Dosing & Uses
Dosage Forms & Strengths
tablet
- 2mg
- 5mg
- 10mg
- 15mg
- 20mg
- 30mg
tablet, embedded with ingestible event marker (IEM) sensor (Abilify MyCite)
- 2mg
- 5mg
- 10mg
- 15mg
- 20mg
- 30mg
Abilify MyCite system is composed of the following components:
- Aripiprazole tablet embedded with an ingestible event marker (IEM) sensor
- MyCite patch (wearable sensor) that detects the signal from the IEM sensor after ingestion and transmits data to a smartphone
- MyCite APP, a smartphone application (app) which is used with a compatible smartphone to display information for the patient
- Web-based portal for healthcare professionals and caregivers
oral disintegrating tablet
- 10mg
- 15mg
oral solution
- 1mg/mL
extended-release injectable IM suspension (Abilify Maintena)
- 300mg/vial or prefilled dual chamber syringe
- 400mg/vial or prefilled dual chamber syringe
extended-release injectable IM suspension (aripiprazole lauroxil [Aristada])
- 441mg/prefilled syringe (300 mg of aripiprazole)
- 662mg/prefilled syringe (450 mg of aripiprazole)
- 882mg/prefilled syringe (600 mg of aripiprazole)
- 1064mg/prefilled syringe (724 mg of aripiprazole)
extended-release injectable IM suspension (aripiprazole lauroxil [Aristada Initio])
- 675mg/2.4mL prefilled syringe (459 mg of aripiprazole)
Schizophrenia
Indicated for treatment of schizophrenia
Also see Administration
PO
- 10-15 mg/day PO initially; may increase after 2 weeks at each dose strength; not to exceed 30 mg/day PO when administered as tablet formulation; efficacy not significantly greater above 15 mg/day
Abilify Maintena
-
Patients who have never taken aripiprazole
- 400 mg IM once monthly initially
- Establish tolerability with aripiprazole PO prior to initiating treatment with Abilify Maintena; may take up to ~ 2 weeks to fully assess tolerability
- Continue aripiprazole PO (10-20 mg/day) or other antipsychotics PO in patients with known aripiprazole tolerance for 14 consecutive days after initial injection
-
Patients stabilized or aripiprazole tolerant
- 400 mg IM once monthly
- Administer monthly dose no sooner than 26 days after previous injection (also see Dosage Modifications)
- Consider dose reduction to 300 mg/month if adverse reaction occurs
Aristada (IM once monthly)
- Establish tolerability with PO aripiprazole before initiating Aristada; may take up to 2 weeks to fully assess tolerability
- Base initial Aristada dose on current aripiprazole PO dose; coadminister aripiprazole PO for 21 consecutive days
- 10 mg/day PO: 441 mg IM once monthly
- 15 mg/day PO: 662 mg IM once monthly or 882 mg IM q6wk or 1064 mg IM q2mo
- ≥20 mg/day PO: 882 mg IM once monthly
- Adjust dose and dosing interval as needed; take into consideration the pharmacokinetics and prolonged-release characteristics of Aristada In the event of early dosing, Aristada should not be given earlier than 14 days after the previous injection
Aristada Initio (single IM dose)
- Indicated in combination with aripiprazole PO for the initiation of Aristada when used for the treatment of schizophrenia
- Used a single dose to initiate Aristada treatment or as a single dose to re-initiate Aristada treatment following a missed dose of Aristada
- Establish tolerability with aripiprazole PO prior to initiating treatment with Aristada Initio; may take up to ~ 2 weeks to fully assess tolerability
- After establishing tolerability with aripiprazole PO, administer the first Aristada IM injection (441 mg, 662 mg, 882 mg, or 1064 mg) in conjunction with both: One dose of Aristada Initio 675 mg IM and one dose of aripiprazole 30 mg PO
- Aristada Initio is only to be used as a single dose and is not for repeated dosing
- First Aristada extended-release IM injection may be administered on the same day as Aristada Initio or up to 10 days thereafter (Refer to Aristada for prescribing information)
- Also see Dosing Considerations
Abilify Asimtufii (IM every 2 months)
-
Never taken aripiprazole
- Establish tolerability with oral aripiprazole before initiating
- 960 mg IM q2Months
- May take up to 2 weeks to fully assess tolerability
- Continue oral aripiprazole (10-20 mg/day) or other antipsychotics PO in patients with known aripiprazole tolerance for 14 consecutive days after initial injection
-
Treated with oral antipsychotics
- Taking oral aripiprazole: Administer first dose along with oral aripiprazole 10-20 mg PO for 14 consecutive days
- Stable on another oral antipsychotic (and known to tolerate aripiprazole): Administer first injection along with oral antipsychotic for 14 consecutive days
-
Receiving Abilify Maintena
- For patients receiving Abilify Maintena (once monthly dosing), administer Abilify Asimtufii 960 mg once q2month in place of next scheduled injection of Abilify Maintena
- Administer first Abilify Asimtufii injection in place of second, or later injection of Abilify Maintena
- If there are adverse reactions with Abilify Asimtufii 960-mg dosage, may reduce dosage to 720 mg once q2months
- May give Abilify Asimtufii up to 2 weeks before or 2 weeks after 2-month scheduled timepoint
Bipolar Mania
Indicated for maintenance monotherapy treatment of bipolar I disorder in adults
PO
- Indicated for acute and maintenance treatment of manic or mixed episodes associated with bipolar I disorder, either as monotherapy or as adjunct to lithium or valproate
- Monotherapy: 15 mg/day PO initially; may be increased gradually; not to exceed 30 mg/day
- Adjunct to lithium or valproate: 10-15 mg/day PO initially; recommended daily dose is 15 mg/day; may be gradually increased; not to exceed 30 mg/day
- Continue stabilization dose for up to 6 weeks; treatment >6 weeks not studied
Abilify Maintena
-
Patients who have never taken aripiprazole
- 400 mg IM once monthly initially
- Administer only by deep IM injection into deltoid or gluteal muscle by healthcare professional
- Establish tolerability with aripiprazole PO prior to initiating treatment with Abilify Maintena; may take up to ~ 2 weeks to fully assess tolerability
- Continue aripiprazole PO (10-20 mg/day) or other PO antipsychotics in patients with known aripiprazole tolerance for 14 consecutive days after initial injection
-
Patients stabilized or aripiprazole tolerant
- 400 mg IM once monthly
- Administer monthly dose no sooner than 26 days after previous injection (also see Dosage Modifications)
- Consider dose reduction to 300 mg/month if adverse reaction occurs
Abilify Asimtufii (IM every 2 months)
-
Never taken aripiprazole
- Establish tolerability with oral aripiprazole before initiating
- 960 mg IM q2Months
- May take up to 2 weeks to fully assess tolerability
- Continue oral aripiprazole (10-20 mg/day) or other antipsychotics PO in patients with known aripiprazole tolerance for 14 consecutive days after initial injection
-
Treated with oral antipsychotics
- Taking oral aripiprazole: Administer first dose along with oral aripiprazole 10-20 mg PO for 14 consecutive days
- Stable on another oral antipsychotic (and known to tolerate aripiprazole): Administer first injection along with oral antipsychotic for 14 consecutive days
-
Receiving Abilify Maintena
- For patients receiving Abilify Maintena (once monthly dosing), administer Abilify Asimtufii 960 mg once q2month in place of next scheduled injection of Abilify Maintena
- Administer first Abilify Asimtufii injection in place of second, or later injection of Abilify Maintena
- If there are adverse reactions with Abilify Asimtufii 960-mg dosage, may reduce dosage to 720 mg once q2months
- May give Abilify Asimtufii up to 2 weeks before or 2 weeks after 2-month scheduled timepoint
Major Depressive Disorder
2-5 mg/day PO initially; increased weekly PRN by ≤5 mg/day to dose range of 2-15 mg/day
Used adjunctively with other antidepressants
Dosage Modifications (Oral)
Poor metabolizers and drugs that affect cytochrome-P 450
- Known CYP2D6 poor metabolizers: Administer half of recommended dose
- Known CYP2D6 poor metabolizers taking concomitant strong
- CYP3A4 inhibitors: Administer a quarter of the recommended dose (ie, decrease dose by 75%)
- Strong CYP2D6 or CYP3A4 inhibitors: Administer half of recommended dose
- Strong CYP2D6 AND CYP3A4 inhibitors: Administer a quarter of the recommended dose (ie, decrease dose by 75%)
- Strong CYP3A4 inducers: double recommended dose over 1-2 weeks
Dosage Modifications (Abilify Maintena)
CYP2D6 poor metabolizers: 300 mg IM
CYP2D6 poor metabolizers taking concomitant CYP3A4 inhibitor: 200 mg IM
Patients taking 400 mg IM
- Strong CYP2D6 OR CYP3A4 inhibitors: 300 mg IM
- CYP2D6 AND CYP 3A4 inhibitors: 200 mg IM
- CYP3A4 inducers: Avoid use
Patients taking 300 mg IM
- Strong CYP2D6 OR CYP3A4 inhibitors: 200 mg IM
- CYP2D6 AND CYP3A4 inhibitors: 160 mg IM
- CYP3A4 inducers: Avoid use
Dosage Modifications (Aristada)
No dosage changes if CYP450 modulators are added for <2 wk
Strong CYP3A4 inhibitor for >2 wk
- Reduce the dose to the next lower strength No dosage adjustment necessary in patients taking 441 mg, if tolerated
- Poor CYP2D6 metabolizers: Reduce dose to 441 mg from 662 mg, 882 mg, or 1064 mg; no dosage adjustment necessary in patients taking 441 mg, if tolerated
Strong CYP2D6 inhibitor for >2 wk
- Reduce the dose to the next lower strength
- No dosage adjustment necessary in patients taking 441 mg, if tolerated
- Poor CYP2D6 metabolizers: No dose adjustment required
Both strong CYP3A4 and CYP2D6 inhibitors for >2 wk
- Avoid use for patients taking 662 mg, 882 mg, or 1064 mg
- No dosage adjustment necessary in patients taking 441 mg, if tolerated
CYP3A4 inducers for >2 wk
- No dose adjustment for 662 mg, 882 mg, or 1064 mg
- Increase the 441 mg dose to 662 mg
Dosage Modifications (Aristada Initio)
Only available at a single strength as a single-dose prefilled syringes, so no dosage adjustments are possible
CYP2D6 poor metabolizers, strong CYP3A4 inhibitors, and strong CYP3A4 inducers: Avoid use
