Aripiprazole

Aripiprazole is prescribed in a tablet and solution form for treating mental health conditions including schizophrenia, bipolar I disorder and multiple depressive disorders.

Overview

Aripiprazole comes in tablet and solution form and treats mental health conditions. It can be used by itself or with other medications to remedy mental conditions like major depressive disorder, schizophrenia, bipolar I disorder, and manic-depressive illness. This medication also treats children with autistic disorder who have irritability or Tourette syndrome. A patient must obtain a prescription from their doctor for aripiprazole. A doctor will review the medical history of the patient and will assist the patient in reducing side effects from medications or foods.

Aripiprazole is manufactured under two US brand names: Abilify and Abilify Discmelt.

Aripiprazole is an antipsychotic agent, it changes the way chemicals within the brain affect patients.

It is available as a solution, as a tablet, and as a disintegrating tablet.

The most important information regarding aripiprazole is that it is could increase the possibility of death in adults who are older with dementia-related illnesses. For this reason, it is not approved for prescription for people with psychotic conditions that are related to or similar to dementia. Also, it has been reported that younger people occasionally experience suicidal thoughts while on medication for a psychiatric or major depressive disorder. Report any unusual changes in your symptoms or mood to your doctor.

Prior to Use

A patient should contemplate whether or not aripiprazole is right for them by comparing the side effects of the medication against the benefit that the medication will provide them. The patient and doctor must work together to determine whether or not this medication is the right decision for the patient. For more information, see the section within this article titled Warnings and Interactions.

Condition(s) treated

  • Schizophrenia
  • Major depressive disorder
  • Bipolar I disorder (manic-depressive illness)

Type of medicine

  • Mental health medication (antipsychotic agent)

Side Effects

Medications can occasionally cause unwarranted side effects along with the benefits. Not every side effect will occur, but if they do take place they may require medical care. Consult your physician right away if any of these side effects take place:

More Common Side Effects – Medical Care Required

  • Walking in a shuffling manner
  • Uninhibited facial, back, and neck movements
  • Speaking difficulty
  • Restlessness
  • Limb stiffness
  • Jerking, stiffness, or trembling of muscles
  • Drooling
  • Body twisted movements
  • Balance control loss

Less Common Side Effects – Medical Care Required

  • Vision blurred
  • Dizziness
  • Headache
  • Eye movement inability
  • Eyelid spasms or increased blinking
  • Nervousness
  • Pounding in the ears
  • Heartbeat quicker/slower than normal
  • Sticking out tongue
  • Difficulty swallowing or breathing
  • Facial expressions that are unusual

Rare Side Effects – Medical Care Required

  • Unrestrained movements of legs and arms
  • Unrestrained chewing movements
  • Tongue moving rapidly or worm-like
  • Tiredness
  • Sweating
  • Skin paleness (unusual)
  • Muscle stiffness (severe)
  • Muscle spasm
  • Lip puckering or smacking
  • Fever
  • Extremities jerking
  • Convulsions
  • Consciousness loss (sudden)
  • Cheek puffing
  • Blood pressure higher/lower than usual
  • Bladder (loss of control of)

Side Effects: Incidence Not Known – Medical Care Required

  • Weakness/tiredness (unusual)
  • Tongue swelling/puffiness/itching
  • Skin redness
  • Skin hives/welts/itching/rash
  • Lips swelling/puffiness/itching
  • Hive-like swelling (large) on feet, legs, genitals, hands, throat, tongue, lips, eyelids, or face
  • Face swelling/puffiness/itching
  • Eyelid or area around the eye swelling/puffiness/itching
  • Chest tightness

Occasionally, side effects can take place that do not necessarily require medical care. These particular side effects may disappear as your body accustoms to the treatment and the overall medication. Consult your physician for information regarding how to reduce or prevent certain side effects. Ask your doctor if you have any questions regarding the following side effects, if they are prolonged, or become troublesome.

More Common Side Effects – Medical Care Not Required

  • Weight gain
  • Vision blurred
  • Trouble sleeping
  • Stomach pain, discomfort, or general upset
  • Stomach acidity or sourness
  • Sore throat
  • Shaking
  • Runny nose
  • Rash
  • Nervousness
  • Need be moving
  • Lightheadedness
  • Irritability
  • Indigestion
  • Inability to sit quietly
  • Hyperventilation
  • Heartburn
  • Headache
  • Fever
  • Fear
  • Dry mouth
  • Bowel movement trouble (stool)
  • Belching
  • Belching
  • Anxiety

Less Common Side Effects – Medical Care Not Required

  • Unintended injury
  • Swelling/bloating of the feet, lower legs, hands, arms, or face
  • Body pains or aches
  • Congestion
  • Coughing
  • Difficulty moving
  • Throat soreness/dryness
  • Appetite increase
  • Salivation increase
  • Joint pain
  • Hoarseness
  • Muscle cramping or aching
  • Muscle stiffness or pains
  • Sneezing
  • Stuffy nose
  • Joints swelling
  • Weight gain (rapid)
  • Neck glands swollen/tender
  • Hands/feet tingling
  • Tremor
  • Weight loss/gain (unusual)
  • Voice changes

There can be additional side effects for certain patients when they take aripiprazole. If any additional side effects take place, consult your doctor.

