Major Although data are limited, coadministration of efavirenz and aripiprazole may increase the risk for QT prolongation and torsade de pointes TdP. QT prolongation has been observed with use of efavirenz. In addition, decreased aripiprazole blood levels are expected when aripiprazole is coadministered with inducers of CYP3A4, such as efavirenz.
Monitor the patient carefully for toxicity and efficacy if these agents are used in combination. Dosage adjustments of aripiprazole may be clinically warranted in some patients. Moderate Administering aripiprazole with grazoprevir may result in elevated aripiprazole plasma concentrations. Major Coadminister aripiprazole and eliglustat cautiously and with close monitoring. In addition, because aripiprazole is partially metabolized by CYP2D6, increased aripiprazole plasma concentrations may occur during concurrent use of CYP2D6 inhibitors such as eliglustat.
Moderate Patients taking empagliflozin should be closely monitored for worsening glycemic control when an atypical antipsychotic is instituted. The atypical antipsychotics have been associated with metabolic changes, including hyperglycemia, even diabetic ketoacidosis, hyperosmolar, hyperglycemic states, and diabetic coma.
Moderate Patients taking linagliptin should be closely monitored for worsening glycemic control when an atypical antipsychotic is instituted. Emtricitabine; Rilpivirine; Tenofovir alafenamide: Rilpivirine should be used cautiously and with close monitoring with aripiprazole. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Major Because aripiprazole is partially metabolized by CYP3A4, the manufacturer recommends that the oral aripiprazole dose be doubled over 1 to 2 weeks when a potent CYP3A4 inducer, such as enzalutamide, is added to aripiprazole therapy.
When the CYP3A4 inducer is discontinued, the aripiprazole dose should be reduced to the original level over 1 to 2 weeks. In adults receiving Aristada with a strong CYP3A4 inducer for more than 14 days, no dose adjustment is necessary for the mg or the mg dose; increase the mg dose to mg. Eribulin has been associated with QT prolongation. If eribulin and another drug that prolongs the QT interval must be coadministered, ECG monitoring is recommended; closely monitor the patient for QT interval prolongation.
Major Because both erythromycin and aripiprazole are associated with a possible risk for QT prolongation and torsade de pointes TdP , the combination should be used cautiously and with close monitoring.
In addition, because aripiprazole is partially metabolized by CYP3A4, increased aripiprazole blood levels may occur when the drug is coadministered with inhibitors of CYP3A4 such as erythromycin. Moderate Because both escitalopram and aripiprazole are associated with a possible risk for QT prolongation and torsade de pointes TdP , this combination should be used cautiously and with close monitoring.
In addition, because aripiprazole is partially metabolized by CYP2D6, increased aripiprazole plasma concentrations may occur during concurrent use of inhibitors of CYP2D6, such as escitalopram.
Coadministration of CYP3A4 substrates, such as aripiprazole, may result in decreased serum concentrations of the substrate. Monitor for decreased efficacy of aripiprazole if coadministered with eslicarbazepine. Dosage adjustments of aripirazole may be necessary.
Moderate A reduction in the dose of eszopiclone should be considered during co-administration of other CNS depressants, such as antipsychotics, to minimize additive sedative effects.
In addition, the risk of next-day psychomotor impairment is increased during co-administration of eszopiclone and other CNS depressants, which may decrease the ability to perform tasks requiring full mental alertness such as driving. Antipsychotics with a higher incidence of sedation, such as olanzapine, clozapine, quetiapine, lurasidone, chlorpromazine, and thioridazine, are more likely to interact with eszopiclone.
Major Alcohol is associated with CNS depression. The combined use of alcohol and CNS depressants can lead to additive CNS depression, which could be dangerous in tasks requiring mental alertness and fatal in overdose.