Hepatic impairment
- Mild-to-severe (Child-Pugh score 5-15): No dosage adjustment necessary
Renal impairment
- Mild-to-severe (GFR 15-90 mL/min): No dosage adjustment necessary
Dosage Modifications (Abilify Asimtufii)
CYP2D6 poor metabolizers
- Known CYP2D6 poor metabolizers: 720 mg q2months
- Known CYP2D6 poor metabolizers taking concomitant CYP3A4 inhibitors: Avoid use
Coadministration with strong CYP2D6 inhibitors
- Patients taking 960 mg: Decrease to 720 mg q2months
Coadministration with strong CYP3A4 inhibitors
- Patients taking 960 mg: Decrease to 720 mg q2months
Coadministration with strong CYP2D6 inhibitors and strong CY3A4 inhibitors
- Patients taking 960 mg: Avoid use
Coadministration with strong CY3A4 inducers
- Patients taking 960 mg: Avoid use
Dosing Considerations
Aristada Initio
- Not interchangeable with Aristada due to differing pharmacokinetic profiles
Abilify MyCite indications
- Treatment of adults with schizophrenia
- Adjunctive treatment of adults with major depressive disorder Treatment of bipolar I disorder
-
Treatment of bipolar I disorder
- Acute treatment of adults with manic and mixed episodes as monotherapy and as adjunct to lithium or valproate
- Maintenance treatment of adults as monotherapy and as adjunct to lithium or valproate
Abilify MyCite detection
- Most ingestions will be detected within 30 minutes, although it may take up to 2 hr for the smartphone app and web portal to detect the ingested tablet
- In some cases, the ingested tablet may not be detected
- If the tablet is not detected after ingestion, do not repeat the dose
N-Glycanase 1 Deficiency (Orphan)
Orphan designation for treatment of N-glycanase 1 (NGLY1) deficiency
Orphan sponsor
- Perlara PBC; 2625 Alcatraz Ave, #435; Berkeley, California 94705
Dosage Forms & Strengths
tablet
- 2mg
- 5mg
- 10mg
- 15mg
- 20mg
- 30mg
tablet, orally disintegrating
- 10mg
- 15mg
oral solution
- 1mg/mL
Schizophrenia
Indicated for treatment of schizophrenia in adolescents aged13-17 years
<13 years: Safety and efficacy not established
13-17 years: 2 mg/day PO initially; increase to 5 mg/day after 2 days; may further increase to recommended dose of 10 mg/day after additional 2 days; subsequent doses may increase by 5 mg/day; maintenance: 10-30 mg/day
Bipolar Mania
Indicated for acute manic or mixed episodes, either as monotherapy or as adjunct to lithium or valproate
10-17 years: 2 mg/day PO initially; increased to 5 mg/day after 2 days; may further increase to recommended dosage of 10 mg/day after additional 2 days; subsequent doses may increase by 5 mg/day; maintenance: 10-30 mg/day
Autism
Indicated for irritability associated with autistic disorder
<6 years: Safety and efficacy not established
6-17 years: 2 mg/day PO initially; increase gradually at ≥1 week intervals to target dosage of 5 mg/day; may gradually be further increase PRN to 10 mg/day or higher; not to exceed 15 mg/day
Tourette Disorder
Indicated for treatment of Tourette disorder
<6 years: Safety and efficacy not established
6-18 years (<50 kg)
- Initiate at 2 mg/day PO with a target dose of 5 mg/day after 2 days
- The dose can be increased to 10 mg/day in patients who do not achieve optimal control of tics
- Dosage adjustments should occur gradually at intervals of no less than 1 week
6-18 years (≥50 kg)
- Initiate at 2 mg/day PO for 2 days, and then increase to 5 mg/day for 5 days, with a target dose of 10 mg/day on day 8
- The dose can be increased up to 20 mg/day for patients who do not achieve optimal control of tics
- Dosage adjustments should occur gradually in increments of 5 mg/day at intervals of no less than 1 week
Dosage Modifications (Oral)
Poor metabolizers and drugs that affect cytochrome-P 450
- Known CYP2D6 poor metabolizers: Administer half of recommended dose
- Known CYP2D6 poor metabolizers taking concomitant strong
- CYP3A4 inhibitors: Administer a quarter of the recommended dose (ie, decrease dose by 75%)
- Strong CYP2D6 or CYP3A4 inhibitors: Administer half of recommended dose
- Strong CYP2D6 AND CYP3A4 inhibitors: Administer a quarter of the recommended dose (ie, decrease dose by 75%)
- Strong CYP3A4 inducers: double recommended dose over 1-2 weeks
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (4)
- amisulpride
amisulpride, aripiprazole. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Increases risk of neuroleptic malignant syndrome.
- cisapride
aripiprazole and cisapride both increase QTc interval. Contraindicated.
- dronedarone
aripiprazole and dronedarone both increase QTc interval. Contraindicated.
- thioridazine
aripiprazole and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (126)
- amiodarone
aripiprazole and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
aripiprazole and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- apalutamide
apalutamide will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.
- apomorphine
aripiprazole decreases effects of apomorphine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- arsenic trioxide
aripiprazole and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
aripiprazole and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
aripiprazole and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- azithromycin
aripiprazole and azithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- bedaquiline
aripiprazole and bedaquiline both increase QTc interval. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- bromocriptine
aripiprazole decreases effects of bromocriptine by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- buprenorphine
aripiprazole and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- cabergoline
aripiprazole decreases effects of cabergoline by pharmacodynamic antagonism. Contraindicated.
- calcium/magnesium/potassium/sodium oxybates
aripiprazole, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- carbamazepine
carbamazepine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If carbamazepine is started in a patient already taking aripiprazole, the aripiprazole dose should be doubled; reduce aripiprazole dose if carbamazepine is discontinued
- ceritinib
ceritinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- chloramphenicol
chloramphenicol will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- chloroquine
chloroquine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole and chloroquine both increase QTc interval. Avoid or Use Alternate Drug. - chlorpromazine
aripiprazole and chlorpromazine both increase QTc interval. Avoid or Use Alternate Drug.
- cimetidine
cimetidine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- citalopram
aripiprazole and citalopram both increase QTc interval. Avoid or Use Alternate Drug.
- clarithromycin
clarithromycin will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug. - clozapine
aripiprazole and clozapine both increase QTc interval. Avoid or Use Alternate Drug.
- crizotinib
aripiprazole and crizotinib both increase QTc interval. Avoid or Use Alternate Drug.
- dacomitinib
dacomitinib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.
- desflurane
desflurane and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- disopyramide
aripiprazole and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
aripiprazole and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
- dopamine
aripiprazole decreases effects of dopamine by pharmacodynamic antagonism. Contraindicated.
- droperidol
aripiprazole and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- eliglustat
aripiprazole and eliglustat both increase QTc interval. Avoid or Use Alternate Drug.
eliglustat and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug. - encorafenib
aripiprazole and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
aripiprazole and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- enzalutamide
enzalutamide will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- eribulin
aripiprazole and eribulin both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin base
erythromycin base will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug. - erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug. - erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- erythromycin stearate
erythromycin stearate will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
fexinidazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates. - flecainide
aripiprazole and flecainide both increase QTc interval. Avoid or Use Alternate Drug.
- fluconazole
aripiprazole and fluconazole both increase QTc interval. Contraindicated.
- fluoxetine
fluoxetine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
aripiprazole and fluoxetine both increase QTc interval. Avoid or Use Alternate Drug. - fluphenazine
aripiprazole and fluphenazine both increase QTc interval. Avoid or Use Alternate Drug.
- foscarnet
aripiprazole and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.
- glasdegib
aripiprazole and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
- hydrocodone
hydrocodone, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- hydroxychloroquine sulfate
aripiprazole and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
aripiprazole and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- idelalisib
idelalisib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
- iloperidone
aripiprazole and iloperidone both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
aripiprazole and inotuzumab both increase QTc interval. Avoid or Use Alternate Drug.
- isoflurane
aripiprazole and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- itraconazole
aripiprazole and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.
aripiprazole and ivosidenib both decrease QTc interval. Avoid or Use Alternate Drug. - lefamulin
lefamulin and aripiprazole both increase QTc interval. Avoid or Use Alternate Drug.
