aripiprazole (Rx)

Brand and Other Names:Abilify, Abilify Maintena, more...Abilify MyCite, Aristada, Aristada Initio
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Dosing & Uses

AdultPediatric

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

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

  • 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

  • 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

Bipolar Mania

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

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

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
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Interactions

Interaction Checker

and aripiprazole

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      Serious - Use Alternative

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            Contraindicated (3)

            • 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 (119)

            • abametapir

              abametapir will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • amiodarone

              aripiprazole and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

            • 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.

            • 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.

            • 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

            • 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.

            • 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.

            • 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.

            • ketoconazole

              ketoconazole will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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.

            • 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 (391)

            • 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.

            • 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 will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              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.

            • 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.

            • 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.

            • 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.

            • 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, 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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).

            • 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.

            • 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.

            • 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.

            • 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.

            • 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

              modafinil will decrease the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              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.

            • 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 (29)

            • amiodarone

              amiodarone will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 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.

            • 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.

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            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
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            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
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            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.

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            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%)

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            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
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            Images

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            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            5 mg tablet
            aripiprazole oral
            -
            2 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
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            20 mg tablet
            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
            -
            15 mg tablet
            aripiprazole oral
            -
            15 mg tablet
            aripiprazole oral
            -
            1 mg/mL solution
            aripiprazole oral
            -
            20 mg tablet
            aripiprazole oral
            -
            10 mg tablet
            aripiprazole oral
            -
            2 mg tablet
            aripiprazole oral
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            30 mg tablet
            aripiprazole oral
            -
            5 mg tablet
            aripiprazole oral
            -
            1 mg/mL solution
            aripiprazole oral
            -
            30 mg tablet
            aripiprazole oral
            -
            20 mg tablet
            aripiprazole oral
            -
            10 mg tablet
            aripiprazole oral
            -
            2 mg tablet
            aripiprazole oral
            -
            15 mg tablet
            aripiprazole oral
            -
            5 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            20 mg tablet
            aripiprazole oral
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            30 mg tablet
            aripiprazole oral
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            30 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            5 mg tablet
            aripiprazole oral
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            2 mg tablet
            aripiprazole oral
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            10 mg tablet
            aripiprazole oral
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            5 mg tablet
            aripiprazole oral
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            2 mg tablet
            aripiprazole oral
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            30 mg tablet
            aripiprazole oral
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            20 mg tablet
            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
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            15 mg tablet
            aripiprazole oral
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            2 mg tablet
            aripiprazole oral
            -
            5 mg tablet
            Abilify oral
            -
            2 mg tablet
            Abilify oral
            -
            10 mg tablet
            Abilify oral
            -
            20 mg tablet
            Abilify oral
            -
            30 mg tablet
            Abilify oral
            -
            5 mg tablet
            Abilify oral
            -
            15 mg tablet
            Abilify Maintena intramuscular
            -
            300 mg syringe
            Abilify Maintena intramuscular
            -
            400 mg vial
            Abilify Maintena intramuscular
            -
            300 mg vial
            Abilify Maintena intramuscular
            -
            400 mg vial
            Abilify Maintena intramuscular
            -
            300 mg vial
            Abilify Maintena intramuscular
            -
            400 mg vial
            Abilify Maintena intramuscular
            -
            400 mg syringe

            Copyright © 2010 First DataBank, Inc.

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            Patient Education
            aripiprazole oral

            ARIPIPRAZOLE DISINTEGRATING TABLET - ORAL

            (AR-i-PIP-ra-zole)

            COMMON BRAND NAME(S): Abilify Discmelt

            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 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.Do not remove the tablet from the blister pack until just before taking. Dry your hands before peeling back the foil on the blister pack to carefully remove a tablet. Do not push the tablet through the foil. The tablet is fragile and should not be cut, split, or broken before using. Place each dose on the tongue, allow it to dissolve completely, then swallow it with saliva. You do not need to take this medication with water.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 persist or worsen, 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, 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.This medication may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).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.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.Laboratory and/or medical tests (such as blood sugar, weight, cholesterol/triglyceride levels) may be performed before you start treatment, periodically to monitor your progress, or to check for side effects. 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 at room temperature away from light and moisture. 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 August 2021. Copyright(c) 2021 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.

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            Formulary

            FormularyPatient Discounts

            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.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.