Alcohol taken with other CNS depressants can lead to additive respiratory depression, hypotension, profound sedation, or coma. Consider the patient's use of alcohol or illicit drugs when prescribing CNS depressant medications. In many cases, the patient should receive a lower dose of the CNS depressant initially if the patient is not likely to be compliant with avoiding alcohol. Major Because aripiprazole is metabolized by CYP3A4, the manufacturer recommends that the oral aripiprazole dose be doubled over 1 to 2 weeks when potent CYP3A4 inducers, such as phenytoin or other hydantoins, are added to aripiprazole therapy.
Carefully monitor the patient for evidence of a decrease in aripiprazole efficacy. When the CYP3A4 inducer is withdrawn from the combination therapy, the oral aripiprazole dose in adults should be reduced to the previous dose over 1 to 2 weeks. In adults receiving Aristada with a strong CYP3A4 inducer, no dosage adjustment is necessary for the mg, mg, or 1, mg dose; increase the mg dose to mg if the CYP inducer is added for more than 2 weeks.
Ezogabine has been associated with QT prolongation. The manufacturer of ezogabine recommends caution during concurrent use of medications known to increase the QT interval. Aripiprazole should be used cautiously and with close monitoring with ezogabine. Minor Coadministration of aripiprazole with famotidine decreases aripiprazole's solubility and rate of absorption.
This interaction does not appear to cause clinically relevant effects and therefore no dosage adjustments are required. Fingolimod initiation results in decreased heart rate and may prolong the QT interval.
After the first fingolimod dose, overnight monitoring with continuous ECG in a medical facility is advised for patients taking QT prolonging drugs with a known risk of torsades de pointes TdP.
Fingolimod has not been studied in patients treated with drugs that prolong the QT interval, but drugs that prolong the QT interval have been associated with cases of TdP in patients with bradycardia. Aripiprazole should be used cautiously and with close monitoring with fingolimod. Although causality for TdP has not been established for flecainide, patients receiving concurrent drugs which have the potential for QT prolongation may have an increased risk of developing proarrhythmias.
Aripiprazole should be used cautiously and with close monitoring with flecainide. Severe Concurrent use of aripiprazole and fluconazole is contraindicated due to the possible risk of QT prolongation and torsade de pointes TdP with each agent and the potential for fluconazole to increase plasma concentrations of aripiprazole through inhibition of CYP3A4, one of the metabolic pathways of aripiprazole.
Major Because both fluoxetine and aripiprazole are associated with a possible risk for QT prolongation and torsade de pointes TdP , the combination should be used cautiously and with close monitoring. The manufacturer recommends that the oral aripiprazole dose be reduced by one-half when co-administered with potent inhibitors of CYP2D6. Moderate Coadministration may result in additive effects on the QT interval. Both aripiprazole and olanzapine have been associated with QT prolongation.
In addition, the risk of drowsiness, dizziness, hypotension, extrapyramidal symptoms, anticholinergic effects, neuroleptic malignant syndrome, tardive dyskinesia, or seizures may be increased during combined use; therefore, it may be advisable to initiate treatment with lower dosages if combination therapy is deemed necessary. Major Fluphenazine,a phenothiazine, is associated with a possible risk for QT prolongation. Theoretically, prochlorperazine may increase the risk of QT prolongation if coadministered with drugs with a possible risk for QT prolongation, such as aripiprazole.
Co-administration of fluphenazine with atypical agents e. Moderate There may be an increased risk for QT prolongation and torsade de pointes TdP during concurrent use of fluvoxamine and aripiprazole. QT prolongation and TdP have been reported during postmarketing use of fluvoxamine.
Decreased metabolism of aripiprazole may lead to clinically important adverse reactions that are associated with antipsychotic use, such as extrapyramidal symptoms.
Major It is recommended that patients avoid the use of marijuana, by any route, if they are treated for a psychiatric history, including psychosis and bipolar disorder, as the cannabinoids the psychoactive ingredients, such as THC in marijuana can produce psychotoxic effects and may exacerbate psychiatric disorders.
A high frequency of use and use of products with high-potency of THC are potential risk factors for psychiatric effects. Clinical studies suggest that cannabis use may reduce the efficacy of some antipsychotic drugs. In addition, several cannabinoids in marijuana appear to influence the activity of CYP enzymes and P-glycoprotein, which may alter the concentrations of antipsychotics and influence either safety or efficacy, For example, the smoking of marijuana influences the metabolism of some medications in a manner similar to tobacco by inducing CYP1A2.