Contact your healthcare professional for general questions regarding side effects. Side effects can also be reported to the FDA, by calling 1-800-FDA-1088.

Dosage

This medication should be taken exactly as prescribed by your physician. Never take more than the prescribed amount. Never take this medication more often than the prescribed schedule. Never take this medication for a longer period of time than prescribed by your doctor. Side effects are increased when incorrect dosing takes place.

A medication guide typically comes with aripiprazole. Be sure to read and carefully follow the instructions. Consult your physician about any questions you may have.

For patients taking the orally disintegrating tablet, be sure to dry your hands thoroughly prior to handling the tablet. Wait until you are actually ready to take the medication to open the blister package containing the tablet. The tablet should be removed from the blister pack by first peeling the foil back, and then removing the tablet from the plastic casing. Never push the tablet forcefully through the foil. Do not split or break the tablet, it will quickly melt by simply placing the tablet in your mouth. Only after the tablet has disintegrated should you swallow or sip water.

Place the whole tablet into your mouth. Never chew, crush, or break them.

Aripiprazole may be taken with food, as long as grapefruit is avoided. See the Warnings section of this article for more information. Follow the directions given to you by your doctor if they have instructed for you to take it a particular way.

Different individuals may receive distinct prescriptions as the medication varies depending on patient and illness characteristics. Only take this medication according to the physician’s directions or the instructions on the label. The information below gives only average doses of aripiprazole. Do not change your dose unless your physician instructs you to adjust it.

The strength of the medication determines the total quantity of aripiprazole needed. Additionally, the medical problem and the total dose count each day, how spaced out the doses are, and the time it takes to take the medication will determine how the medication is prescribed. The following section lists aripiprazole doses for informational use only and presents the information regarding oral dosage forms, specifically orally disintegrating tablets and tablets.

Bipolar mania

  • Adults: Take 15 milligrams (mg) once per day (when given simultaneously with valproate or lithium, the initial dose should be 10 to 15 mg once per day). The physician may shift the dose as required; however, the dose is never typically higher than 30 mg each day.
  • Children 10 and older: Patients should take 2 mg once per day initially. The medication dosage will progressively be raised to 10 mg once per day. The physician may shift the dose as required; however, the dose is never typically higher than 30 mg each day.
  • Children 10 and younger: Physician must determine the dose.

Depression

  • Adults: Take 2 to 5 mg once per day initially. The physician may shift the dose as required; however, the dose is never typically higher than 15 mg each day.
  • Children: Physician must determine the dose.

Irritability in Children with Autistic Disorder

  • Children 6 to 17: Patient should take 2 mg once per day initially. The physician may shift the dose as required; however, the dose is never typically higher than 15 mg each day.
  • Children under 6: Physician must determine the dose.

Schizophrenia

  • Adults: Take 10 to 15 mg once per day initially. The physician may shift the dose as required; however, the dose is never typically higher than 30 mg each day.
  • Children 13 to 17: Patient should take 2 mg once per day initially. The medication dosage will progressively be raised to 10 mg once per day. The physician may shift the dose as required; however, the dose is never typically higher than 30 mg each day.
  • Children under 13: Physician must determine the dose.

Tourette’s disorder

  • Children 6 to 18: Patient should take 2 mg once per initially. The physician may shift the dose as required; however, the dose is never typically higher than 20 mg each day.
  • Children under 6: Physician must determine the dose.

Missed Dose

Take aripiprazole right away if a dose is missed. However, if the scheduled next dose is closer the patient should skip the dose that was missed and return to the normal dosing schedule. Never double dose.

Overdose

Symptoms of Overdose

Emergency medical attention should be obtained right away if any symptoms of overdose take place.

