*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Aristada (aripiprazole lauroxil) is a long-acting injectable used for schizophrenia.1 It is generally well-tolerated and preferred for its ease of use and reduced pill burden. Aristada lasts about one to two months and is injected into the muscle. It can take up to 2 weeks to fully work, but begins working within a few days. Most insurance companies will cover Aristada, or coupons are available.
If you’re considering Aristada, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Aristada or another medication may help your symptoms.
Boxed Warning: Aripiprazole – Risk of death in older patients with dementia-related psychosis and risk of suicidal thoughts and behaviors
Aripiprazole, the active ingredient in Aristada, has a black box warning. This is the most serious type of warning from the Food and Drug Administration (FDA). Aripiprazole can increase the risk of dealth in older patents with dementia-related psychosis as well as increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with aripiprazole and any other medications before starting treatment.
What Is Aristada?
Aristada is a Food and Drug Administration (FDA)-approved long-acting injectable for adults with schizophrenia. An FDA-approved drug has been tested with randomized controlled trials to prove it is safe and effective. Aristada can also be used off-label, which means that a prescriber may decide to use a medication for a use that is not specifically FDA-approved, but believes it may benefit a patient. Off-label uses for aripiprazole include:
- Bipolar disorder, types I and II2
- Depression3
- Autism spectrum disorders4
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How Does Aristada Work?
Aristada works by increasing serotonin and dopamine levels in the brain. It’s thought that how serotonin and dopamine work in the brain may help stabilize mood. Aristada can help with symptoms of schizophrenia by reducing hallucinations or delusions and improving decision-making, attention, and memory. It may sometimes also diminish tics, disorganized behavior, and emotional instability.
How Effective Is Aristada?
Injectable Aristada is as safe and effective as the oral form and was found more effective than other injectable medications.5, 6 Also, satisfaction is also reportedly higher for injectables than oral antipsychotics. In addition, guidelines do not favor one drug over another, but they do recommend long-acting injectables.7
How Long Does Aristada Last?
Aristada lasts up to one month, 6 weeks, or 2 months long.1 If your medication is wearing off around the time you get your next injection, talk to your doctor, and they can help with a solution. They may prescribe the tablet form of Aristada to take for a few days at the end of the month before your next injection.
How Long Does it Take for Aristada to Work?
Aristada can take up to 2 weeks to fully work.1 The process begins with receiving Aristada in a short-acting form to see if you will tolerate the medication. Then, either an initial injection form, a tablet form, or both are taken with Aristada. Tablets are taken for three weeks or once if you also received the initial injection.
How Long Do I Need to Keep Taking Aristada?
Keep taking Aristada for the duration of treatment your doctor recommends. Also, you should take Aristada until your doctor says it’s okay for you to stop taking it. However, schizophrenia is a chronic lifelong condition with no cure. Call your doctor or pharmacist if you need to stop taking the medication.
Side Effects of Aristada
Side effects that can occur from Aristada may be related to the medication’s actions of dopamine and serotonin.1 Some side effects can persist as long as you take Aristada, while some can go away or improve after about two weeks. Side effects that can improve as your body adjusts include tiredness and headaches.
Common Side Effects of Aristada
The most common side effects of Aristada include pain at the injection site, loss of muscle control, nausea, and headaches.1 Each person’s response may vary. These side effects are normally mild and typically do not require medical attention.
Common side effects of Aristada include:*1
- Involuntary muscle movement
- Injection site pain
- Increased weight
- Tiredness
- Headache
- Insomnia
- Restlessness
*All medications, including Aristada, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Serious Side Effects of Aristada
Aristada can cause serious side effects that could be life-threatening, requiring immediate medical attention.1 Serious side effects most often affect the tongue, mouth, throat, and limb muscles. If you experience a loss of muscle control, tell your doctor or pharmacist immediately.
Serious side effects of Aristada include:*1
- Allergic reaction
- Uncontrolled body movements
- Stroke
- Tardive dyskinesia
- Neuroleptic malignant syndrome
- Falls
- Seizures
*All medications, including Aristada, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
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Aristada Warnings & Precautions
Aristada carries warnings that may require immediate medical attention.1 Warnings for Aristada include heart events in some patients and a serious, potentially fatal, and possibly irreversible movement disorder. Drops in blood pressure may occur and may lead to falls. Neuroleptic malignant syndrome (NMS) is a serious side effect that is rare but may occur. Symptoms of NMS include confusion, loss of consciousness, seizures, or muscle rigidity.
Warnings and precautions for taking Aristada include:1, 8
- Dementia-related psychosis: In people with dementia, antipsychotics can cause an increased risk of death.
- Stroke: Heart events, such as stroke, could occur in patients 65 years or older.
- Suicidal thoughts or behaviors in young adults or teens: Careful at-home monitoring of young patients should be done often for your mental health and safety. Suicidal thoughts and behaviors are rare but do require emergency medical care.