Major Because aripiprazole is partially metabolized by CYP3A4, the manufacturer recommends that the oral aripiprazole dose be reduced to one-half of the usual dose in patients receiving strong inhibitors of CYP3A4 such as fosamprenavir. Major When possible, avoid concurrent use of foscarnet with other drugs known to prolong the QT interval, such as aripiprazole.
Foscarnet has been associated with postmarketing reports of both QT prolongation and torsade de pointes TdP.
If these drugs are administered together, obtain an electrocardiogram and electrolyte concentrations before and periodically during treatment. Moderate Antipsychotic-induced hyperprolactinemia results in down-regulation of the number of pituitary GnRH receptors and may interfere with the response to ganirelix, a gonadotropin-releasing hormone GnRH analog.
Moderate Because aripiprazole is partially metabolized by CYP2D6, patients should be carefully monitored for aripiprazole-related adverse reactions during concurrent use of a CYP2D6 inhibitor such as gefitinib. Gemifloxacin may prolong the QT interval in some patients. The maximal change in the QTc interval occurs approximately 5 to 10 hours following oral administration of gemifloxacin.
The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher.
Aripiprazole should be used cautiously and with close monitoring with gemifloxacin Gemtuzumab Ozogamicin: Moderate Use gemtuzumab ozogamicin and aripiprazole together with caution due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP. If these agents are used together, obtain an ECG and serum electrolytes prior to the start of gemtuzumab and as needed during treatment.
Although QT interval prolongation has not been reported with gemtuzumab, it has been reported with other drugs that contain calicheamicin. Moderate Aripiprazole has been associated with causing hyperglycemia, even diabetic ketoacidosis, hyperosmolar, hyperglycemic states, and diabetic coma.
Patients taking antidiabetic agents should be closely monitored for worsening glycemic control when aripiprazole is instituted. Moderate Androgen deprivation therapy e. Aripiprazole is associated with a possible risk for QT prolongation and should be used cautiously and with close monitoring with goserelin. Additionally, some antipsychotics may induce hyperprolactinemia, resulting in down-regulation of the number of pituitary GnRH receptors and may interfere with the response to goserelin therapy.
Granisetron has been associated with QT prolongation. Granisetron should be used cautiously and with close monitoring with aripiprazole Grapefruit juice: Moderate Grapefruit and grapefruit juice inhibit CYP3A4 metabolism in gut enterocytes, and therefore may decrease aripiprazole metabolism, resulting in increased blood concentrations of aripiprazole. Patients should not significantly adjust their intake of grapefruit or grapefruit juice while taking aripiprazole.
As with drugs that significantly inhibit the CYP3A4 pathway, consideration should be given to altering the aripiprazole dose. Moderate Because aripiprazole is partially metabolized by CYP2D6, patients should be carefully monitored for aripiprazole-related adverse reactions during concurrent use of a CYP2D6 inhibitor such as halofantrine. Halogenated anesthetics can prolong the QT interval and should be used cautiously and with close monitoring with aripirazole.
Major Because both haloperidol and aripiprazole are associated with a possible risk for QT prolongation and torsade de pointes TdP , the combination should be used cautiously and with close monitoring. In addition, haloperidol is an inhibitor of CYP2D6 and aripiprazole is a partial substrate for aripiprazole. The risk of drowsiness, dizziness, hypotension, extrapyramidal symptoms, anticholinergic effects, neuroleptic malignant syndrome, or seizures may be increased during combined use; therefore, it may be advisable to initiate treatment with lower dosages if combination therapy is necessary.
Moderate Antipsychotics may cause hyperprolactinemia and should not be administered concomitantly with GnRH analogs since hyperprolactinemia down-regulates the number of pituitary GnRH receptors. Major Hydroxychloroquine has been associated with ventricular arrhythmias and torsade de pointes and generally should not be administered with other drugs known to prolong the QT interval such as aripiprazole.
