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Aristada
Aristada (aripiprazole lauroxil) is a long-acting injectable antipsychotic medication used to treat schizophrenia in adults. It is a prodrug of aripiprazole, which means it converts into aripiprazole once in the body. Aripiprazole is a partial dopamine agonist, helping to regulate dopamine and serotonin levels in the brain. Aristada is designed for long-term management of schizophrenia symptoms, providing the benefits of aripiprazole over extended periods with fewer injections, improving adherence to treatment.
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Frequently Asked Questions
How long does it take for Aristada to start working?
It may take several weeks for Aristada to start improving symptoms of schizophrenia. Patients often begin with a 21-day oral overlap of aripiprazole to maintain therapeutic levels as the long-acting injection takes effect.
How often will I need to get Aristada injections?
The frequency of Aristada injections depends on the dose. Depending on your prescribed dose, you may receive injections every 4 weeks, 6 weeks, or 8 weeks.
Can I stop taking oral antipsychotic medication after my first Aristada injection?
No, it’s usually recommended to continue oral aripiprazole for the first 21 days after the initial Aristada injection to ensure adequate blood levels while the long-acting injection takes effect.
What should I do if I miss an Aristada injection?
If you miss a scheduled injection, contact your healthcare provider as soon as possible to reschedule. Missing an injection may reduce the effectiveness of your treatment.
Can Aristada cause weight gain?
Yes, weight gain is a possible side effect of Aristada, along with other metabolic changes. Regular monitoring of weight, blood sugar, and cholesterol levels is recommended while using this medication.
Comprehensive Drug Guide
How Does Aristada Work?
Aristada works as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors and as an antagonist at serotonin 5-HT2A receptors. This helps to balance dopamine and serotonin levels in the brain, reducing psychotic symptoms such as hallucinations, delusions, and disorganized thinking. By stabilizing these neurotransmitter systems, Aristada helps manage both positive and negative symptoms of schizophrenia.
Common Dosages
- 441 mg, 662 mg, 882 mg, and 1064 mg in pre-filled syringes.
- The frequency of administration ranges from every 4 weeks, 6 weeks, or 8 weeks based on the dose and patient needs.
Typical Dosing
- The initial dose is typically 441 mg, 662 mg, or 882 mg depending on the patient's needs, followed by injections every 4 to 8 weeks.
- 1064 mg is administered every 8 weeks.
- A 21-day oral aripiprazole overlap is often required when starting Aristada to ensure adequate drug levels in the body.
Typical Dosing
FDA Approved Indications
- Schizophrenia in adults
Off-Label Uses
Who Shouldn't Take Aristada?
- Known hypersensitivity to aripiprazole or any other components of the formulation
- Patients with a history of neuroleptic malignant syndrome (NMS), a rare but serious reaction to antipsychotics
Advice From The Pharmacist
- Aristada must be administered by a healthcare provider, so keep regular appointments for injections.
- It is important to maintain the oral aripiprazole overlap during the initial 21 days of treatment unless otherwise directed.
- Report any unusual movements, stiffness, or tardive dyskinesia (involuntary facial or body movements) to your healthcare provider immediately.
- Aristada may cause drowsiness or dizziness, so avoid driving or operating heavy machinery until you know how it affects you.
Side Effects of Aristada
Common Side Effects
- Weight gain
- Drowsiness
- Restlessness
- Injection site reactions (pain, swelling, or redness)
Uncommon/Severe Side Effects
- Tardive dyskinesia (involuntary muscle movements, especially in the face)
- Neuroleptic malignant syndrome (NMS) (a potentially life-threatening condition involving muscle rigidity, fever, and altered mental status)
- Metabolic changes (increased blood sugar, cholesterol, or triglycerides)
- Orthostatic hypotension (sudden drop in blood pressure when standing)
Risks and Warnings of Aristada
- Tardive dyskinesia: Prolonged use of Aristada may cause involuntary movements, particularly in older adults. Symptoms can be irreversible even after stopping the medication.
- Neuroleptic malignant syndrome (NMS): This rare but serious reaction can cause muscle stiffness, fever, confusion, and organ failure. Seek immediate medical attention if symptoms develop.
- Metabolic changes: Aristada can cause weight gain, hyperglycemia, and changes in cholesterol levels. Regular monitoring of blood sugar and lipids is advised.
- Suicidal thoughts: As with other antipsychotic medications, there is a risk of suicidal thoughts in some patients, especially when starting the medication.
Interactions with Aristada
Common Drug Interactions
- CYP3A4 inhibitors (e.g., ketoconazole) and CYP2D6 inhibitors (e.g., fluoxetine) can increase blood levels of aripiprazole, which may necessitate a lower dose of Aristada.
- CYP3A4 inducers (e.g., carbamazepine) may reduce the effectiveness of Aristada, leading to a higher dose requirement.
- Alcohol: Avoid consuming alcohol while using Aristada, as it may increase the risk of drowsiness or dizziness.
Alternatives to Aristada
- Abilify Maintena (aripiprazole): Another long-acting injectable formulation of aripiprazole used for schizophrenia and bipolar disorder.
- Invega Sustenna (paliperidone palmitate): A long-acting injectable antipsychotic used for schizophrenia and schizoaffective disorder.
- Risperdal Consta (risperidone long-acting injection): Another long-acting injectable antipsychotic used for schizophrenia and bipolar disorder.
- Zyprexa Relprevv (olanzapine): A long-acting injectable formulation of olanzapine for the treatment of schizophrenia.