  • Diarrhea
  • Pulse quickness/pounding/irregularity
  • Heart quickness/pounding/irregularity
  • Pupils large/dilated/enlarged (black portion of eye)
  • Nausea
  • Loss/lack of strength
  • Vomiting
  • Drowsiness/sleepiness (unusual)
  • Light sensitivity for eyes heightened
  • Vomiting

Directions and Unpackaging

Only take this medication as directed by a physician. Patients should never take doses that are more or less than the doctor prescribed (or doses that are taken more or less frequently). These can greatly increase the chances of adverse side effects.

Carefully read and be sure all instructions are understood prior to taking this medication. A guide for patient directions offers instructions and a medication summary.

Interactions

Drug Interactions

While some prescriptions should not be combined, it is up to your doctor to determine if other medications can be combined despite the chances that an interaction could occur. The prescribing physician could decide to adjust the dose or take additional precautions. While taking this prescription, it is exceptionally important that the doctor is aware of any additional medications the patient may be taking. The list below outlines medications that can potentially have negative interactions with aripiprazole. This list is not necessarily comprehensive.

It is not recommended to take aripiprazole while taking any of the following medications. The physician may decide to change doses of the other medications the patient is currently taking, or they may decide not to prescribe aripiprazole.

  • Ziprasidone
  • Thioridazine
  • Terfenadine
  • Sparfloxacin
  • Saquinavir
  • Posaconazole
  • Piperaquine
  • Pimozide
  • Metoclopramide
  • Mesoridazine
  • Fluconazole
  • Dronedarone
  • Cisapride
  • Bromopride
  • Bepridil
  • Amisulpride
  • Amifampridine

Combining this medication with the following prescriptions is typically not suggested, but it could be necessary in certain cases. During instances when both medications are prescribed at the same time, your physician may adjust the dose or frequency of doses for both or one of the medications.

  • Zuclopenthixol
  • Vorinostat
  • Voriconazole
  • Vinflunine
  • Vilanterol
  • Venlafaxine
  • Vemurafenib
  • Vardenafil
  • Vandetanib
  • Triptorelin
  • Trimipramine
  • Trazodone
  • Tramadol
  • Toremifene
  • Tolterodine
  • Tizanidine
  • Tetrabenazine
  • Telithromycin
  • Telavancin
  • Telaprevir
  • Tapentadol
  • Tamoxifen
  • Tacrolimus
  • Sunitinib
  • Sulpiride
  • Sufentanil
  • St John's Wort
  • Sotalol
  • Sorafenib
  • Solifenacin
  • Sodium Phosphate, Monobasic
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Sevoflurane
  • Sertindole
  • Ritonavir
  • Risperidone
  • Rilpivirine
  • Rifampin
  • Remifentanil
  • Ranolazine
  • Quinine
  • Quinidine
  • Quetiapine
  • Protriptyline
  • Propafenone
  • Promethazine
  • Prochlorperazine
  • Procainamide
  • Probucol
  • Pitolisant
  • Pipamperone
  • Pimavanserin
  • Phenytoin
  • Perphenazine
  • Periciazine
  • Perflutren Lipid Microsphere
  • Pentazocine
  • Pentamidine
  • Pazopanib
  • Pasireotide
  • Paroxetine
  • Panobinostat
  • Paliperidone
  • Oxymorphone
  • Oxycodone
  • Other Interactions
  • Ondansetron
  • Olanzapine
  • Ofloxacin
  • Octreotide
  • Norfloxacin
  • Nilotinib
  • Nelfinavir
  • Nafarelin
  • Moxifloxacin
  • Morphine Sulfate Liposome
  • Morphine
  • Mizolastine
  • Mitotane
  • Milnacipran
  • Mifepristone
  • Metronidazole
  • Methadone
  • Meperidine
  • Mefloquine
  • Lumefantrine
  • Lopinavir
  • Levofloxacin
  • Leuprolide
  • Lapatinib
  • Ketoconazole
  • Ivabradine
  • Itraconazole
  • Indinavir
  • Imipramine
  • Iloperidone
  • Idelalisib
  • Ibutilide
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydroquinidine
  • Hydromorphone
  • Hydrocodone
  • Histrelin
  • Haloperidol
  • Halofantrine
  • Granisetron
  • Goserelin
  • Gonadorelin
  • Gemifloxacin
  • Gatifloxacin
  • Galantamine
  • Fosphenytoin
  • Foscarnet
  • Formoterol
  • Fluoxetine
  • Flibanserin
  • Flecainide
  • Fingolimod
  • Fentanyl
  • Felbamate
  • Famotidine
  • Escitalopram
  • Erythromycin
  • Eribulin
  • Enzalutamide
  • Efavirenz
  • Ebastine
  • Droperidol
  • Doxylamine
  • Doxepin
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dofetilide
  • Disopyramide
  • Dihydrocodeine
  • Deslorelin
  • Desipramine
  • Delamanid
  • Degarelix
  • Dasatinib
  • Dabrafenib
  • Cyclobenzaprine
  • Crizotinib
  • Conivaptan
  • Codeine
  • Cobicistat
  • Clozapine
  • Clomipramine
  • Clarithromycin
  • Citalopram
  • Ciprofloxacin
  • Chlorpromazine
  • Chloroquine
  • Ceritinib
  • Carbamazepine
  • Butorphanol
  • Buserelin
  • Bupropion
  • Buprenorphine
  • Bromazepam
  • Boceprevir
  • Bedaquiline
  • Azithromycin
  • Atazanavir
  • Astemizole
  • Asenapine
  • Arsenic Trioxide
  • Apomorphine
  • Anagrelide
  • Amitriptyline
  • Amiodarone
  • Alfuzosin
  • Alfentanil

