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Questions and Answers
Aripiprazole long-acting injection demonstrates significant prolactin-related adverse effects compared to other SGAs.
Aripiprazole long-acting injection demonstrates significant prolactin-related adverse effects compared to other SGAs.
False (B)
A starting dose of aripiprazole for establishing tolerability is recommended to be between 5mg/day to 15mg/day.
A starting dose of aripiprazole for establishing tolerability is recommended to be between 5mg/day to 15mg/day.
False (B)
Two 400mg injections of aripiprazole LAI can be administered simultaneously at distinct sites to initiate treatment.
Two 400mg injections of aripiprazole LAI can be administered simultaneously at distinct sites to initiate treatment.
True (A)
Peak plasma levels of aripiprazole are expected to appear 14 days after the injection.
Peak plasma levels of aripiprazole are expected to appear 14 days after the injection.
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Patients receiving enzyme-inhibiting drugs can be treated with a 300mg monthly dose of aripiprazole.
Patients receiving enzyme-inhibiting drugs can be treated with a 300mg monthly dose of aripiprazole.
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The incidence of akathisia, insomnia, nausea, and restlessness is higher with aripiprazole compared to oral alternatives.
The incidence of akathisia, insomnia, nausea, and restlessness is higher with aripiprazole compared to oral alternatives.
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Aripiprazole long-acting injection has received FDA approval for the maintenance treatment of major depressive disorder.
Aripiprazole long-acting injection has received FDA approval for the maintenance treatment of major depressive disorder.
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A significant increase in peak plasma levels is observed at steady state compared to the first dose peak.
A significant increase in peak plasma levels is observed at steady state compared to the first dose peak.
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The two-injection start regimen for switching to aripiprazole LAI requires aripiprazole oral to be taken for four weeks before the injections.
The two-injection start regimen for switching to aripiprazole LAI requires aripiprazole oral to be taken for four weeks before the injections.
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Aripiprazole lauroxil is commonly used outside of the United States.
Aripiprazole lauroxil is commonly used outside of the United States.
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In the one-injection start regimen for switching from depot antipsychotics, oral aripiprazole can be discontinued after one week.
In the one-injection start regimen for switching from depot antipsychotics, oral aripiprazole can be discontinued after one week.
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If a patient refuses oral aripiprazole, the clinician must use the one-injection start regimen.
If a patient refuses oral aripiprazole, the clinician must use the one-injection start regimen.
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The dose of 800mg of aripiprazole is expected to reach therapeutic plasma concentrations without prior oral treatment.
The dose of 800mg of aripiprazole is expected to reach therapeutic plasma concentrations without prior oral treatment.
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Aripiprazole LAI and oral aripiprazole can be taken simultaneously for more than two weeks during the transition period.
Aripiprazole LAI and oral aripiprazole can be taken simultaneously for more than two weeks during the transition period.
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The drug Aristada Initio requires oral supplementation to achieve effective blood levels within four days.
The drug Aristada Initio requires oral supplementation to achieve effective blood levels within four days.
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Risperidone LAI should not be considered when switching to aripiprazole LAI using the two-injection start method.
Risperidone LAI should not be considered when switching to aripiprazole LAI using the two-injection start method.
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Study Notes
Aripiprazole Long-Acting Injection
- Aripiprazole LAI is a viable alternative to other SGAs due to its lack of prolactin-related and metabolic adverse effects.
- FDA-approved for schizophrenia and bipolar I disorder maintenance treatment.
- One-injection start regimen requires initial oral aripiprazole (10-20mg/day) for 14 days toestablish tolerability and response.
- One-injection start: 400mg aripiprazole LAI injection on day 1, followed by 14 days of oral aripiprazole.
- Two-injection start: Two 400mg aripiprazole LAI injections on day 1 at different sites, simultaneous 20mg oral aripiprazole.
- Peak plasma levels 7 days after injection, trough levels achieved within 4 weeks.
- Dose adjustments should account for increased peak plasma levels after steady state.
- Lower dose options:
- 300mg monthly for those who cannot tolerate 400mg.
- 200mg monthly only for those receiving enzyme-inhibiting drugs.
- Incidence of akathisia, insomnia, nausea, and restlessness is similar to oral aripiprazole.
Switching to Aripiprazole LAI
- No formal recommendations exist for switching, but considerations are based on pharmacokinetic data.
Switching From Oral Antipsychotics
- Cross-taper: Switch to oral aripiprazole over two weeks.
- One-injection start: Start aripiprazole LAI, continue oral aripiprazole for two weeks.
- Two-injection start: Start two-injection regimen after two weeks oral aripiprazole.
Switching From Depot Antipsychotics (excluding risperidone LAI)
- One-injection start: Start aripiprazole LAI after two weeks; discontinue oral aripiprazole after another two weeks.
- Two-injection start: Start two-injection regimen after two weeks of oral aripiprazole.
Switching From Risperidone LAI
- One-injection start: Start aripiprazole LAI after two weeks; discontinue oral aripiprazole after another two weeks.
- Two-injection start: Start two-injection regimen after two weeks of oral aripiprazole.
Important Considerations
- Oral aripiprazole may not be required before injection if prior response and tolerability are established.
- Two-injection start regimen is recommended when oral aripiprazole cannot be given.
Other LAI Aripiprazole Brands
- Aripiprazole lauroxil (Aristada) is another LAI formulation, available for monthly, 6-weekly or two-monthly injections.
- Doses: 441mg, 662mg, 882mg, and 1064mg, delivering aripiprazole doses of 300mg, 450mg, 600mg, and 724mg respectively.
- Aristada Initio is a special formulation for initial treatment.
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Description
This quiz provides an in-depth overview of Aripiprazole Long-Acting Injection (LAI) as an alternative treatment for schizophrenia and bipolar I disorder. It covers FDA approval, dosing regimens, and potential side effects, including considerations for dose adjustments. Test your knowledge on this modern treatment option and its administration protocols.