- lenvatinib
aripiprazole and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
- levodopa
aripiprazole decreases effects of levodopa by pharmacodynamic antagonism. Avoid or Use Alternate Drug.
- levodopa inhaled
aripiprazole decreases effects of levodopa inhaled by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Atypical (2nd generation) antipsychotics inhibit dopamine D2 receptors in varying degrees (clozapine and quetiapine are lower risk). .
- lisuride
aripiprazole decreases effects of lisuride by pharmacodynamic antagonism. Contraindicated.
- lonafarnib
lonafarnib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
- lopinavir
lopinavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
aripiprazole and lopinavir both increase QTc interval. Avoid or Use Alternate Drug. - maprotiline
aripiprazole and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.
- mefloquine
mefloquine increases toxicity of aripiprazole by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- methadone
aripiprazole and methadone both increase QTc interval. Avoid or Use Alternate Drug.
- methyldopa
aripiprazole decreases effects of methyldopa by pharmacodynamic antagonism. Contraindicated.
- metoclopramide intranasal
aripiprazole, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
aripiprazole increases toxicity of metoclopramide intranasal by pharmacodynamic synergism. Avoid or Use Alternate Drug. Potential for additive effects, including increased frequency and severity of tardive dyskinesia, other extrapyramidal symptoms, and neuroleptic malignant syndrome. - midostaurin
aripiprazole and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mifepristone
aripiprazole and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.
- moxifloxacin
aripiprazole and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nefazodone
nefazodone will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nilotinib
aripiprazole and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- olopatadine intranasal
aripiprazole and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
aripiprazole and ondansetron both increase QTc interval. Avoid or Use Alternate Drug.
- osimertinib
aripiprazole and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
aripiprazole and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ozanimod
aripiprazole and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
- paliperidone
aripiprazole and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
aripiprazole and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
- paroxetine
paroxetine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- pazopanib
aripiprazole and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pentamidine
aripiprazole and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- perphenazine
aripiprazole and perphenazine both increase QTc interval. Avoid or Use Alternate Drug.
- pimavanserin
aripiprazole and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
aripiprazole and pimozide both increase QTc interval. Contraindicated.
- pitolisant
aripiprazole and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
aripiprazole and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- posaconazole
aripiprazole and posaconazole both increase QTc interval. Contraindicated.
- pramipexole
aripiprazole decreases effects of pramipexole by pharmacodynamic antagonism. Contraindicated.
- procainamide
aripiprazole and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
aripiprazole and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- quetiapine
aripiprazole and quetiapine both increase QTc interval. Avoid or Use Alternate Drug.
- quinidine
aripiprazole and quinidine both increase QTc interval. Contraindicated.
- quinine
aripiprazole and quinine both increase QTc interval. Avoid or Use Alternate Drug.
- ranolazine
aripiprazole and ranolazine both increase QTc interval. Avoid or Use Alternate Drug.
- ribociclib
aripiprazole and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.
- rifabutin
rifabutin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- rifampin
rifampin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- ropinirole
aripiprazole decreases effects of ropinirole by pharmacodynamic antagonism. Contraindicated.
- safinamide
aripiprazole decreases effects of safinamide by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Dopamine antagonists may decrease safinamide effects and exacerbate Parkinson disease symptoms.
- saquinavir
aripiprazole and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
- selinexor
selinexor, aripiprazole. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- selpercatinib
aripiprazole and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
aripiprazole and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- sodium oxybate
aripiprazole, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- sorafenib
aripiprazole and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
aripiprazole and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- St John's Wort
St John's Wort will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- sufentanil SL
sufentanil SL, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tetrabenazine
aripiprazole and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- thiothixene
aripiprazole and thiothixene both increase QTc interval. Avoid or Use Alternate Drug.
- tipranavir
tipranavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- toremifene
aripiprazole and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- trazodone
aripiprazole and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- vandetanib
aripiprazole and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
- vemurafenib
aripiprazole and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
- voriconazole
aripiprazole and voriconazole both increase QTc interval. Avoid or Use Alternate Drug.
- vorinostat
aripiprazole and vorinostat both increase QTc interval. Avoid or Use Alternate Drug.
- voxelotor
voxelotor will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
- ziprasidone
aripiprazole and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (412)
- abiraterone
abiraterone increases levels of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.
- acarbose
aripiprazole, acarbose. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- aclidinium
aclidinium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of aclidinium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - acrivastine
acrivastine and aripiprazole both increase sedation. Use Caution/Monitor.
- albiglutide
aripiprazole, albiglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- albuterol
aripiprazole increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and aripiprazole both increase sedation. Use Caution/Monitor.
- alfuzosin
aripiprazole and alfuzosin both increase QTc interval. Use Caution/Monitor.
- almotriptan
almotriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- alprazolam
alprazolam and aripiprazole both increase sedation. Use Caution/Monitor.
- amifostine
amifostine, aripiprazole. Either increases effects of the other by anti-hypertensive channel blocking. Use Caution/Monitor. Due to its alpha adrenergic antagonism, atypical antipsychotic agents has the potential to enhance the effect of certain antihypertensive agents. Monitor blood pressure and adjust dose accordingly.
- amitriptyline
aripiprazole and amitriptyline both increase sedation. Use Caution/Monitor.
aripiprazole and amitriptyline both increase QTc interval. Use Caution/Monitor. - amobarbital
amobarbital and aripiprazole both increase sedation. Use Caution/Monitor.
- amoxapine
aripiprazole and amoxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.
aripiprazole and amoxapine both increase sedation. Use Caution/Monitor.
aripiprazole and amoxapine both increase QTc interval. Use Caution/Monitor. - anagrelide
aripiprazole and anagrelide both increase QTc interval. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
anticholinergic/sedative combos decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of anticholinergic/sedative combos by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - apomorphine
aripiprazole and apomorphine both increase sedation. Use Caution/Monitor.
aripiprazole and apomorphine both increase QTc interval. Use Caution/Monitor. - aprepitant
aprepitant will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- arformoterol
aripiprazole increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aripiprazole and arformoterol both increase QTc interval. Use Caution/Monitor. - armodafinil
armodafinil will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. - artemether/lumefantrine
artemether/lumefantrine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
artemether/lumefantrine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - asenapine
asenapine and aripiprazole both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and aripiprazole both increase sedation. Use Caution/Monitor.
- atazanavir
atazanavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- atracurium
atracurium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atracurium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of atracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine
atropine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of atropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atropine IV/IM
aripiprazole increases effects of atropine IV/IM by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
atropine IV/IM decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
atropine IV/IM decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. - avapritinib
avapritinib and aripiprazole both increase sedation. Use Caution/Monitor.
- azelastine
azelastine and aripiprazole both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and aripiprazole both increase sedation. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna alkaloids decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of belladonna alkaloids by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - belladonna and opium
belladonna and opium and aripiprazole both increase sedation. Use Caution/Monitor.
belladonna and opium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
belladonna and opium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of belladonna and opium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - belzutifan
belzutifan will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.
- benazepril
aripiprazole, benazepril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypotensive effects.
- benperidol
aripiprazole and benperidol both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and benperidol both increase sedation. Use Caution/Monitor. - benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and aripiprazole both increase sedation. Use Caution/Monitor.
- benzphetamine
aripiprazole increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- bosentan
bosentan will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- brexanolone
brexanolone, aripiprazole. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and aripiprazole both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and aripiprazole both increase sedation. Use Caution/Monitor.
- brivaracetam
brivaracetam and aripiprazole both increase sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and aripiprazole both increase sedation. Use Caution/Monitor.
- budesonide
budesonide will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- buprenorphine
buprenorphine and aripiprazole both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and aripiprazole both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and aripiprazole both increase sedation. Use Caution/Monitor.
- buprenorphine transdermal
buprenorphine transdermal and aripiprazole both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
aripiprazole increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
buprenorphine, long-acting injection and aripiprazole both increase sedation. Use Caution/Monitor. - bupropion
bupropion will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- butabarbital
butabarbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
butabarbital and aripiprazole both increase sedation. Use Caution/Monitor. - butalbital
butalbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
butalbital and aripiprazole both increase sedation. Use Caution/Monitor. - butorphanol
butorphanol and aripiprazole both increase sedation. Use Caution/Monitor.
- caffeine
aripiprazole increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- captopril
aripiprazole, captopril. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood pressure. Monitor blood pressure.
- carbinoxamine
carbinoxamine and aripiprazole both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and aripiprazole both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.
cenobamate, aripiprazole. Either increases effects of the other by sedation. Use Caution/Monitor. - chloral hydrate
chloral hydrate and aripiprazole both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and aripiprazole both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and aripiprazole both increase sedation. Use Caution/Monitor.
- chlorpromazine
aripiprazole and chlorpromazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and chlorpromazine both increase sedation. Use Caution/Monitor. - chlorpropamide
aripiprazole, chlorpropamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- chlorzoxazone
chlorzoxazone and aripiprazole both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and aripiprazole both increase sedation. Use Caution/Monitor.
- ciprofloxacin
aripiprazole and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
- cisatracurium
cisatracurium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cisatracurium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of cisatracurium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - clemastine
clemastine and aripiprazole both increase sedation. Use Caution/Monitor.
