

Brand name: Abilify®.
Active ingredient name: Aripiprazole.
Type of medication: Atypical antipsychotic.
Available in Canada from: Otsuka Pharmaceutical Co. Ltd (2 mg, 5 mg, 10 mg, 15 mg, 30 mg); Bristol-Myers Squibb Canada (20 mg).
Form: Oral tablets.
Generic: YYes: Apo-Aripiprazole (Apotex Inc.), Auro-Aripiprazole (Auro Pharma Inc.), PMS-Aripiprazole (Pharmascience Inc.), Sandoz-Aripiprazole (Sandoz Canada Inc.), Teva-Aripiprazole (Teva Limited Canada), Mint-Aripiprazole (Mint Pharmaceuticals Inc.), Sai-Aripiprazole (Sanis Health Inc.)
Listed on Ontario formulary: Yes (with suggested criteria for coverage*).
OHIP+  coverage: Yes (with suggested criteria for coverage*).
 
*This product has a therapeutic note, which suggests a physician should prescribe it for the treatment of schizophrenia or other psychotic disorders in individuals who have had a failure, intolerance or contraindication to at least one less expensive antipsychotic alternative.
 
Note: Abilify® is also available as a long-acting injectable called Abilify® Maintena®

What is Abilify used for?

Abilify is used to treat the symptoms of schizophrenia in adults and adolescents (15 - 17 years of age). It can be used alone or in combination with other therapies for schizophrenia. It is also used to treat adults with bipolar disorder and as adjunctive (add-on) therapy for adults with major depressive disorder. It is also used to treat adolescents (13 - 17 years of age) with bipolar I disorder. Abilify is sometimes used to treat other conditions. Talk to your doctor to understand why you are taking Abilify.

How should I take Abilify?

  • You can take Abilify with or without food, preferably with a full glass of water. The tablet cannot be crushed, chewed or cut. Swallow whole. If you have difficulties swallowing please speak to your doctor or pharmacist to discuss other options.
  • Abilify is available in 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 30 mg tablets in Canada. It is also available in a long-acting injection formulation which is discussed in detail in the next section.
  • Of note, Abilify is available in a short-acting injection and liquid in the United States. It is not yet available in Canada in these other formulations, but that is something that may occur in the near future.
  • Adults: The dose range for Abilify is 2 mg - 30 mg daily. The usual dose for adults is 10 mg - 15 mg once per day, up to a maximum of 30 mg per day. Your doctor may prescribe doses that are higher than 30 mg based on your individual situation.
  • Adolescents (15 - 17 years of age): The usual dose in adolescents is typically 10 mg once a day. Your doctor may prescribe you a lower dose (2 mg) to start. The dose will likely be increased to 5 mg after a few days, then to 10 mg after that. Depending on how you respond and tolerate the 10 mg dose, your doctor may adjust the dose up or down, to a maximum of 30 mg once a day.

What are the common side effects seen with Abilify? 

The most common side effects of Abilify include:
  • Feeling of restlessness (akathisia)
  • Headache
  • Abnormal movements (extrapyramidal side effects)
  • Nausea, vomiting, upset stomach
  • Insomnia
  • Constipation
  • Anxiety

What are rare but potentially serious side effects seen with Abilify?

  • Decrease in white blood cell count (agranulocytosis)
  • Cerebrovascular event (stroke)
  • Anaphylactic reaction (severe allergy)
  • Diabetic ketoacidosis (DKA)
  • Neuroleptic malignant syndrome (NMS)

Warnings/Precautions

New information has become available from the U.S. Food and Drug Administration to suggest that some individuals taking Abilify may experience compulsive or uncontrollable urges to gamble, binge eat, shop and have sex. These urges were reported to have stopped when the dose of the medication was reduced or the medication was discontinued. These impulse-control problems or urges are rare, however, it is important to inform your physician if you or a family member/friend experience any of these urges while taking Abilify. 
 
More information on this topic can be found at: http://www.fda.gov/Drugs/DrugSafety/ucm498662.htm?source=govdelivery&utm_medium=email&utm_source=govdelivery
 
Elderly individuals with dementia-related psychosis who are treated with antipsychotic medication are at an increased risk of death compared to individuals not receiving antipsychotics. Most deaths appear to be either cardiovascular or infectious. Abilify is not approved for the treatment of dementia-related psychosis. Some individuals with dementia may, however, be treated with this medication. Discuss the potential risks and benefits of this medication with your doctor for this indication.

What medications interact with Abilify?

Tell all your doctors, pharmacists and dental care providers that you are taking Abilify. You should also tell your doctor or pharmacist if you are taking any other medications, including those obtained without a prescription, and herbal and vitamin products. When the levels of a medication are increased or decreased in your bloodstream, this can affect the medication’s efficacy and safety.
 
The following medications might increase the levels of Abilify in your bloodstream:
  • Ketoconazole (anti-fungal)
  • Quinidine (anti-arrhythmic)
The following medications might decrease the levels of Abilify in your bloodstream:
  • Carbamazepine (anti-convulsant)
  • St. John’s Wort (herbal medication)

 The following types of medications may interact with Abilify:

  • Anti-Parkinson agents (dopamine agonists)
  • Certain medications for allergies (e.g., Benadryl [diphenhydramine])
  • Certain medications for sleep (e.g., lorazepam, zopiclone)
  • Certain medications for pain (e.g., fentanyl)