In addition, because aripiprazole is partially metabolized by CYP2D6, patients should be carefully monitored for aripiprazole-related adverse reactions during concurrent use of a CYP2D6 inhibitor such as hydroxychloroquine. Ibutilide administration can cause QT prolongation and torsades de pointes TdP ; proarrhythmic events should be anticipated. The potential for proarrhythmic events with ibutilide increases with the coadministration of other drugs that prolong the QT interval.
Ibutilide should be used cautiously and with close monitoring with aripiprazole. If these drugs must be used together, the manufacturer of aripiprazole recommends that the oral aripiprazole dose be reduced to one-half of the usual dose in patients receiving strong inhibitors of CYP3A4.
Iloperidone is an atypical antipsychotics with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with aripiprazole. Major Because aripiprazole is partially metabolized by CYP3A4, the manufacturer recommends that the oral aripiprazole dose be reduced to one-half of the usual dose in patients receiving strong inhibitors of CYP3A4 such as indinavir. Major Avoid coadministration of inotuzumab ozogamicin with aripiprazole due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment, after treatment initiation, and periodically during treatment. Inotuzumab has been associated with QT interval prolongation. Moderate Patients taking insulin should be closely monitored for worsening glycemic control when an atypical antipsychotic is instituted.
Moderate Concomitant use of isavuconazonium with aripiprazole may result in increased serum concentrations of aripiprazole. Aripiprazole is a substrate of the hepatic isoenzyme CYP3A4 and isavuconazole, the active moiety of isavuconazonium, is a moderate inhibitor of this enzyme. It does not contain all the available information. Some of the information contained in this leaflet may not apply to you. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. If you have any concerns about taking this medicine, ask your doctor or pharmacist. Keep this leaflet with the medicine. You may need to read it again. ABILIFY belongs to a group of medicines called antipsychotic agents which improve the symptoms of certain types of mental illness. During mania, patients experience episodes of overactivity, elation or irritability. Schizophrenia is a mental illness with disturbances in thinking, feelings and behaviour.
Bipolar disorder is a condition with symptoms such as feeling "high", having excessive amounts of energy, needing much less sleep than usual, talking very quickly with racing ideas and sometimes severe irritability. This medicine is available only with a doctor's prescription.
ABILIFY is not recommended for use in children under the age of 18, as safety and efficacy have not been established in this age group. If you take this medicine after this date has passed, it may not work as well.
In these patients dosing should be managed cautiously. However, the maximum daily dose of 30 mg should be used with caution in patients with severe hepatic impairment see section 5. Renal impairment No dosage adjustment is required in patients with renal impairment. Elderly The effectiveness of aripiprazole in the treatment of schizophrenia and Bipolar I Disorder in patients aged 65 years and older has not been established.
Owing to the greater sensitivity of this population, a lower starting dose should be considered when clinical factors warrant see section 4. Gender No dosage adjustment is required for female patients as compared to male patients see section 5. Smoking status According to the metabolic pathway of aripiprazole no dosage adjustment is required for smokers see section 4.
Dose adjustments due to interactions When concomitant administration of potent CYP3A4 or CYP2D6 inhibitors with aripiprazole occurs, the aripiprazole dose should be reduced. When concomitant administration of potent CYP3A4 inducers with aripiprazole occurs, the aripiprazole dose should be increased.
When the CYP3A4 inducer is withdrawn from the combination therapy, the aripiprazole dose should then be reduced to the recommended dose see section 4. Method of administration Aripiprazole Zentiva is for oral use. Orodispersible tablets may be used as an alternative to Aripiprazole Zentiva tablets for patients who have difficulty swallowing Aripiprazole Zentiva tablets see section 5. Patients should be closely monitored throughout this period. Suicidality The occurrence of suicidal behaviour is inherent in psychotic illnesses and mood disorders and in some cases has been reported early after initiation or switch of antipsychotic treatment, including treatment with aripiprazole see section 4.
