Abilify


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Related to Abilify: Seroquel, Cymbalta

aripiprazole

Abilify

Pharmacologic class: Quinolone-derived atypical antipsychotic agent

Therapeutic class: Antipsychotic, neuroleptic

Pregnancy risk category C

FDA Box Warning

• Drug increased mortality in elderly patients with dementia-related psychosis. Although causes of death were varied, most appeared to be cardiovascular or infectious. Drug isn't approved to treat dementia-related psychosis.

• Children, adolescents, and young adults taking antidepressants for major depressive disorder and other psychiatric disorders are at increased risk for suicidal thinking and behavior.

• Drug isn't approved for use in children with depression.

Action

Unclear. Thought to exert partial agonist activity at central dopamine D2 and type 1A serotonin (5-HT1A) receptors and antagonistic activity at serotonin 5-HT2A receptors. Also has alpha-adrenergic and histamine1-blocking properties.

Availability

Injection: 9.75 mg/1.3 ml (7.5 mg/ml)

Oral solution: 1 mg/ml

Tablets: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Tablets (orally disintegrating): 10 mg, 15 mg

Indications and dosages

Schizophrenia

Adults: 10 to 15 mg P.O. daily. If needed, increase to 30 mg daily after 2 weeks.

Adolescents ages 13 to 17: Initially, 2 mg P.O. daily; increase to 5 mg P.O. after 2 days. Then increase to 10 mg P.O. after 2 additional days. Subsequent dosage intervals should occur in increments no greater than 5 mg, up to a maximum of 30 mg.

To maintain stability in schizophrenic patients

Adults: 15 mg P.O. daily. Therapy may continue for up to 26 weeks with periodic evaluations.

Adolescents ages 13 to 17: General recommendation, continue responding patients beyond the acute response but at the lowest dosage needed to maintain remission.

Acute manic and mixed episodes associated with bipolar disorder

Adults: 30 mg P.O. daily for up to 3 weeks

Agitation associated with schizophrenia or bipolar mania

Adults: Usual dosage, 5.25 to 15 mg I.M. as single dose. Recommended dosage is 9.75 mg I.M. as single dose. No additional benefit was demonstrated for 15 mg compared to 9.75 mg. Lower dosage of 5.25 mg may be considered when clinical factors warrant. If agitation warranting second dose persists following initial dose, cumulative dosages up to total of 30 mg/day may be given. However, efficacy of repeated doses in agitated patients hasn't been systematically evaluated in controlled clinical trials. Also, safety of total daily doses greater than 30 mg or injections given more frequently than every 2 hours hasn't been adequately evaluated in clinical trials. If ongoing aripiprazole therapy is clinically indicated, oral aripiprazole ranging from 10 to 30 mg/day P.O. should replace aripiprazole injection as soon as possible.

Adjunctive treatment of major depressive disorder

Adults: Initially, 2 to 5 mg P.O. daily. May increase up to 15 mg daily at increments of up to 5 mg/day at intervals of no less than 1 week.

Dosage adjustment

• Concurrent use of potent CYP3A4 inhibitors (such as ketoconazole), CYP2D6 inhibitors (such as fluoxetine, paroxetine, quinidine), or CYP3A4 inducers (such as carbamazepine)

Contraindications

• Hypersensitivity to drug

Precautions

Use cautiously in:
• cerebrovascular disease, hypotension, seizure disorder, suicidal ideation
• high risk for aspiration pneumonia
• neuroleptic malignant syndrome, tardive dyskinesia, diabetes mellitus
• leukopenia, neutropenia, agranulocytosis
• pregnant or breastfeeding patients
• elderly patients (with dementia-related psychosis)
• children, adolescents, and young adults with major depressive disorder

Administration

• Give with or without food.
• Don't administer with grapefruit juice.
• Be aware that oral solution may be substituted for tablets on a mg-to-mg basis up to 25-mg dose. Patients receiving 30 mg of tablets should receive 25 mg of oral solution.

Adverse reactions

CNS: dizziness, insomnia, akathisia, agitation, anxiety, headache, light-headedness, drowsiness, tremor, tardive dyskinesia, seizures, neuroleptic malignant syndrome, increased suicide risk

CV: orthostatic hypotension, hypertension, peripheral edema, chest pain, bradycardia, tachycardia

EENT: rhinitis

GI: nausea, vomiting, diarrhea, constipation, jaundice, abdominal pain, esophageal motility disorders, dysphagia

GU: urinary incontinence

Respiratory: cough

Skin: rash

Other: fever, hypersensitivity reactions (including anaphylaxis)

Interactions

Drug-drug.CNS depressants: increased sedation

Drugs that induce CYP3A4: decreased aripiprazole effect

Drugs that inhibit CYP3A4 or CYP2D6: serious toxic effects

Other antipsychotic agents: increased extrapyramidal effects

Drug-diagnostic tests.Granulocytes, leukocytes, neutrophils: decreased values

Serum glucose: increased level

Drug-herbs.Kava: increased CNS depression

Drug-behaviors.Alcohol use: increased sedation

Patient monitoring

Watch for signs and symptoms of depression, and evaluate patient for suicidal ideation.
• Monitor neurologic status closely. Watch for tardive dyskinesia.