- clobazam
clobazam will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.
aripiprazole, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). - clomipramine
aripiprazole and clomipramine both increase sedation. Use Caution/Monitor.
aripiprazole and clomipramine both increase QTc interval. Use Caution/Monitor. - clonazepam
clonazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- clonidine
clonidine, aripiprazole. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- clorazepate
clorazepate and aripiprazole both increase sedation. Use Caution/Monitor.
- clozapine
aripiprazole and clozapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and clozapine both increase sedation. Use Caution/Monitor. - cobicistat
cobicistat will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce aripiprazole dose by 25% and by approximately 50% if administered with CYP3A4 inhibitor and CYP206 inhibitor
- codeine
codeine and aripiprazole both increase sedation. Use Caution/Monitor.
- conivaptan
conivaptan will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cortisone
cortisone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- crizotinib
crizotinib increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.
- crofelemer
crofelemer increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.
- cyclizine
cyclizine and aripiprazole both increase sedation. Use Caution/Monitor.
cyclizine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
cyclizine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclobenzaprine
cyclobenzaprine and aripiprazole both increase sedation. Use Caution/Monitor.
cyclobenzaprine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
aripiprazole increases effects of cyclobenzaprine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclosporine
cyclosporine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and aripiprazole both increase sedation. Use Caution/Monitor.
- dabrafenib
dabrafenib will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- dantrolene
dantrolene and aripiprazole both increase sedation. Use Caution/Monitor.
- daridorexant
aripiprazole and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
darifenacin decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
darifenacin decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of darifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - darunavir
darunavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dasatinib
dasatinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole and dasatinib both increase QTc interval. Use Caution/Monitor. - deferasirox
deferasirox will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- degarelix
aripiprazole and degarelix both increase QTc interval. Use Caution/Monitor.
- desipramine
aripiprazole and desipramine both increase sedation. Use Caution/Monitor.
aripiprazole and desipramine both increase QTc interval. Use Caution/Monitor. - desvenlafaxine
desvenlafaxine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg
- deutetrabenazine
aripiprazole and deutetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely. The risk for parkinsonism, neuroleptic malignant syndrome, and akathisia may be increased by concomitant use of deutetrabenazine and dopamine antagonists or antipsychotics.
aripiprazole and deutetrabenazine both increase sedation. Use Caution/Monitor.
aripiprazole and deutetrabenazine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexamethasone
dexamethasone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dexchlorpheniramine
dexchlorpheniramine and aripiprazole both increase sedation. Use Caution/Monitor.
- dexfenfluramine
aripiprazole increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and aripiprazole both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
aripiprazole increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
aripiprazole increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromethorphan
dextromethorphan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- dextromoramide
dextromoramide and aripiprazole both increase sedation. Use Caution/Monitor.
- DHEA, herbal
DHEA, herbal will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- diamorphine
diamorphine and aripiprazole both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- dichlorphenamide
dichlorphenamide and aripiprazole both decrease serum potassium. Use Caution/Monitor.
- dicyclomine
dicyclomine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
dicyclomine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of dicyclomine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diethylpropion
aripiprazole increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and aripiprazole both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and aripiprazole both increase sedation. Use Caution/Monitor.
- dihydroergotamine
dihydroergotamine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- diltiazem
diltiazem will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Closely monitor when aripiprazole is used with a moderate CYP3A4 inhibitor, due to potential risks for increased aripiprazole systemic exposure and effects. Refer to drug monograph for specific dosing modifications are dependent on indication, genotype, and drug formulation.
- dimenhydrinate
dimenhydrinate and aripiprazole both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and aripiprazole both increase sedation. Use Caution/Monitor.
diphenhydramine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
diphenhydramine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - diphenoxylate hcl
diphenoxylate hcl and aripiprazole both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and aripiprazole both increase sedation. Use Caution/Monitor.
- dobutamine
aripiprazole increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dolasetron
aripiprazole and dolasetron both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and aripiprazole both increase QTc interval. Use Caution/Monitor.
- dopamine
aripiprazole increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
aripiprazole increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
aripiprazole and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
aripiprazole and doxepin both increase sedation. Use Caution/Monitor.
doxepin and aripiprazole both increase QTc interval. Use Caution/Monitor. - doxylamine
doxylamine and aripiprazole both increase sedation. Use Caution/Monitor.
- dronedarone
dronedarone will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- droperidol
aripiprazole and droperidol both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and droperidol both increase sedation. Use Caution/Monitor. - duvelisib
duvelisib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. will increase the level or effect of
- efavirenz
efavirenz will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
efavirenz and aripiprazole both increase QTc interval. Use Caution/Monitor. - elagolix
elagolix will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.
- eletriptan
eletriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- eliglustat
eliglustat increases levels of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of aripiprazole by affecting hepatic enzyme CYP2E1 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. - encorafenib
encorafenib, aripiprazole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
- ephedrine
aripiprazole increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
aripiprazole increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
aripiprazole increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ergoloid mesylates
ergoloid mesylates, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ergotamine
ergotamine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- erythromycin lactobionate
aripiprazole and erythromycin lactobionate both increase QTc interval. Use Caution/Monitor.
- erythromycin stearate
aripiprazole and erythromycin stearate both increase QTc interval. Use Caution/Monitor.
- escitalopram
aripiprazole and escitalopram both increase QTc interval. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, aripiprazole. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- estazolam
estazolam and aripiprazole both increase sedation. Use Caution/Monitor.
- ethanol
aripiprazole and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and aripiprazole both increase sedation. Use Caution/Monitor.
- etravirine
etravirine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- exenatide injectable solution
aripiprazole, exenatide injectable solution. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- exenatide injectable suspension
aripiprazole, exenatide injectable suspension. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- fedratinib
fedratinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
fedratinib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary. - fenfluramine
aripiprazole increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aripiprazole decreases effects of fenfluramine by pharmacodynamic antagonism. Use Caution/Monitor. Potent serotonin receptor antagonists may decrease fenfluramine efficacy. If coadministered, monitor appropriately. - fentanyl
fentanyl, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- fesoterodine
fesoterodine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
fesoterodine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of fesoterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - fingolimod
fingolimod and aripiprazole both increase QTc interval. Use Caution/Monitor.
- flavoxate
flavoxate decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
flavoxate decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of flavoxate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - flibanserin
flibanserin, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- fluconazole
fluconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fludrocortisone
fludrocortisone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fluphenazine
aripiprazole and fluphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and fluphenazine both increase sedation. Use Caution/Monitor. - flurazepam
flurazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- formoterol
aripiprazole increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aripiprazole and formoterol both increase QTc interval. Use Caution/Monitor. - fosamprenavir
fosamprenavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fosaprepitant
fosaprepitant will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fosphenytoin
fosphenytoin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- fostemsavir
aripiprazole and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- frovatriptan
frovatriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ganaxolone
aripiprazole and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
aripiprazole and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
aripiprazole and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
aripiprazole and gilteritinib both increase QTc interval. Use Caution/Monitor.
- glimepiride
aripiprazole, glimepiride. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glipizide
aripiprazole, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glyburide
aripiprazole, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- glycopyrrolate
aripiprazole increases effects of glycopyrrolate by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
- glycopyrrolate inhaled
glycopyrrolate inhaled decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
glycopyrrolate inhaled decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of glycopyrrolate inhaled by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - goserelin
aripiprazole and goserelin both increase QTc interval. Use Caution/Monitor.
- granisetron
aripiprazole and granisetron both increase QTc interval. Use Caution/Monitor.
- grapefruit
grapefruit will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- griseofulvin
griseofulvin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- guanfacine
guanfacine, aripiprazole. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects; potential delirium.
- haloperidol
aripiprazole and haloperidol both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and haloperidol both increase sedation. Use Caution/Monitor.
aripiprazole and haloperidol both increase QTc interval. Use Caution/Monitor. - henbane
henbane decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
henbane decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of henbane by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - histrelin
aripiprazole and histrelin both increase QTc interval. Use Caution/Monitor.
- homatropine
homatropine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
homatropine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of homatropine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hydrocortisone
hydrocortisone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- hydromorphone
hydromorphone and aripiprazole both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and aripiprazole both increase sedation. Use Caution/Monitor.
aripiprazole and hydroxyzine both increase QTc interval. Use Caution/Monitor. - hyoscyamine
hyoscyamine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of hyoscyamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - hyoscyamine spray
aripiprazole increases effects of hyoscyamine spray by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
hyoscyamine spray decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
hyoscyamine spray decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor. - iloperidone
aripiprazole and iloperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and iloperidone both increase sedation. Use Caution/Monitor.
iloperidone increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. - imipramine
aripiprazole and imipramine both increase sedation. Use Caution/Monitor.
- indacaterol, inhaled
aripiprazole and indacaterol, inhaled both increase QTc interval. Use Caution/Monitor.
- indinavir
indinavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- insulin aspart
aripiprazole, insulin aspart. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin degludec
aripiprazole decreases effects of insulin degludec by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin degludec/insulin aspart
aripiprazole decreases effects of insulin degludec/insulin aspart by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin detemir
aripiprazole, insulin detemir. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glargine
aripiprazole, insulin glargine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin glulisine
aripiprazole, insulin glulisine. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin inhaled
aripiprazole decreases effects of insulin inhaled by Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; dose of antidiabetic agents may need adjustment and increased frequency of glucose monitoring may be required.
