Abilify Maintena: The Monthly Antipsychotic Injection for Schizophrenia and Bipolar I Disorder

Abilify Maintena

What is Abilify Maintena?

Abilify Maintena (aripiprazole) is an extended-release injectable suspension of aripiprazole that only has to be given once a month.

It is a second-generation or atypical antipsychotic used to treat schizophrenia and bipolar I disorder.

Not having enough neurotransmitters such as dopamine and serotonin can affect the way we think, feel and behave. Abilify Maintena partially activates dopamine D2 and serotonin 5-HT1A receptors, which helps restore their balance in the brain.

Blocking activity at 5-HT2A receptors also contributes to its antipsychotic effect.

Abilify Maintena was approved by the US Food and Drug Administration (FDA) for use in 2013 as an improvement from the previous formulations of aripiprazole that have been used since 2002.


Abilify Maintena must only be injected by a healthcare provider and should not be self-administered.

Abilify Maintena carries the risk of severe side effects, including an increased chance of death in elderly patients who have dementia-related psychosis.

It is important to note that Abilify Maintena is not intended for the treatment of individuals suffering from psychosis due to confusion and memory loss as a result of dementia.

Prior to Medication Use

Abilify Maintena is a medication that should not be used if you are allergic to aripiprazole or any of the ingredients present in it.

Hence, before taking Abilify Maintena, review the complete list of ingredients carefully.

If you have had an allergic reaction to aripiprazole or any other component present in this drug in the past, inform your doctor immediately.

Your healthcare provider will evaluate whether it is safe for you to use Abilify Maintena or not based on your medical history and current health condition.

Possible Reactions

Abilify Maintena may cause serious side effects, including:

See "Important information" above.

Stroke (cerebrovascular problems) in elderly people with dementia-related psychosis that can lead to death.

Neuroleptic malignant syndrome (NMS), a serious condition that can lead to death. Call your healthcare provider or go to the nearest emergency room right away if you have some or all of the following symptoms of NMS:

high fever


changes in pulse, heart rate, and blood pressure

stiff muscles


Uncontrolled body movements (tardive dyskinesia). This medication may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop receiving Abilify Maintena. Tardive dyskinesia may also start after you stop receiving this medication.

Problems with your metabolism such as:

high blood sugar (hyperglycemia): Increases in blood sugar can happen in some people who receive this medication. Extremely high blood sugar can lead to coma or death. If you have diabetes or risk factors for diabetes (such as being overweight or a family history of diabetes), your healthcare provider should check your blood sugar before you start receiving this medication and during your treatment.

Call your healthcare provider if you have any of these symptoms of high blood sugar while receiving Abilify Maintena:

feel very thirsty

need to urinate more than usual

feel very hungry

feel weak or tired

feel sick to your stomach

Increased fat levels (cholesterol and triglycerides) in your blood.

Weight gain. You and your healthcare provider should check your weight regularly.

Unusual urges. Some people receiving this medication have had unusual urges such as gambling, binge eating or eating that you cannot control (compulsive), compulsive shopping and sexual urges. If you or your family members notice that you are having unusual urges or behaviors, talk to your healthcare provider.

Decreased blood pressure (orthostatic hypotension). You may feel lightheaded or faint when you rise too quickly from a sitting or lying position.

Low white blood cell count

Seizures (convulsions)

Problems controlling your body temperature so that you feel too warm. See "What should I avoid while receiving Abilify Maintena?"

Difficulty swallowing

The most common side effects of Abilify Maintena include:

weight gain

inner sense of restlessness such as feeling like you need to move (akathisia)

injection site pain


These are not all the possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Medication Interactions

When it comes to taking Abilify Maintena, it is important to consider its potential interactions with other medications. It is recommended that you inform your healthcare provider of all the medicines you are currently taking, including prescription drugs and over-the-counter medication, vitamins, and herbal supplements.

These can impact how well Abilify works or lead to serious side effects. Your healthcare provider will be able to tell you whether or not it is safe for you to take this medication in combination with other drugs.

It's also important that during treatment with Abilify Maintena that you don't start or stop any medications without first discussing this with your healthcare provider.

Maintaining a list of all the medicines you're taking can help ensure that no harmful drug interactions occur

Recommended Dosage Guidelines

Abilify Maintena should only be given by an intramuscular injection. Therefore, patients who have not taken aripiprazole before should take oral aripiprazole beforehand to confirm that they can handle the medicine. The injection should be done in the deltoid or gluteal muscle.

The recommended dose for Abilify Maintena is 400 mg per month as a single shot. However, if adverse reactions occur in patients, the dose can be reduced to 300 mg. Along with their first dose, patients should take 14 consecutive days of concurrent oral aripiprazole (10-20 mg) or their existing antipsychotic medication.

There are two types of kits available for Abilify Maintena - one is a single-dose pre-filled dual chamber syringe and the other is a single-dose vial containing lyophilized powder that requires reconstitution before usage.

For further details about the dosage of this medication, please refer to its full prescribing information.

Consequences of Missed Dose: What to Expect?

If you are taking Abilify Maintena, it's important to note that missing a dose may cause a disruption in your treatment plan.

Ideally, you should not miss any doses of this medication. However, if for some reason you do happen to miss a dose of Abilify Maintena, it's important to take action right away.

We recommend that you reach out to your healthcare provider as soon as possible after realizing that you have missed a dose. They will be able to provide you with guidance on what steps to take next in order to minimize the impact on your treatment plan.

In summary, missing a dose of Abilify Maintena can be problematic for your condition. So, if this happens make sure consult with your healthcare provider immediately.

Precautions and Avoidances: Navigating Abilify Maintena

Do not drive, operate machinery, or do other dangerous activities until you know how Abilify Maintena affects you. It might make you feel drowsy.

Avoid drinking alcohol while receiving this medication.

Avoid becoming too hot or dehydrated while receiving this medication. To prevent this:

- Do not exercise too much.

- In hot weather, stay indoors in a cool place if possible.

- Stay out of the sun.

- Do not wear too much clothing or heavy clothing.

- Drink plenty of water.

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