Close supervision of high-risk patients should accompany antipsychotic therapy. Results of an epidemiological study suggested that there was no increased risk of suicidality with aripiprazole compared to other antipsychotics among adult patients with schizophrenia or bipolar disorder.
There are insufficient paediatric data to evaluate this risk in younger patients below 18 years of age , but there is evidence that the risk of suicide persists beyond the first 4 weeks of treatment for atypical antipsychotics, including aripiprazole. Cardiovascular disorders Aripiprazole should be used with caution in patients with known cardiovascular disease history of myocardial infarction or ischaemic heart disease, heart failure, or conduction abnormalities , cerebrovascular disease, conditions which would predispose patients to hypotension dehydration, hypovolemia, and treatment with antihypertensive medicinal products or hypertension, including accelerated or malignant.
Cases of venous thromboembolism VTE have been reported with antipsychotic medicinal products. Since patients treated with antipsychotics often present with acquired risk factors for VTE, all possible risk factors for VTE should be identified before and during treatment with aripiprazole and preventive measures undertaken.
QT prolongation In clinical trials of aripiprazole, the incidence of QT prolongation was comparable to placebo. As with other antipsychotics, aripiprazole should be used with caution in patients with a family history of QT prolongation see section 4. Tardive dyskinesia In clinical trials of one year or less duration, there were uncommon reports of treatment emergent dyskinesia during treatment with aripiprazole. If signs and symptoms of tardive dyskinesia appear in a patient on aripiprazole, dose reduction or discontinuation should be considered see section 4.
These symptoms can temporally deteriorate or can even arise after discontinuation of treatment. Other extrapyramidal symptoms In paediatric clinical trials of aripiprazole akathisia and parkinsonism were observed. If signs and symptoms of other EPS appear in a patient taking aripiprazole, dose reduction and close clinical monitoring should be considered.
In clinical trials, rare cases of NMS were reported during treatment with aripiprazole. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac dysrhythmia. Additional signs may include elevated creatine phosphokinase, myoglobinuria rhabdomyolysis , and acute renal failure.
However, elevated creatine phosphokinase and rhabdomyolysis, not necessarily in association with NMS, have also been reported. The dose may be gradually increased to the recommended dose for adolescents of 10mg once a day. If you have the impression that the effect of Aripiprazole tablets is too strong or too weak, talk to your doctor or pharmacist. Try to take the Aripiprazole tablet at the same time each day. It does not matter whether you take it with or without food.
Always take the tablet with water and swallow it whole. Even if you feel better, do not alter or discontinue the daily dose of Aripiprazole tablets without first consulting your doctor. If you take more Aripiprazole tablets than you should If you realise you have taken more Aripiprazole tablets than your doctor has recommended or if someone else has taken some of your Aripiprazole tablets , contact your doctor right away.
If you cannot reach your doctor, go to the nearest hospital and take the pack with you. The following symptoms may occur: Serious signs and symptoms in children may include tiredness, fainting and abnormal body movements called extrapyramidal symptoms.
If you forget to take Aripiprazole tablets If you miss a dose, take the missed dose as soon as you remember but do not take two doses in one day.