- insulin lispro
aripiprazole, insulin lispro. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin NPH
aripiprazole, insulin NPH. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- insulin regular human
aripiprazole, insulin regular human. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ipratropium
ipratropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
ipratropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of ipratropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - isoniazid
isoniazid will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- isoproterenol
aripiprazole increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- istradefylline
istradefylline will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
- itraconazole
itraconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. For aripiprazole oral formulations other than the extended-release injectable: Reduce aripiprazole dose by 50% of the usual dose when initiating concomitant therapy with a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (e.g., paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider reducing apixaban dose to up to 75% when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor. For extended-release injectable aripiprazole: Please refer to prescribing information.
- ketoconazole
ketoconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce aripiprazole oral dose by 50% of the usual dose when concomitantly using a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (eg, paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider dose reductions to 25% of the usual dose when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor initially and then adjusted to achieve a favorable clinical response.
- ketotifen, ophthalmic
aripiprazole and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lapatinib
lapatinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole and lapatinib both increase QTc interval. Use Caution/Monitor. - larotrectinib
larotrectinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lasmiditan
lasmiditan, aripiprazole. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, aripiprazole. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- lenacapavir
lenacapavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- letermovir
letermovir increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- leuprolide
aripiprazole and leuprolide both increase QTc interval. Use Caution/Monitor.
- levalbuterol
aripiprazole increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
aripiprazole and levalbuterol both increase QTc interval. Use Caution/Monitor. - levofloxacin
aripiprazole and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levoketoconazole
levoketoconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce aripiprazole oral dose by 50% of the usual dose when concomitantly using a strong CYP3A4 inhibitor, and further to 25% of the usual dose in patients who are also receiving strong CYP2D6 inhibitors (eg, paroxetine, quinidine) or who are CYP2D6 poor metabolizers. Consider dose reductions to 25% of the usual dose when combining a strong CYP3A4 inhibitor with a less potent CYP2D6 inhibitor initially and then adjusted to achieve a favorable clinical response.
- levomilnacipran
levomilnacipran, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- levorphanol
levorphanol and aripiprazole both increase sedation. Use Caution/Monitor.
- linezolid
linezolid, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- liraglutide
aripiprazole, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- lisdexamfetamine
aripiprazole increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lithium
lithium, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
aripiprazole and lithium both increase QTc interval. Use Caution/Monitor. - lofepramine
aripiprazole and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
aripiprazole and lofexidine both increase sedation. Use Caution/Monitor.
aripiprazole and lofexidine both increase QTc interval. Use Caution/Monitor. - loperamide
aripiprazole and loperamide both increase QTc interval. Use Caution/Monitor.
- loprazolam
loprazolam and aripiprazole both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- lorcaserin
lorcaserin will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
lorcaserin, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - lorlatinib
lorlatinib will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- lormetazepam
lormetazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- loxapine
aripiprazole and loxapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and loxapine both increase sedation. Use Caution/Monitor. - loxapine inhaled
aripiprazole and loxapine inhaled both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and loxapine inhaled both increase sedation. Use Caution/Monitor. - lumefantrine
lumefantrine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
lumefantrine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - lurasidone
lurasidone, aripiprazole. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
aripiprazole and maprotiline both increase sedation. Use Caution/Monitor.
- marijuana
marijuana will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole and marijuana both increase sedation. Use Caution/Monitor. - meclizine
meclizine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
meclizine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of meclizine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - melatonin
aripiprazole and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and aripiprazole both increase sedation. Use Caution/Monitor.
meperidine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - meprobamate
aripiprazole and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
aripiprazole increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and aripiprazole both increase sedation. Use Caution/Monitor.
- metformin
aripiprazole, metformin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- methadone
methadone and aripiprazole both increase sedation. Use Caution/Monitor.
methadone, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - methamphetamine
aripiprazole increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and aripiprazole both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
methscopolamine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of methscopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - methylenedioxymethamphetamine
aripiprazole increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methylergonovine
methylergonovine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- methylphenidate
aripiprazole increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.
- methylprednisolone
methylprednisolone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- metoclopramide
aripiprazole and metoclopramide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
- metronidazole
metronidazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- miconazole vaginal
miconazole vaginal will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- midazolam
midazolam and aripiprazole both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, aripiprazole. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
aripiprazole increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If these drugs must be used together, follow manufacturer recommendations
- miglitol
aripiprazole, miglitol. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- milnacipran
milnacipran, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- mirabegron
mirabegron will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- mirtazapine
aripiprazole and mirtazapine both increase sedation. Use Caution/Monitor.
aripiprazole and mirtazapine both increase QTc interval. Use Caution/Monitor. - mitotane
mitotane decreases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
- modafinil
aripiprazole increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and aripiprazole both increase sedation. Use Caution/Monitor.
- motherwort
aripiprazole and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
aripiprazole and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
aripiprazole and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and aripiprazole both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- nateglinide
aripiprazole, nateglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- nelfinavir
nelfinavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nevirapine
nevirapine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nifedipine
nifedipine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nilotinib
nilotinib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- nizatidine
nizatidine will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- norepinephrine
aripiprazole increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
aripiprazole and nortriptyline both increase sedation. Use Caution/Monitor.
aripiprazole and nortriptyline both increase QTc interval. Use Caution/Monitor. - octreotide
aripiprazole and octreotide both increase QTc interval. Use Caution/Monitor.
- ofloxacin
aripiprazole and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
aripiprazole and olanzapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and olanzapine both increase sedation. Use Caution/Monitor.
aripiprazole and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - oliceridine
oliceridine, aripiprazole. Either increases toxicity of the other by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
oliceridine, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. - olodaterol inhaled
aripiprazole and olodaterol inhaled both increase QTc interval. Use Caution/Monitor.
- onabotulinumtoxinA
onabotulinumtoxinA decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
onabotulinumtoxinA decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - opium tincture
opium tincture and aripiprazole both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and aripiprazole both increase sedation. Use Caution/Monitor.
- osilodrostat
osilodrostat and aripiprazole both increase QTc interval. Use Caution/Monitor.
- oxazepam
oxazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- oxcarbazepine
oxcarbazepine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- oxybutynin
oxybutynin decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin topical
oxybutynin topical decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin topical decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxybutynin transdermal
oxybutynin transdermal decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
oxybutynin transdermal decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - oxycodone
oxycodone and aripiprazole both increase sedation. Use Caution/Monitor.
- oxymorphone
oxymorphone and aripiprazole both increase sedation. Use Caution/Monitor.
- paliperidone
aripiprazole and paliperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and paliperidone both increase sedation. Use Caution/Monitor. - pancuronium
pancuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pancuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of pancuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - papaveretum
papaveretum and aripiprazole both increase sedation. Use Caution/Monitor.
- papaverine
aripiprazole and papaverine both increase sedation. Use Caution/Monitor.
- paroxetine
paroxetine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- pasireotide
aripiprazole and pasireotide both increase QTc interval. Use Caution/Monitor.
- peginterferon alfa 2b
peginterferon alfa 2b, aripiprazole. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.
- pentazocine
pentazocine and aripiprazole both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
pentobarbital and aripiprazole both increase sedation. Use Caution/Monitor. - perphenazine
aripiprazole and perphenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and perphenazine both increase sedation. Use Caution/Monitor. - phendimetrazine
aripiprazole increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenelzine
phenelzine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- phenobarbital
phenobarbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
phenobarbital and aripiprazole both increase sedation. Use Caution/Monitor. - phentermine
aripiprazole increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
aripiprazole increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
aripiprazole increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- phenytoin
phenytoin will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- pholcodine
aripiprazole and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
aripiprazole and pimozide both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and pimozide both increase sedation. Use Caution/Monitor. - pioglitazone
aripiprazole, pioglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- pirbuterol
aripiprazole increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
posaconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- pralidoxime
pralidoxime decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
pralidoxime decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of pralidoxime by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pramlintide
aripiprazole, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- prednisone
prednisone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- primaquine
aripiprazole and primaquine both increase QTc interval. Use Caution/Monitor.
- primidone
primidone will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
primidone and aripiprazole both increase sedation. Use Caution/Monitor. - procarbazine
procarbazine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- prochlorperazine
aripiprazole and prochlorperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and prochlorperazine both increase sedation. Use Caution/Monitor. - promethazine
aripiprazole and promethazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
promethazine and aripiprazole both increase sedation. Use Caution/Monitor.
promethazine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - propantheline
propantheline decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
propantheline decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of propantheline by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propylhexedrine
aripiprazole increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
aripiprazole and protriptyline both increase sedation. Use Caution/Monitor.
- quazepam
quazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- quetiapine
aripiprazole and quetiapine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and quetiapine both increase sedation. Use Caution/Monitor. - quinidine
quinidine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ramelteon
aripiprazole and ramelteon both increase sedation. Use Caution/Monitor.
- rapacuronium
rapacuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rapacuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of rapacuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - remimazolam
remimazolam, aripiprazole. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- repaglinide
aripiprazole, repaglinide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ribociclib
ribociclib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rifapentine
rifapentine will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rilpivirine
aripiprazole and rilpivirine both increase QTc interval. Use Caution/Monitor.