Some medications can cause adverse effects if they are taken near the time the patient is eating as interactions can take place. The use of tobacco or alcohol can also trigger various interactions to take place. It is not recommended to combine the following food with aripiprazole.

  • Grapefruit juice
  • Grapefruit products

Individuals who have other medical issues should take extra caution when taking this medication. Your doctor should be aware of any other medical problems that you currently already have as they can impact the effectiveness of this medication. The following medical conditions are especially important for your doctor to be aware of:

  • Stroke (history of)
  • Seizures (history of) – take caution; these conditions can be made worse
  • Phenylketonuria (PKU) – take caution; condition can become worse as the oral aripiprazole tablet contains
  • phenylalanine
  • Neutropenia (low white blood cell count)
  • Neuroleptic malignant syndrome (NMS, history of)
  • Low blood pressure (hypertension)
  • Ischemic heart disease (history of)
  • Hypovolemia (reduction in blood volume)
  • Hyperglycemia (high blood sugar)
  • Heart rhythm issues
  • Heart failure
  • Heart disease
  • Heart attack (history of)
  • Drug abuse/dependence (history of)
  • Difficulty swallowing – take caution; side effects may become worse
  • Diabetes (or if it has been in the family)
  • Depression
  • Dehydration
  • Blood vessel disease
  • Alcohol abuse (history of)

Warnings

If the patient has any pre-existing medical problems, aripiprazole could cause additional issues. Medical checkups should take place regularly to ensure the patient is not experiencing any adverse reactions. Regular checkups will allow for the occurrence of undesirable outcomes to be reduced and it will give the physician the opportunity to monitor if the medication is working correctly. Blood and/or urine tests could be necessary to determine if undesirable effects are taking place.

Allergies

It is imperative that the doctor is aware of any uncommon or allergic reactions to this medication, including skin rash, hives, or other skin abnormalities. The patient should not continue to use aripiprazole if they experience an allergic reaction. Consult a medical professional right away regarding the next steps to take.

Be sure your physician is knowledgeable of any allergies the patient has, including to foods, animals, dyes, or preservatives. Read the directions on the direction label or package carefully and look for any ingredients that may prompt a negative interaction.

Precautions

Thoughts of suicide can occur and may be increased for certain patients. The doctor should be alerted right away if the patient feels more depressed or is contemplating hurting themselves after taking aripiprazole. Report to your physician if troubling thoughts get worse quickly, or if thoughts or actions are disturbing. The doctor should be made aware if the patient has difficulty sleeping, has a major increase of energy, becomes upset easily, or behaves in a reckless manner. Inform your doctor of any other suddenly intense feelings, such as anger, nervousness, tendency towards violence, restlessness, or feelings of terror. The physician should be made aware of the patient or any family members who have bipolar disease (also known as manic-depressive illness) or who has attempted to commit suicide.

The effects of central nervous system (CNS) depressants and alcohol could be increased by this medication. These include medications that make the patient less alert or drowsy. Certain CNS depressants that would impact the effects of aripiprazole are antihistamines, allergy medications, hay fever medications, tranquilizers, sedatives, cold/allergy medication, sleeping medications, prescription pain medications, narcotics, seizure medications, muscle relaxants, or anesthetics (some dental anesthetics also apply). Consult your physician prior to taking any type of CNS depressant while on this medication.

Aripiprazole can cause trouble thinking, drowsiness, or difficulty regulating movements. Be sure to be familiar with your own personal reactions your body has after taking this medication. Know your personal reactions to aripiprazole before you operate machinery, such as driving, or do other jobs requiring clear thinking, alertness, and coordination.

