Aripiprazole (intramuscular route)


    Brand Name

    US Brand Name

    Abilify

    Abilify Asimtufii

    Abilify Maintena


    Description

    Aripiprazole injection is used to treat agitation caused by schizophrenia or bipolar mania.

    Aripiprazole extended-release injection is used to treat schizophrenia (a mental disorder) and bipolar disorder (manic-depressive illness). It works in the brain to change how certain chemicals affect patients. Aripiprazole is an antipsychotic agent.

    This medicine is to be given only by or under the immediate supervision of your doctor.

    This product is available in the following dosage forms:

    • Powder for Suspension, Extended Release
    • Suspension, Extended Release

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of aripiprazole injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of this medicine in elderly patients. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving aripiprazole injection. This medicine should not be used to treat behavioral problems in elderly patients who have dementia or Alzheimer disease.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Bepridil
    • Bromopride
    • Cisapride
    • Dronedarone
    • Fluconazole
    • Ketoconazole
    • Levoketoconazole
    • Mavorixafor
    • Mesoridazine
    • Metoclopramide
    • Pimozide
    • Piperaquine
    • Posaconazole
    • Saquinavir
    • Sparfloxacin
    • Terfenadine
    • Thioridazine
    • Ziprasidone

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abametapir
    • Abiraterone Acetate
    • Abiraterone Acetate, Micronized
    • Adagrasib
    • Alfentanil
    • Alfuzosin
    • Alprazolam
    • Amiodarone
    • Amisulpride
    • Amitriptyline
    • Anagrelide
    • Apalutamide
    • Apomorphine
    • Arsenic Trioxide
    • Asenapine
    • Astemizole
    • Atazanavir
    • Avacopan
    • Azithromycin
    • Bedaquiline
    • Bentazepam
    • Benzhydrocodone
    • Boceprevir
    • Bromazepam
    • Buprenorphine
    • Bupropion
    • Buserelin
    • Butalbital
    • Butorphanol
    • Calcium Oxybate
    • Cannabidiol
    • Cannabis
    • Carbamazepine
    • Celecoxib
    • Ceritinib
    • Cetirizine
    • Chlordiazepoxide
    • Chloroquine
    • Chlorpromazine
    • Ciprofloxacin

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Grapefruit Juice

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Blood vessel disease or
    • Dehydration or
    • Heart attack or stroke, history of or
    • Heart disease or
    • Heart failure, history of or
    • Heart rhythm problems or
    • Hypotension (low blood pressure) or
    • Hypovolemia (decrease in the volume of blood) or
    • Ischemic heart disease, history of or
    • Trouble with swallowing—Use with caution. May cause side effects to become worse.
    • Depression or
    • Diabetes, or family history of or
    • Dyslipidemia (high cholesterol or fats in the blood) or
    • Hyperglycemia (high blood sugar) or
    • Neuroleptic malignant syndrome (NMS), history of or
    • Neutropenia (low white blood cells) or
    • Reduced white blood cell count, history of or
    • Seizures, history of—Use with caution. May make these conditions worse.

    Proper Use

    A nurse or other trained health professional will give you this medicine in a hospital or clinic. It will be given as a shot into a muscle in your arm or buttock.

    This injection is given together with the oral medicine for the first dose. The second dose and the injections that follow are given instead of the oral medicine. Be sure to keep all appointments for the injections.

    This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

    Missed Dose

    This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

    Be sure to keep all appointments for the injections.


    Precautions

    It is very important that your doctor check your progress at regular visits to allow for changes in your dose and help reduce any unwanted effects. Blood and urine tests may be needed to check for unwanted effects.

    This medicine may increase risk for stroke in elderly patients with dementia. Tell your doctor right away if you have confusion, difficulty in speaking, slow speech, inability to speak, inability to move the arms, legs, or facial muscles, double vision, or headache while using this medicine.

    This medicine may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.

    This medicine may add to the effects of alcohol and other medicines that make you drowsy or less alert. Some examples of these medicines are antihistamines or medicines for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicines, prescription pain medicines or narcotics, medicines for seizures or barbiturates, muscle relaxants, or anesthetics (medicines that numb), including some dental anesthetics. If you are taking any of these medicines, make sure you tell your doctor before you receive aripiprazole injection.

    Aripiprazole may cause drowsiness, trouble with thinking, or trouble with controlling body movements, which may lead to falls, fractures, or other injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

    Check with your doctor right away if you have difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, seizures, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

    This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

    Some people who have used this medicine had unusual changes in their behavior. Talk with your doctor right away if you start having unusual urges, including gambling urges, binge or compulsive eating, compulsive shopping, or sexual urges while using this medicine.

    Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

    This medicine may make it more difficult for your body to cool down. It might reduce how much you sweat. Your body could get too hot if you do not sweat enough. If your body gets too hot, you might feel dizzy, weak, tired, or confused. Avoid places that are very hot. Call your doctor if drinking cool water and moving away from the heat does not cool you down.

    This medicine can temporarily lower the number of white blood cells in your blood, increasing the chance of getting an infection. If you can, avoid people with infections. Check with your doctor immediately if you think you are getting an infection or if you get a fever or chills, cough or hoarseness, lower back or side pain, or painful or difficult urination.

    This medicine may increase your weight. Your doctor may need to check your weight on a regular basis while you are using this medicine.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    More common

    • Difficulty with speaking
    • drooling
    • loss of balance control
    • muscle trembling, jerking, or stiffness
    • restlessness
    • shuffling walk
    • stiffness of the limbs
    • twisting movements of the body
    • uncontrolled movements, especially of the face, neck, and back

    Less common

    • Blurred vision
    • dizziness
    • fast, pounding, or irregular heartbeat or pulse
    • headache
    • inability to move the eyes
    • increased blinking or spasms of the eyelid
    • nervousness
    • pounding in the ears
    • sticking out the tongue
    • trouble breathing or swallowing
    • unusual facial expressions

    Rare

    • Fast heartbeat
    • high fever
    • increased sweating
    • lip smacking or puckering
    • loss of bladder control
    • muscle spasm or jerking of all extremities
    • puffing of the cheeks
    • rapid or worm-like movements of the tongue
    • seizures
    • severe muscle stiffness
    • sudden loss of consciousness
    • tiredness
    • uncontrolled chewing movements
    • uncontrolled movements of the arms and legs
    • unusually pale skin

    Incidence not known

    • Black, tarry stools
    • chest pain or tightness
    • cough
    • hives or welts, itching, or skin rash
    • itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
    • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
    • redness of the skin
    • sore throat
    • sores, ulcers, or white spots on the lips or in the mouth
    • swollen glands
    • unusual bleeding or bruising
    • unusual tiredness or weakness

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Infection from breathing foreign substance into the lungs
    • seizure that will not stop
    • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Belching
    • difficulty having a bowel movement
    • dry mouth
    • fear
    • fever
    • heartburn
    • hyperventilation
    • inability to sit still
    • indigestion
    • irritability
    • lightheadedness
    • need to keep moving
    • runny nose
    • shaking
    • stomach discomfort, upset, or pain
    • trouble sleeping
    • weight gain

    Less common

    • Accidental injury
    • bloating or swelling of the face, arms, hands, lower legs, or feet
    • body aches or pain
    • congestion
    • difficulty with moving
    • hoarseness
    • increased appetite
    • joint pain
    • muscle aching or cramping
    • muscle pains or stiffness
    • sneezing
    • stuffy nose
    • swollen joints
    • tender, swollen glands in the neck
    • tingling of the hands or feet
    • tremor
    • unusual weight gain or loss
    • voice changes

    Incidence not known

    • Hiccups

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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