- risperidone
aripiprazole and risperidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and risperidone both increase sedation. Use Caution/Monitor.
aripiprazole and risperidone both increase QTc interval. Use Caution/Monitor. - ritonavir
ritonavir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rocuronium
rocuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
rocuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of rocuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rolapitant
rolapitant will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.
- romidepsin
aripiprazole and romidepsin both increase QTc interval. Use Caution/Monitor.
- rosiglitazone
aripiprazole, rosiglitazone. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- rucaparib
rucaparib will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.
- rufinamide
rufinamide will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- salmeterol
aripiprazole increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- saquinavir
saquinavir increases levels of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. Consider aripiprazole dose reduction by 50%.
- saxagliptin
aripiprazole, saxagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- scopolamine
scopolamine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
scopolamine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of scopolamine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - scullcap
aripiprazole and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
secobarbital and aripiprazole both increase sedation. Use Caution/Monitor. - selegiline
selegiline, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sertraline
sertraline will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
aripiprazole and sertraline both increase QTc interval. Use Caution/Monitor. - shepherd's purse
aripiprazole and shepherd's purse both increase sedation. Use Caution/Monitor.
- sitagliptin
aripiprazole, sitagliptin. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of aripiprazole by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of aripiprazole by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of enhanced CNS depression when using higher dose of magnesium sulfate together with a CNS depressant.
- solifenacin
solifenacin decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
solifenacin decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
aripiprazole and solifenacin both increase QTc interval. Use Caution/Monitor. - stiripentol
stiripentol, aripiprazole. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
- sufentanil
sufentanil and aripiprazole both increase sedation. Use Caution/Monitor.
- sumatriptan
sumatriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sumatriptan intranasal
sumatriptan intranasal, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- sunitinib
aripiprazole and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
aripiprazole and tacrolimus both increase QTc interval. Use Caution/Monitor.
- tapentadol
tapentadol and aripiprazole both increase sedation. Use Caution/Monitor.
- tazemetostat
tazemetostat will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- tecovirimat
tecovirimat will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.
- telavancin
aripiprazole and telavancin both increase QTc interval. Use Caution/Monitor.
- temazepam
temazepam and aripiprazole both increase sedation. Use Caution/Monitor.
- terbinafine
terbinafine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.
- terbutaline
aripiprazole increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tetrabenazine
aripiprazole and tetrabenazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Modify Therapy/Monitor Closely.
- thioridazine
aripiprazole and thioridazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and thioridazine both increase sedation. Use Caution/Monitor. - thiothixene
aripiprazole and thiothixene both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and thiothixene both increase sedation. Use Caution/Monitor. - tiotropium
tiotropium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tiotropium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of tiotropium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tolazamide
aripiprazole, tolazamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolbutamide
aripiprazole, tolbutamide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- tolterodine
tolterodine decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
tolterodine decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of tolterodine by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - topiramate
topiramate will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
aripiprazole and topiramate both increase sedation. Modify Therapy/Monitor Closely. - tramadol
tramadol and aripiprazole both increase sedation. Use Caution/Monitor.
- tranylcypromine
tranylcypromine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- trazodone
aripiprazole and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and aripiprazole both increase sedation. Use Caution/Monitor.
- triclabendazole
aripiprazole and triclabendazole both increase QTc interval. Use Caution/Monitor.
- triclofos
triclofos and aripiprazole both increase sedation. Use Caution/Monitor.
- trifluoperazine
aripiprazole and trifluoperazine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and trifluoperazine both increase sedation. Use Caution/Monitor. - trimipramine
aripiprazole and trimipramine both increase sedation. Use Caution/Monitor.
aripiprazole and trimipramine both increase QTc interval. Use Caution/Monitor. - triprolidine
triprolidine and aripiprazole both increase sedation. Use Caution/Monitor.
- triptorelin
aripiprazole and triptorelin both increase QTc interval. Use Caution/Monitor.
- trospium chloride
trospium chloride decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - valbenazine
valbenazine and aripiprazole both increase QTc interval. Use Caution/Monitor.
- vardenafil
aripiprazole and vardenafil both increase QTc interval. Use Caution/Monitor.
- vecuronium
vecuronium decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
vecuronium decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of vecuronium by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - venlafaxine
venlafaxine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
venlafaxine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction). - verapamil
verapamil will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- vilanterol/fluticasone furoate inhaled
aripiprazole and vilanterol/fluticasone furoate inhaled both increase QTc interval. Use Caution/Monitor.
- vilazodone
vilazodone, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- voclosporin
aripiprazole and voclosporin both increase QTc interval. Use Caution/Monitor.
- voriconazole
voriconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- xylometazoline
aripiprazole increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
aripiprazole increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- zafirlukast
zafirlukast will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ziconotide
aripiprazole and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
aripiprazole and ziprasidone both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and ziprasidone both increase sedation. Use Caution/Monitor. - zolmitriptan
zolmitriptan, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- zotepine
aripiprazole and zotepine both increase antidopaminergic effects, including extrapyramidal symptoms and neuroleptic malignant syndrome. Use Caution/Monitor.
aripiprazole and zotepine both increase sedation. Use Caution/Monitor.
Minor (33)
- acetazolamide
acetazolamide will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- amiodarone
amiodarone will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- amobarbital
amobarbital will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- anastrozole
anastrozole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- asenapine
asenapine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of aripiprazole by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- celecoxib
celecoxib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- chasteberry
chasteberry decreases effects of aripiprazole by pharmacodynamic antagonism. Minor/Significance Unknown. (Theoretical interaction).
- chloroquine
chloroquine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cimetidine
cimetidine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- cyclophosphamide
cyclophosphamide will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- darifenacin
darifenacin will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- diphenhydramine
diphenhydramine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- dronedarone
dronedarone will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- duloxetine
duloxetine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ethanol
ethanol, aripiprazole. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.
- eucalyptus
aripiprazole and eucalyptus both increase sedation. Minor/Significance Unknown.
- famotidine
famotidine decreases levels of aripiprazole by unspecified interaction mechanism. Minor/Significance Unknown.
- haloperidol
haloperidol will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ibuprofen/famotidine
ibuprofen/famotidine decreases levels of aripiprazole by unspecified interaction mechanism. Minor/Significance Unknown.
- imatinib
imatinib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- maraviroc
maraviroc will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- marijuana
marijuana will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- nilotinib
nilotinib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- parecoxib
parecoxib will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- perphenazine
perphenazine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- propafenone
propafenone will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- quinacrine
quinacrine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ranolazine
ranolazine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- ritonavir
ritonavir will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- sage
aripiprazole and sage both increase sedation. Minor/Significance Unknown.
- thioridazine
thioridazine will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
- tipranavir
tipranavir will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.