- Drug and dose errors: Errors have occurred by confusing Aristada monthly injections with Aristada Initio, a one-time dose. A good habit is to double-check a medication’s label and appearance with each use.
- Neuroleptic malignant syndrome (NMS): NMS is a potentially fatal side effect that can occur from Aristada from excess dopamine in the body or brain. Side effects include muscle stiffening, increased heart rate, sweating, confusion, and fever.
- Tardive dyskinesia: Tardive dyskinesia is a potentially irreversible condition that causes involuntary muscle contraction. Symptoms include tongue “clicking”, rapid eye-blinking, and loss of control of arms or legs.
- Metabolism changes: Aristada can affect your blood sugar levels, and lead to diabetes. It can also cause an increase in cholesterol and weight gain.
- Gambling or other compulsive behaviors: Like other drugs in its class, Aristada can cause new or worsened impulsive behaviors. Behaviors may include a strong urge to gamble, shop, or eat.
- Drops in blood pressure upon waking or standing up: Symptoms of a sudden drop in blood pressure from Aristada include dizziness, lightheadedness, and increased heart rate may occur. If not treated, drops in blood pressure can lead to fainting or falls.
- Falls: Antipsychotics can cause several side effects that can lead to falls. Side effects include movement or sensory impairment, drops in blood pressure, and drowsiness.
- Changes in blood cell counts: Aripiprazole can lower the number of blood cells available that fight infections. Monitor yourself for fever or other signs of infection, such as redness, swelling, fatigue, or muscle pain.
- Seizures: Do not use Aristada with other drugs or substances that can lower the seizure threshold. Substances, such as alcohol and bupropion (Wellbutrin), can increase your risk of seizures if combined with Aristada.
- Movement- or thought-impairment: Aristada can impair your ability to move or think clearly. Do not operate heavy machinery, such as vehicles or forklifts, until you know how Aristada will affect you.
- Body temperature dysregulation: Aristada affects the body’s serotonin levels, which may have some side effects for the first 4-6 weeks of taking this medication. Factors that can contribute to dysregulation include heavy exercise, dehydration, extreme heat, and certain medications.
- Difficulty or pain when swallowing: Difficulty swallowing or throat pain may occur from irregular muscle movements. Call your doctor or pharmacist immediately if you have abnormal tongue movements.
Drug Interactions With Aristada
Four types of substances you should avoid while taking Aristada include:1, 8
- Itraconazole, clarithromycin, quinidine, fluoxetine, and paroxetine: Anti-infectives and anti-depressants can increase the concentration of Aristada and risk serious side effects.
- Carbamazepine and rifampin: These drugs can reduce Aristada’s effectiveness.
- Blood pressure medications:
- Lorazepam and other benzodiazepines: Drops in blood pressure upon sitting up or standing may occur if Aristada is taken with medications similar to Xanax.
- Alcohol: Do not take Aristada with alcohol. Blood pressure changes, falls, or seizures may occur.
This is not a comprehensive list of the possible interactions with Aristada. You should talk with your healthcare provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Aristada.
Aristada Dosages for FDA-Approved Treatment
Aristada is approved for use in adults 18-65 years old.1 If your body cannot break down certain liver enzymes, you may require a lower dosage than usual. It is uncertain if Aristada is safe to use in children and teenagers. In general, Aristada should not be used during pregnancy or while breastfeeding.
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Aristada Form & Strengths
Aristada is provided as an extended-release intramuscular injection.1 It not only improves medication adherence compared to tablets but also increases the length of time the medication acts. Also, Aristada is only available in an injectable form, and its generic form (aripiprazole) comes as a tablet.
The strength of your medication is determined based on your tolerance and the strength needed to manage your symptoms. Some may notice the effects of the medication shortly after the injection is given.1 Your doctor may choose Aristada over other long-acting antipsychotic injectables because Aristada may increase energy levels.
Aristada is available in the following forms and strengths:1
- 441 milligrams (mg) intramuscular injection
- 662 mg intramuscular injection
- 882 mg intramuscular injection
- 1064 mg intramuscular injection
Aristada Dosages for Adults With Schizophrenia
Aristrada is an FDA-approved treatment injectable for schizophrenia.1 Some may notice symptom improvement within a few days, though it may take up to 2 weeks to see the maximum effect as part of schizophrenia treatment.9 The tablet form of aripiprazole is given for 3 weeks while the injection kicks in. The half-life of an aripiprazole tablet is 75 hours or about 2 weeks. If you have already been taking aripiprazole and are switching to the injectable form, you shouldn’t notice a gap in care.1
Here is Aristada dosage information for schizophrenia in adults:1
- Typical starting dosage: You will initially receive 675 mg of Aristada Initio. Then, the starting dose of Aristada is 441 mg.
- Dosage increases: Your doctor may increase your dose to 662 mg and then 882 mg.
- Maximum dosage: The maximum amount of Aristada that should be injected at one time is 1064 mg.
