Aripiprazole lauroxil (US brand name Aristada®) is an extended-release injectable second-generation (“atypical”) antipsychotic.
On this page, we will provide basic information about this medication. Links to other articles on this website with more advanced information and tips related to this medication and related topics are provided below—under Related Pages below.
FDA indication
Treatment of schizophrenia in adults
Mechanism of action/ Pharmacodynamics
It may mediate its effect via partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
Side effects
The commonest side effect of aripiprazole lauroxil (occurring in 5% or more of patients and at least twice the rate of placebo) was akathisia.
Contraindications
Known hypersensitivity to aripiprazole.
Warnings and Precautions
Warnings and Precautions are related to:
– Cerebrovascular Adverse Reactions in Elderly Patients with Dementia-Related Psychosis
– Dosing and medication errors: Due to dispensing errors between Aristada and Aristada Initio
– Neuroleptic Malignant Syndrome
– Tardive Dyskinesia
– Metabolic Changes
– Leukopenia, Neutropenia, and Agranulocytosis
– Pathological gambling and compulsive behaviors
– Orthostatic Hypotension and Syncope
– Seizures
– Potential for Cognitive and Motor Impairment
Dosing
Step 1: Make sure the person has taken aripiprazole orally and is tolerating it
Step 2: Choose the dose of aripiprazole lauroxil. It comes in four strengths: 441 mg, 662 mg, 882 mg and 1064 mg. These doses are equivalent to oral aripiprazole 300 mg, 450 mg, 600 mg, and 724 mg respectively.
Since the aripiprazole lauroxil will be given once a month, patients on oral aripiprazole 10 mg/day will need 300 mg of aripiprazole in a month (10 X 30 days). If you want to keep the person on the same dose, you would give 441 mg of aripiprazole intramuscularly once a month.
For patients on 15 mg/day of oral aripiprazole, give 662 mg of aripiprazole lauroxil once a month or 882 mg every 6 weeks or 1064 mg every 2 months.
For patients on 20 mg/day or more of oral aripiprazole, give 882 mg of aripiprazole lauroxil once a month.
Step 3: Choose the interval between doses. For the 441 mg and 662 mg doses, give the injection once a month. If you decide to give 882 mg of aripiprazole lauroxil, you can give it every 6 weeks. For 1064 mg dose, you can give it every 2 months.
Step 4: For the first 21 days, give BOTH oral aripiprazole and aripiprazole lauroxil.
Step 5: Adjust the dose and the interval between doses based on response and side effects.
Step 6: If the patient needs an increase in the dose, you can either increase the dose when the next injection is due OR give the aripiprazole lauroxil earlier than scheduled. However, the earliest a second injection can be given is 14 days after the first one.
Step 7: If the person later starts on a strong inhibitor or inducer of either cytochrome P450 2D6 or 3A4 to be taken for more than two weeks, you will have to adjust the dose of the aripiprazole lauroxil.
Dosage forms and strengths
Extended-release injectable suspension: 441 mg, 662 mg, 882 mg or 1064 mg
Important! This page does not provide all the information needed to prescribe this medication. Please refer to the full Prescribing Information (see the link below) before prescribing this medication.
Related Pages
Aripiprazole lauroxil (Aristada®) versus Aripiprazole (Abilify Maintena®)
CPT billing code for administration of injections
FDA issues a new warning about aripiprazole (impulse control problems)
What should I be doing to monitor patients who are on an antipsychotic?
Aripiprazole (Abilify Maintena®)
Olanzapine (Zyprexa Relprevv®)
Paliperidone palmitate (Invega Sustenna®)
Paliperidone palmitate 3-month (Invega Trinza®)
Risperidone long-acting injection (Risperdal Consta®)
Aripiprazole (Abilify®): Basic Information
How to order, store, and administer naltrexone extended-release injection (Vivitrol®)
Second-Generation (“Atypical”) Antipsychotics
References
Prescribing information for aripiprazole lauroxil (Aristada®)
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