Adverse Effects
>10%
Weight gain (8-30%)
Headache (27%)
Agitation (19%)
Insomnia (18%)
Anxiety (17%)
Nausea and vomiting (11-15%)
Akathisia (10-13%)
Lightheadedness (11%)
Constipation (10-11%)
1-10%
Dizziness (10%)
Dyspepsia (9%)
Somnolence (5-8%)
Fatigue (6%)
Restlessness (6%)
Tremor (6%)
Dry mouth/xerostomia (5%)
Extrapyramidal disorder (5%)
Orthostatic hypotension (1-5%)
Musculoskeletal stiffness (4%)
Abdominal discomfort (3%)
Blurred vision (3%)
Cough (3%)
Pain (3%)
Myalgia (2%)
Rash
Rhinitis
Aripiprazole lauroxil
- Extrapyramidal symptoms (5-7%)
- Injection site reactions (4%)
- Pain at injection site (<2%)
- Increased weight (<2%)
- Increased creatinine phosphokinase (<2%)
- Akathisia (<2%)
- Headache (<2%)
- Insomnia (<2%)
- Restlessness (<2%)
<1%
Altered mental status
Autonomic instability
Dysphagia
Hyperpyrexia
Muscle rigidity
Neuroleptic malignant syndrome (NMS)
Seizure
Tardive dyskinesia
Aripiprazole lauroxil
- Cardiac – Angina pectoris, tachycardia, palpitations
- Gastrointestinal disorders – Constipation, dry mouth
- General disorders – Asthenia
- Musculoskeletal – Muscular weakness
- Nervous system disorders – Dizziness
- Psychiatric disorders – Anxiety, suicide
Postmarketing Reports
Pathological gambling
Hiccups
Falls
Oculogyric crisis, and drug reaction with eosinophilia and systemic symptoms (DRESS)
Aripiprazole lauroxil
- Occurrences of allergic reaction (anaphylactic reaction, angioedema, laryngospasm, pruritus/urticaria, or oropharyngeal spasm), pathological gambling, hiccups and blood glucose fluctuation
Warnings
Black Box Warnings
Dementia-related Psychosis
- Not approved for dementia-related psychosis; patients with dementia-related psychosis who are treated with antipsychotic drugs are at increased risk of death, as shown in short-term controlled trials; deaths reported in trials appeared to be either cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature
Suicidal thoughts and behaviors
- Aripiprazole PO and Abilify injection only
- Antidepressants increased risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking antidepressants for major depressive disorders and other psychiatric illnesses, as shown in short-term studies; monitor for worsening and emergence of suicidal thoughts and behaviors
Contraindications
Hypersensitivity to aripiprazole
Cautions
Risk of extrapyramidal symptoms (EPS) (eg, pseudoparkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesia; monitor
Tardive dyskinesia may occur; may consider discontinuation of therapy if clinically indicated
Use may be associated with neuroleptic malignant syndrome (NMS); monitor for mental status changes, fever, muscle rigidity and/or autonomic instability
May cause somnolence, postural hypotension, motor and sensory instability, which may lead to falls and, consequently, fractures or other injuries; perform complete fall risk assessments when initiating antipsychotic treatment and recurrently for patients on long-term antipsychotic therapy
Use caution in patients with known cardiovascular disease, cerebrovascular disease, or predisposition to hypotension; may increase incidence of cerebrovascular adverse reactions (eg, stroke, transient ischemic attack, including fatalities)
Monitor heart rate and blood pressure and warn patients with known cardiovascular or cerebrovascular disease, and risk of dehydration or syncope
Use caution in patients with Parkinson disease; may aggravate motor disturbances
May increase risk of suicidal tendencies in children and adolescents (see Black Box Warnings)
FDA warning regarding off-label use for dementia in elderly (see Black Box Warnings)
Patients may act on dangerous impulses (eg, gambling)
Monitor for orthostatic hypotension
May cause seizures or convulsions; use cautiously in patients with history of seizures or with conditions that lower the seizure threshold
May cause CNS depression, which may impair physical or mental abilities; use caution when operating heavy machinery
Use caution in patients at risk of pneumonia; antipsychotic therapy has been associated with esophageal dysmotility and aspiration
Impairment of core body temperature regulation possible; use caution in dehydration, heat exposure, strenuous exercise, and concomitant medication possessing anticholinergic effects
Potential dosing and medication errors
- Aristada and Aristada Initio
- Medication errors (eg, substitution, dispensing errors) between Aristada and Aristada Initio may occur
- Aristada Initio is intended only for single administration
- Do not substitute Aristada Initio for Aristada because of differing pharmacokinetic profiles
Leukopenia, neutropenia, and agranulocytosis
- Leukopenia/neutropenia and agranulocytosis reported; possible risk factors for leukopenia/neutropenia include preexisting low white blood cell (WBC) count and history of drug-induced leukopenia/neutropenia
- If patient has history of clinically significant low WBC count or drug-induced leukopenia/neutropenia, monitor complete blood count (CBC) frequently during first few months of therapy; discontinue drug at first sign of clinically significant WBC decline <1000/mcL in absence of other causative factors, and continue monitoring WBC count until recovery
Metabolic changes
- Atypical antipsychotics have been associated with metabolic changes that may increase cardiovascular or cerebrovascular risk, including dyslipidemia and body weight gain
- Increased risk of hyperglycemia and diabetes; in some cases, hyperglycemia concomitant with use of atypical antipsychotics has been associated with ketoacidosis, hyperosmolar coma, or death; monitor patients for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness; monitor glucose regularly in patients with and at risk for diabetes
- Significant weight gain reported with therapy; monitor waist circumference and BMI
Drug interaction overview
- See Dosage Modifications
- Strong CYP3A4 and CYP2D6 inhibitors: Coadministration of oral aripiprazole with strong CYP3A4 or CYP2D6 inhibitors increased the exposure of aripiprazole compared to the use of oral aripiprazole alone
- Strong CYP3A4 inducers: Coadministration of oral aripiprazole with strong CYP3A4 inducers decreased the exposure of aripiprazole compared to the use of oral aripiprazole alone
- Antihypertensives: Due to its alpha adrenergic antagonism, aripiprazole may potentiate the effects of certain antihypertensive agents; avoid concomitant use with Aristada Initio
- Benzodiazepines: Orthostatic hypotension and the intensity of sedation was greater with the combination of oral aripiprazole and lorazepam as compared to that observed with aripiprazole alone; avoid concomitant use with Aristada Initio
Pregnancy & Lactation
Pregnancy
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ARISTADA during pregnancy; For more information, contact the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or visit http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/
Neonates exposed to antipsychotic drugs during third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms following delivery; limited published data on aripiprazole use in pregnant women are not sufficient to inform any drug-associated risks for birth defects or miscarriage; no teratogenicity observed in animal reproductive studies with intramuscular administration of drug
Extrapyramidal and/or withdrawal symptoms, including agitation, hypertonia, hypotonia, tremor, somnolence, respiratory distress and feeding disorder reported in neonates exposed to antipsychotic drugs during the third trimester of pregnancy; symptoms have varied in severity; monitor neonates for extrapyramidal and/or withdrawal symptoms and manage symptoms appropriately; some neonates recover within hours or days without specific treatment; others required prolonged hospitalization
Lactation
Aripiprazole is present in human breast milk; there are reports of poor weight gain in breastfed infants exposed to aripiprazole and reports of inadequate milk supply in lactating women taking aripiprazole; development and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from treatment or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Atypical antipsychotic; partial agonist at dopamine D2 and serotonin type 1 (5-HT1A) receptors; antagonist at serotonin type 2 (5-HT2A) receptor; also has alpha-blocking activity
Aristada Initio
- Prodrug of aripiprazole and its activity is primarily due to aripiprazole, and to a lesser extent dehydro-aripiprazole (major metabolite of aripiprazole), which has been shown to have affinities for D2 receptors similar to aripiprazole and represents 30-40% of the aripiprazole exposure in plasma
Absorption
Bioavailability: 87% (tablet); 100% (IM)
Peak plasma time: 1-3 hr (IR); 5-7 hr (ER); 3-5 hr (tablet); ~27 days (Aristada Initio)
Distribution
Protein bound: 99%
Vd: 404 L (aripiprazole IV); 268 L (Aristada Initio)
Metabolism
Metabolized by CYP2D6 and CYP3A4
Metabolites: Dehydroaripiprazole (40%)
Elimination
Half-life: 75 hr (parent drug); 94 hr (metabolite); 30-47 days (IM); 146 hr (poor metabolizers)
Half-life, Aristada Initio: 15-18 days
Excretion: Feces (55%), urine (25%)
Administration
Oral Administration
Oral solution can be substituted for tablets on a mg-per-mg basis up to the 25 mg dose level; patient receiving 30 mg tablets should receive 25 mg of solution
Tablet
- May take with or without food
- Swallow tablet whole; do not divide, crush, or chew
ODT
- Dosing for orally disintegrating tablets (ODT) is the same as for the oral tablets
- May take with or without food
- Do not open the blister until ready to take the ODT
- Remove 1 ODT by opening the package and peeling back the foil on the blister to expose the tablet
- Do not push the tablet through the foil because this could damage the tablet
- Immediately upon opening the blister, using dry hands, remove the tablet and place the entire ODT on tongue
- Tablet disintegration occurs rapidly in saliva; recommended to take without liquid, however, if needed, it can be taken with liquid
- Do not attempt to split the tablet
Abilify MyCite
- May take with or without food
- Swallow tablet whole; do not divide, crush, or chew
MyCite Patch
- Apply the MyCite patch only when instructed by the app to the left side of the body just above the lower edge of the rib cage
- Do not place the patch in areas where the skin is scraped, cracked, inflamed, or irritated, or in a location that overlaps the area of the most recently removed patch
- Instruct patients to keep the patch on when showering, swimming, or exercising
- Change patch weekly or sooner as needed
- The app will prompt patient to change the patch and will direct patient to apply and remove the patch correctly
- Patients undergoing an MRI need to remove their patch and replace with a new one as soon as possible
- If there is skin irritation, instruct patients to remove the patch
IM Preparation (Abilify Maintena)
Do no substitute IM long-acting depot suspension formulations
Vial
- Reconstitute lyophilized power with sterile water for injection (SWI); discard any unused portion of diluent
- 400 mg/vial: 1.9 mL SWI
- 300 mg/vial: 1.5 mL SWI
- Final concentration for either vial is 200 mg/mL following reconstitution
- Slowly inject SWI into vial; shake the vial vigorously for 30 seconds until the reconstituted suspension appears uniform, homogeneous suspension that is opaque and milky-white.