How to Take Aristada Injections
Aristada is given by a nurse as an injection, most often into the gluteal muscle but sometimes into the shoulder.1 When receiving injections, it is best to relax that muscle as much as possible. This helps the needle enter more easily. Again, your doctor may prescribe the tablet form in case your medication starts to wear off at the end of its duration. It is important to take medications as directed by your doctor.
How Often Can You Take Aristada?
Injections can be taken every month, 6 weeks, or two months.1 The chosen timeframe will depend on individual factors. Factors may include your preference for the injection location, your ability to tolerate the medication and insurance coverage.
Coping With Injection Site Pain & Discomfort
Check with your doctor if it’s appropriate for you to take pain medication before your injection.1 Typically, a pain medication, like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), is used beforehand. Also, a local anesthetic, like lidocaine, may be used before taking Aristada.10 You can also try an ice pack for 15 minutes twice daily to numb the area before the injection.11
Long-acting Injectables
Long-acting injectables, such as Aristada, are unique because they release the medication from the muscle into the blood slowly over time.1 They are alternatives to daily tablets and may be helpful if you have trouble remembering to take your medication. Alternative long-acting injectables for schizophrenia include Invega (paliperidone), Risperdal (risperidone), and Zyprexa (olanzapine).
How to Get Aristada
To get Aristada or find out if it may be right for you, consult with your primary care provider or psychiatrist. Aristada is only available by prescription from your doctor and is typically taken at a doctor’s office or clinic. Prescriptions may be obtained from online psychiatry services or in-person office visits. A psychiatrist can help you consider this medication by explaining the potential risks and benefits of using Aristada.
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How Much Does Aristada Cost?
Most insurance policies will cover Aristada injections. If you do not have insurance, you can find a manufacturer coupon for Aristada online for as low as $10 per injection.12 If your psychiatrist does not have samples and you still cannot afford Aristada, clinics often have samples.
How to Know if Aristada Is Right for You
Your doctor will determine if Aristada is right for you based on factors such as your age, medical conditions, and tolerability. It is unknown if Aristada is safe for children and teens. Aristada should not be used in dementia-related psychosis, as it can increase your risk of death. Also, Aristada is not safe for use in the third trimester of pregnancy or during lactation.
FAQs About Aristada Injections
Here are frequently asked questions you and others may have about Aristada injections.
Is Aristada the Same as Abilify & Abilify Maintena?
Aristada and Abilify both contain aripiprazole as the active drug. The difference between Aristada and Abilify is that Aristada is an injection, while Abilify is a tablet taken daily. Abilify Maintena is another type of aripiprazole injection but is only available in a once-monthly formula. Also, your insurance may prefer one agent over another.
Is Aristada Similar to Invega Sustenna?
Aristada and Invega Sustenna are both antipsychotics for injection. However, Invega Sustenna contains the drug paliperidone. Invega Sustenna is also available in one-month and 6-month formulations. In a randomized-controlled trial, Aristada was shown to be more effective than Invega.6
Will I Have Withdrawal Symptoms If I Stop Taking Aristada?
Aristrada can cause withdrawal symptoms, including tardive dyskinesia, a potentially irreversible disorder that causes irregular muscle movements. 1 Withdrawal is rare and rarely irreversible and is usually treated with medicine. Also, it can be prevented by taking your medication as prescribed. If your doctor discontinues your medication, they should slowly decrease it over time.
How Does Aristada Help Symptoms of Schizophrenia?
Aristada may help influence levels of dopamine and serotonin, keeping these levels consistent. Specifically, Astrada may help improve hallucinations, delusions, lack of emotion, lack of motivation, social withdrawal, and disorganized thinking.
Questions to Ask Your Healthcare Provider About Aristada
Questions to ask your doctor include if you are an appropriate patient for Aristada. Also, you may want to know how others have handled common side effects. Other questions may include how well other people like the medication or how well it has helped their symptoms. It is also important for your doctor to check if Aristada is covered or available at a low cost.
Questions to ask your care team about Aristada include:
- How safe is Aristada?
- How long will it take for me to adjust to taking Aristada?
- Am I at risk for more serious symptoms if I am already taking other medications?
- Is it safe for me to drive after my Aristada injection?
- Can my healthcare provider come to my home to give me an Aristada shot?
- What are the advantages and disadvantages of Aristada compared to other schizophrenia treatments?
- How does the long-acting injection schedule of Aristada impact daily life and routine?
- Are there any lifestyle changes or precautions to take into account while on Aristada?
- Can I participate in therapy or counseling alongside Aristada treatment?
- What is the typical duration of Aristada treatment, and are there options for discontinuation or transition to other medications when needed?
- When should I be concerned about withdrawal from Aristada?
- What should I do if I start having side effects from Aristada?
- How well can Aristada improve my symptoms?
- How do I know if I do not need Aristada anymore?
- Are side effects from Aristada tolerated?
- How long does it take to start feeling better from Aristada?
- Who is Aristada right for?
- What non-medication options are there to help with my symptoms?
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