Consult your physician if any symptoms take place that include difficulty breathing, quick heartbeat, seizures (convulsions), sweating increase, high/low blood pressure, muscle stiffness, decrease of bladder control, tiredness, or excessively pale skin. These symptoms could be signs of neuroleptic malignant syndrome (NMS), a serious condition.

A movement disorder, tardive dyskinesia, can be caused by this medication, especially in women who are elderly. Consult your physician immediately if any of the following symptoms occur while on this prescription: puffy cheeks, lip puckering/smacking, unrestrained motions of the arms/legs, unrestrained chewing motions, or rapid/worm-like tongue motions.

Occasionally, people have experienced behavioral changes when taking this medication. Discuss with your physician immediately if uncommon urges take place in your behavior, including gambling urges, compulsive/binge eating, compulsive shopping, or sexual urges while on this medication.

Fainting, lightheadedness, or dizziness can take place, especially when standing up from a sitting or lying position. Rising slowly may be helpful. Consult your physician if the problem gets worse or prolonged.

Aripiprazole can increase difficulty for the body to successfully cool itself down. It could reduce the total amount that your body sweats, or it can make the body too hot if enough sweat is not expelled. If the body becomes too hot, weakness, dizziness, tiredness, or confusion can take place. An upset stomach or vomiting could occur. Be sure to consult your physician if distancing yourself from heat and drinking cold water does not completely cool you down.

Aripiprazole can lower the total amount of sugar in the blood. The oral liquid form of aripiprazole is made up of sugar. Consult your physician immediately if increased urination or increased thirst takes place.

Patients who have diabetes may experience a result change in their blood sugar or urine tests. Consult your physician with any questions you may have.

The white blood cell count can be lower temporarily when patients take aripiprazole, and this raises the chance of infection. It is important to avoid people who have infections. Consult your physician immediately if you suspect an infection is occurring, or if chills, fever, hoarseness, cough, painful/difficulty urinating, or side/lower back pain is experienced.

Aripiprazole can cause weight gain. Your physician may want to monitor your weight regularly while you are taking this medication.

The dose should not be adjusted without prior approval from your physician. Do not stop taking this medication without prior approval from your physician.

Other medications should not be taken unless they have already been discussed with and approved by your doctor. This includes over the counter, nonprescription, and vitamin/herbal supplements.

Specific Demographic Use

Pediatric

The effects of aripiprazole have not been studied in relation to children 13 years old and younger who have schizophrenia or in children 10 years old and younger who have bipolar disorder. It has not yet been determined whether or not aripiprazole is effective and safe for children.

It is not standard treatment to prescribe aripiprazole to teenagers or children who have major depression. There has not been any beneficial use for aripiprazole in children with autistic disorder who are between 6 and 17 years old.

Geriatric

There are not any geriatric-specific problems that would reduce the effectiveness of aripiprazole for elderly patients with bipolar disorder, depression, or schizophrenia. Behavioral issues in elderly patients with Alzheimer’s disease or dementia should not be treated with aripiprazole. One study has shown an increase in death for patients taking aripiprazole.

Breastfeeding

There have not been any studies determining an infant risk in regards to women who breastfeed while taking aripiprazole. However, women who are pregnant should compare the potential benefits against the potential risks prior to breastfeeding while taking aripiprazole.

Storage

Aripiprazole should be kept in a sealed container away from moisture, direct sunlight, freezing, and heat. Do not store in a location where children can easily access this prescription. Outdated medications and medications that are not needed anymore should not be kept. Consult your physician for information regarding how unused medication should be disposed of.

Summary

Aripiprazole treats individuals with schizophrenia, which is a mental illness that triggers unusual or disturbed thinking, inappropriate/strong emotions, loss of interest in life, and more. Adults and teenagers over 13 may take Aripiprazole. This medication can be used by itself or can be combined with other prescriptions to treat manic or mixed episodes (symptoms of depression and mania that occur at the same time) for children 10 and over with bipolar disorder. Aripiprazole can also be prescribed as an antidepressant when the main antidepressant cannot treat all of the symptoms for the patient.

Aripiprazole can also treat children 6 to 17 with autistic disorder. This medication can assist to control behavior when it becomes irritable, aggressive, the mood changes, and it is filled with temper tantrums. Children 6 to 18 years old with Tourette’s disorder can also take Aripiprazole. Geriatric patients should avoid aripiprazole as it has extreme side effects for elderly patients. Side effects include tardive dyskinesia (a movement disorder), high blood sugar (for diabetes patients), and neuroleptic malignant syndrome. Patients with psychosis should not use this medication due to the risk of dementia. It is not clear whether or not this medication is effective and safe for children.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
February 09, 2018