- Do not store reconstituted suspension in syringe Refer to manufacturer’s labeling for full preparation technique
- Inject full syringe contents immediately following reconstitution
- Immediate use is recommended; maintain vial at room temperature if dose is not immediately given; shake for 60 seconds to resuspend particles prior to injection; discard unused portion
Prefilled syringe
- Reconstitute at room temperature
- Rotate the syringe plunger rod to release diluent
- Shake vigorously for 20 seconds or until the suspension is uniform; the resulting suspension will be milky white and opaque (refer to manufacturer’s labeling for full preparation technique)
- Inject full syringe contents immediately following reconstitution
For both formulations, select appropriate hypodermic needle after completing IM preparation
Needle for gluteal injection
- Nonobese patient: 22-ga, 1.5-in
- Obese patient: 21-ga, 2-in
Needle for deltoid injection
- Nonobese patient: 23-ga, 1-in
- Obese patient: 22-ga, 1.5-in
IM Preparation (Aristada)
Tap syringe at least 10 times to dislodge any material which may have settled
Shake the syringe vigorously for a minimum of 30 secs to ensure a uniform suspension; if the syringe is not used within 15 min, shake again for 30 secs
Injection site and associated needle length
- 441 mg dose (deltoid): 21-ga, 1-in or 20-ga, 1.5-in
- 441 mg, 662 mg, 882 mg, or 1064 mg doses (gluteal): 20-ga, 1.5-in or 20-ga 2-in
Attach appropriate needle with a clockwise twisting motion; do not overtighten (could lead to needle hub cracking)
Prime syringe to remove air by bringing the syringe into upright position and tap the syringe to bring air to the top; remove air by depressing the plunger rod; a few drops of suspension will be released
Administer the entire content IM; inject in a rapid and continuous manner in <10 seconds
Cover the needle by pressing the safety device, then dispose the needle, and used and unused items in proper waste container
IM Preparation (Aristada Initio)
Tap syringe at least 10 times to dislodge any material which may have settled
Shake the syringe vigorously for a minimum of 30 secs to ensure a uniform suspension
If syringe is not used within 15 min, shake again for 30 secs
Injection site and associated needle length
- Deltoid: 21 gauge, 1-in or 20 gauge 1.5-in
- Gluteal: 20 gauge, 1-in or 20 gauge 1.5-in
Attach appropriate needle securely with a clockwise twisting motion; do NOT overtighten; overtightening could lead to needle hub cracking
Prime syringe to remove air
Bring syringe into upright position and tap the syringe to bring air to the top Inject in a rapid and continuous manner
Product requires a RAPID injection; do not hesitate
Administer the entire content IM; do not inject by any other route
Dispose of needle and any unused items
IM Administration
Must be administered by a healthcare professional
For IM use only; do not administer IV or SC
Abilfy Maintena
- Slowly inject dosage volume as a single IM injection into the deltoid or gluteal muscle
- Do not massage the injection site
Missed doses (Abilify Maintena)
- 2nd or 3rd dose missed (>4 wk but <5 wk since last injection): Administer injection as soon as possible
- 2nd or 3rd dose missed (>5 wk since last injection): Restart concomitant oral aripiprazole for 14 days with next administered injection
- 4th or subsequent doses missed (>4 wk but <6 wk since last injection): Administer injection as soon as possible
- 4th or subsequent doses missed (>6 wk since last injection): Restart concomitant oral aripiprazole for 14 days with next administered injection
Aristada
- Administer the entire syringe content IM; inject in a rapid and continuous manner in <10 seconds
- 441 mg once monthly: Administer in deltoid or gluteal muscle
- 662 mg monthly, 882 mg monthly or q6wk: Administer in gluteal muscle
- 1064 mg q2mo: Administer in gluteal muscle
Missed doses (Aristada)
- When a dose is missed, administer the next injection as soon as possible, unless the time has exceed 6-8 wk
- Supplemental PO doses should be the same as when the patient initiated Aristada
- See the following for recommendations for missed doses based on last injection dose
Monthly 441 mg
- ≤6 wk: No PO supplementation required
- >6 wk and ≤7 wk: Supplement with 7 days of PO aripiprazole OR single dose of Aristada Initio
- >7 wk: Supplement with 21 days of PO aripiprazole OR reinitiate with a single dose of Aristada Initio and a single dose of aripiprazole 30 mg PO
Monthly 662 mg, monthly 882 mg, or 882 mg q6wk
- ≤8 wk: No PO supplementation required
- >8 wk and ≤12 wk: Supplement with 7 days of PO aripiprazole OR single dose of Aristada Initio
- >12 wk: Supplement with 21 days of PO aripiprazole OR reinitiate with a single dose of Aristada Initio and a single dose of aripiprazole 30 mg PO
1064 mg q2mo
- ≤10 wk: No PO supplementation required
- >10 wk and ≤12 wk: Supplement with 7 days of PO aripiprazole OR single dose of Aristada Initio
- >12 wk: Supplement with 21 days of PO aripiprazole OR reinitiate with a single dose of Aristada Initio and a single dose of aripiprazole 30 mg PO
Storage
PO solution and tablets: Store 25°C (77°F), excursions permitted between 15- 30°C (59-86°F); use oral solution within 6 months after opening
Abilify Maintena (prefilled dual chamber syringe): Store below 30°C (86°F); do not freeze; protect the syringe from light by storing in the original package until time of use
Abilify Maintena (vial): Store at room temperature 25°C (77°F), excursions permitted between 15- 30°C (59-86°F)
Aristada: Store at room temperature 25°C (77°F), excursions permitted between 15-30°C (59-86°F)
Aristada Initio: Store at room temperature 20-25°C (68-77°F) with excursions permitted between 15-30°C (between 59-86°F); do not freeze
Abilify MyCite
Tablets
- Store 20-25°C (68-77°F); excursions permitted between 15-30°C (59-86°F)
- Do not store in humid conditions (eg, bathroom)
Patch (wearable sensor)
- Store between 15-30°C (59-86°F) and 15-93% relative humidity
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Abilify Maintena intramuscular - | 400 mg vial | ![]() | |
Abilify Maintena intramuscular - | 400 mg vial | ![]() | |
Abilify Maintena intramuscular - | 300 mg syringe | ![]() | |
Abilify Maintena intramuscular - | 400 mg vial | ![]() | |
Abilify Maintena intramuscular - | 300 mg vial | ![]() | |
Abilify Maintena intramuscular - | 300 mg vial | ![]() | |
Abilify Maintena intramuscular - | 400 mg syringe | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 1 mg/mL solution | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 1 mg/mL solution | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 1 mg/mL solution | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 30 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
aripiprazole oral - | 20 mg tablet | ![]() | |
aripiprazole oral - | 15 mg tablet | ![]() | |
aripiprazole oral - | 10 mg tablet | ![]() | |
aripiprazole oral - | 5 mg tablet | ![]() | |
aripiprazole oral - | 2 mg tablet | ![]() | |
Abilify oral - | 5 mg tablet | ![]() | |
Abilify oral - | 2 mg tablet | ![]() | |
Abilify oral - | 20 mg tablet | ![]() | |
Abilify oral - | 10 mg tablet | ![]() | |
Abilify oral - | 30 mg tablet | ![]() | |
Abilify oral - | 15 mg tablet | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
aripiprazole oral
ARIPIPRAZOLE - ORAL
(AR-i-PIP-ra-zole)
COMMON BRAND NAME(S): Abilify
WARNING: If you are using aripiprazole in combination with other medication to treat depression, also carefully read the drug information for the other medication.There may be a slightly increased risk of serious, possibly fatal side effects (such as stroke, heart failure, fast/irregular heartbeat, pneumonia) when this medication is used by older adults with dementia. This medication is not approved for the treatment of dementia-related behavior problems. Discuss the risks and benefits of this medication, as well as other effective and possibly safer treatments for dementia-related behavior problems, with the doctor.
USES: Aripiprazole is used to treat certain mental/mood disorders (such as bipolar disorder, schizophrenia, Tourette's syndrome, and irritability associated with autistic disorder). It may also be used in combination with other medication to treat depression. Aripiprazole is known as an antipsychotic drug (atypical type). It works by helping to restore the balance of certain natural chemicals in the brain (neurotransmitters).This medication can decrease hallucinations and improve your concentration. It helps you to think more clearly and positively about yourself, feel less nervous, and take a more active part in everyday life. Aripiprazole can treat severe mood swings and decrease how often mood swings occur.
HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking aripiprazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.The manufacturer directs to swallow this medication whole. However, many similar drugs (immediate-release tablets) can be split/crushed. Follow your doctor's direction on how to take this medication.If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/cup. Do not use a household spoon because you may not get the correct dose.Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.It may take several weeks before you get the full benefit of this drug. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: See also Warning section.Dizziness, lightheadedness, drowsiness, nausea, vomiting, tiredness, excess saliva/drooling, blurred vision, weight gain, constipation, headache, and trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, mental/mood changes (such as increased anxiety, depression, suicidal thoughts), trouble swallowing, restlessness (especially in the legs), shaking (tremor), muscle spasm, mask-like expression of the face, seizures, trouble controlling certain urges (such as gambling, sex, eating or shopping), interrupted breathing during sleep.This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.This medication may rarely cause a condition called tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual uncontrolled movements (especially of the face, mouth, tongue, arms, or legs).This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: See also Warning section.Before taking aripiprazole, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as propylene glycol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: problems with blood flow in the brain (such as cerebrovascular disease, stroke), diabetes (including family history), heart problems (such as low blood pressure, coronary artery disease, heart failure, irregular heartbeat), nervous system problems (such as dementia, NMS, seizures), obesity, low white blood cell count (including history of low white blood cell count caused by medications), swallowing problems, breathing trouble during sleep (sleep apnea).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Liquid preparations of this product may contain sugar. Caution is advised if you have diabetes. Ask your doctor or pharmacist about using this product safely.Older adults may be more sensitive to the side effects of this drug, especially seizures, drowsiness, dizziness, lightheadedness, confusion, tardive dyskinesia, swallowing problems, and other serious (rarely fatal) side effects. (See also Warning section.) Drowsiness, dizziness, lightheadedness, and confusion can increase the risk of falling.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.Since untreated mental/mood problems (such as bipolar disorder, schizophrenia) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: metoclopramide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: very fast heartbeat, loss of consciousness.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood sugar, weight, cholesterol/triglyceride levels) may be done before you start taking this medication and while you are taking it. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store the tablet and the oral liquid at room temperature away from light and moisture. Discard the oral solution 6 months after opening or after the expiration date, whichever comes first. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.