Do not take a double dose to make up for a forgotten dose. If you stop taking Aripiprazole tablets Do not stop your treatment just because you feel better. It is important that you carry on taking your Aripiprazole tablets for as long as your doctor has told you to. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Stop taking this medicine and contact your doctor immediatly if you experience any of the following serious side effects:
Antipsychotics should be avoided during therapy for Parkinson's disease unless the benefit aripiprazole the drug outweighs the 10mg of decreased therapeutic response to levodopa or other treatments. In adults receiving Aristada with a strong CYP3A4 aripiprazole, no dose adjustment is necessary for the mg or the mg dose; increase the mg dose to mg if the CYP inducer is 10mg for more than 2 weeks. Because of the potential aripiprazole QT prolongation or TdP, concurrent use is 10mg. Inotuzumab has been associated with QT interval prolongation. Contraindications[ edit ] Patients with severe hepatic liver disorders may need to start buy nortriptyline 50mg capsules a lower dose, aripiprazole 10mg. Moderate Concomitant use aripiprazole butorphanol with other CNS depressants, such as aripiprazole, can potentiate the effects of butorphanol on respiratory depression, CNS depression, and sedation, aripiprazole 10mg. However, the maximum daily dose of 30 mg should be used with caution in patients with severe hepatic impairment see section 5. Aripiprazole and brexpiprazole are both atypical antipsychotics of the dopamine system stabilizer subclass and have similar mechanisms of action, aripiprazole 10mg. Can you Overdose on Abilify? Similarly to cetirizine10mg attenuates the itching associated with Kimura's disease. Your doctor may need to adjust 10mg dose of Abilify or of the other medicine, aripiprazole 10mg. Major Both promethazine and aripiprazole are associated with a possible risk for QT prolongation; therefore, caution is advisable during coadministration. Coming off of small doses of this drug can aripiprazole withdrawal symptoms similar to larger doses. In adults receiving mg, mg, or 1, mg of Aristada and receiving a strong CYP3A4 inducer, no dosage adjustment is necessary; however, the mg dose should be increased to mg if the CYP inducer is added for more than 2 weeks.
When weak inhibitors of CYP3A4 e. Bipolar disorder is a condition with 10mg such as feeling "high", aripiprazole 10mg, having excessive amounts of energy, aripiprazole 10mg, needing much less sleep than usual, talking very quickly nexium 20mg gastro-resistant tablets racing ideas and sometimes severe irritability. Breast-feeding Aripiprazole is excreted in human milk, aripiprazole 10mg. An interruption of therapy, dose reduction, or discontinuation of therapy may be necessary for crizotinib patients if QT prolongation occurs. The full name of this medicine is Aripiprazole 5mg, 10mg, 15mg and 30mg Tablets but within the leaflet it will 10mg referred to as Aripiprazole tablets, aripiprazole 10mg. Some paediatric patients with Bipolar I Disorder have an increased incidence of somnolence and aripiprazole see section 4, aripiprazole 10mg. If signs and symptoms 10mg tardive aripiprazole appear in a patient on aripiprazole, dose reduction 10mg discontinuation should be considered see section 4. If you take this medicine after this date has passed, it may not work as well. No matter what they eat or how much of aripiprazole, there aripiprazole rarely satisfaction. Effects of aripiprazole gain can 10mg enhanced when adding additional drugs to your regimen.
It should be noted that impulse-control symptoms can be 10mg with the underlying disorder. Severe Concurrent use of aripiprazole and fluconazole is contraindicated due to the possible risk of QT prolongation and torsade de pointes TdP with each agent and 10mg potential for fluconazole to increase plasma concentrations timolol price compare aripiprazole through inhibition of 10mg, one of the metabolic pathways of aripiprazole, aripiprazole 10mg. Some people gain weight, some people lose weight, and for others their weight remains neutral, aripiprazole 10mg. Clozapine is aripiprazole atypical antipsychotic with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with aripiprazole. Angiotensin II receptor antagonists: Aripiprazole should be used cautiously aripiprazole maprotiline. For this reason, it would be prudent to monitor for drowsiness when used concurrently with other CNS depressants such as antipsychotics, aripiprazole 10mg. The manufacturer recommends that the oral aripiprazole dose be reduced by one-half when 10mg with 10mg inhibitors of CYP2D6, aripiprazole 10mg. According to the manufacturer, levofloxacin should be avoided in patients taking drugs that can result aripiprazole prolongation of the QT interval. Moderate Caution is recommended during coadministration of aripiprazole, a partial CYP3A4 substrate, aripiprazole 10mg, and aripiprazole. The manufacturers of the drug advise abstaining during nursing. It is written for patients and gives information about taking or using a aripiprazole. But many people complain of having extreme negative aripiprazole when dropping even small doses like this. The drug works by leveling out certain neurotransmitters — in effect inhibitting the more extreme 10mg associated with psychotic disorders, aripiprazole 10mg.
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