Evaluate patient for neuroleptic malignant syndrome (fever, altered mental status, rigid muscles, arrhythmia, tachycardia, sweating). Stop drug and notify prescriber if these signs and symptoms occur.
• Monitor blood pressure, pulse, CBC with differential, and weight.

Monitor blood glucose level closely; be aware that in patients with diabetes mellitus or risk factors for diabetes, serious hyperglycemia possibly associated with coma or death may occur.

Patient teaching

Instruct patient to immediately contact prescriber if he experiences depression or has suicidal thoughts, altered mental status, rigid muscles, irregular heart beat, excessive sweating, rash, itching, difficulty breathing, or excessive thirst or urination.
• Inform patient that symptoms will subside slowly over several weeks.
• Tell patient he may take drug with or without food.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Tell patient that drug may cause urinary incontinence.
• Caution patient to avoid strenuous exercise and hot environments whenever possible.
• Instruct patient to move slowly when rising to avoid dizziness from sudden blood pressure decrease.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

Abilify

(ə-bĭl′ə-fī′)
A trademark for the drug aripiprazole.

Abilify™

An atypical antipsychotic drug used to manage schizophrenia, bipolar disorder, and Alzheimer’s disease
Pros Weight change, minimal extrapyramidal symptoms
Adverse effects Abdominal pain, accidental injury, back pain, dental pain, dyspepsia, diarrhoea, dry mouth, myalgia, agitation, psychosis, extrapyramidal syndrome, hypertonia, pharyngitis, upper respiratory tract infection, dysmenorrhoea, vaginitis

Abilify

A brand name for the antipsychotic drug ARIPIPRAZOLE, used to treat SCHIZOPHRENIA.
References in periodicals archive ?
The findings also reveal that Bristol-Myers Squibb/Otsuka's Abilify and AstraZeneca's Seroquel continue to gain patient share as adjunctive major depressive disorder treatments, which will contribute to the stability of the unipolar depression market in the near term.
0 billion in 2022, owing to the launch of multiple premium-priced emerging therapies, including bitopertin, Abilify Maintena and paliperidone palmitate three-month depot.
Top 10 Schizophrenia Drug Brands (Zyprexa, Seroquel, Risperdal, Abilify, Geodon, Lonasen, Serdolect, Invega, Fanapt, Saphris) data analysis of Past, Present and Future Market
Abilify and Epogen round out the fourth and fifth spots in quarterly sales gains.
Furthermore, the atypical antipsychotic drug class will experience significant loss of sales in the unipolar depression market owing to continued generic erosion of key agents and, including generic competition to Abilify.
Efficacy was demonstrated in a 12-week randomized, double-blind, placebo-controlled study, which showed treatment with Abilify Maintena, with concomitant oral aripiprazole for the first two weeks, significantly improved symptoms with an acceptable safety and tolerability profile in adult patients experiencing an acute relapse of schizophrenia.
According to Medscape (and Twitter, too), Abilify grosses more money than any other pharmaceutical in the United States.
ABILIFY MAINTENA will be the first commercialized product from the global alliance between Otsuka and Lundbeck focused on developing Central Nervous System (CNS) therapies worldwide.
Bristol-Myers Squibb's and Otsuka's launch of ABILIFY Injection further demonstrates the value of Captisol in supporting line extension strategies for successful pharmaceuticals," said CyDex Chief Executive Officer John M.
However, expansion of the antipsychotic depot class will help the overall schizophrenia market to return to growth, with ongoing uptake of Invega Sustenna and the expected launches of Abilify depot, ALKS 7090, and Fanapt depot.
13, 2014 /PRNewswire/ -- Decision Resources Group finds that in the unipolar depression* market, the expanding use of two recently approved therapies-Lundbeck/Takeda Pharmaceutical's Brintellix (vortioxetine), Actavis (formerly Forest Laboratories)/Pierre Fabre's Fetzima (levomilnacipran ER)-together with the forecasted launch of Otsuka Pharmaceutical/Lundbeck's brexpiprazole in the major pharmaceutical markets (United States, France, Germany, Italy, Spain, United Kingdom and Japan) will offset a steep near-term decline in sales resulting from the loss of market exclusivity for the two key drugs prescribed for unipolar depression-duloxetine (Eli Lilly/Shionogi's Cymbalta/Xeristar, generics) and the atypical antipsychotic Abilify (Bristol-Myers Squibb/Otsuka Pharmaceutical's aripiprazole).
s (New York) profit topped analysts' estimates as sales rose for the mood-stabilizing drug Abilify and the blood thinner Plavix.