Abilify Maintena® Monthly Injection
Extended-Release Injectable for Schizophrenia & Bipolar I Disorder
Understanding Abilify Maintena® (Aripiprazole) Extended-Release Injectable
At CarePoint Infusion, we specialize in providing personalized, comfortable administration of long-acting injectable (LAI) medications. Abilify Maintena is one such treatment that can offer stability and convenience for individuals managing certain mental health conditions.
What is Abilify Maintena?
Abilify Maintena (aripiprazole) is a once-monthly, extended-release injectable prescription medication designed to provide continuous, steady levels of medication in the body for a full month, helping to manage symptoms without the need for a daily pill.
What Conditions Does It Treat?
Abilify Maintena is FDA-approved for:
Schizophrenia
Treatment of schizophrenia in adults for both acute symptoms and maintenance therapy. Helps manage symptoms such as hallucinations, delusions, and disorganized thinking.
Bipolar I Disorder
Maintenance monotherapy of bipolar I disorder in adults to prevent the recurrence of manic or mixed episodes. Helps stabilize mood and reduce episode frequency.
Important Limitation
This medication is not approved for treating dementia-related psychosis. Elderly patients with dementia-related psychosis treated with antipsychotic medications have an increased risk of death.
Key Benefits of Monthly Injectable Treatment
Improved Adherence
Monthly injections eliminate the need to remember daily oral medication, reducing the risk of missed doses and treatment interruptions.
Consistent Coverage
Steady medication levels throughout the month help maintain stable symptom control, avoiding the peaks and troughs of daily oral dosing.
Reduced Relapse Risk
Regular monthly treatment helps prevent symptom recurrence and hospitalizations by ensuring continuous therapeutic drug levels.
Simplified Routine
Once-monthly administration means fewer medication decisions and less daily medication management, allowing focus on recovery and daily life.
How Abilify Maintena Works
Abilify Maintena belongs to a class of medications called atypical antipsychotics. It works by modulating the activity of certain neurotransmitters in the brain, particularly dopamine and serotonin. By helping to restore the balance of these naturally occurring chemical messengers, Abilify Maintena helps reduce symptoms associated with schizophrenia and bipolar I disorder.
The extended-release formulation allows the medication to be slowly released into your system over the course of a month, maintaining consistent therapeutic levels and providing continuous symptom management.
Mechanism of Action
Aripiprazole acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, and as an antagonist at serotonin 5-HT2A receptors. This unique profile helps stabilize dopamine activity—reducing excess dopamine in areas associated with psychosis while preserving dopamine function in areas important for motivation and cognition.
Dosing and Administration
Recommended Dosage
The standard maintenance dose of Abilify Maintena is 400 mg administered once monthly as a single intramuscular injection, no sooner than 26 days after the previous injection.
If adverse effects occur at the 400 mg dose, it may be reduced to 300 mg once monthly under medical supervision.
Treatment Initiation
For patients new to aripiprazole, tolerability must be established with oral aripiprazole before starting Abilify Maintena. There are two initiation regimens:
1-Day Initiation
- Two separate 400 mg intramuscular injections of Abilify Maintena are administered on the first day at different injection sites (deltoid or gluteal muscle)
- One 20 mg dose of oral aripiprazole is taken on the same day
- This approach achieves therapeutic levels quickly
14-Day Initiation
- One 400 mg intramuscular injection of Abilify Maintena is administered on day one
- Oral aripiprazole (10-20 mg daily) or another oral antipsychotic is continued for 14 consecutive days
- This maintains therapeutic antipsychotic concentrations while the long-acting injection begins working
Injection Sites
Abilify Maintena is administered into either the deltoid (shoulder) or gluteal (buttock) muscle. Healthcare providers rotate injection sites between visits to minimize tissue irritation.
Important Note
No titration is required with Abilify Maintena. The medication can be administered at the therapeutic dose immediately, simplifying treatment initiation compared to oral formulations.
What to Expect at CarePoint Infusion
Before Your First Injection
- Medical Evaluation: Your healthcare provider will review your medical history, current medications, and any previous adverse reactions to aripiprazole
- Oral Tolerability Testing: If new to aripiprazole, you'll take oral medication for 1-2 weeks to ensure tolerability before starting Abilify Maintena
- Baseline Monitoring: Weight, blood pressure, blood glucose, and lipid levels may be checked
During Your Monthly Visits
- Clinical Assessment: Brief evaluation of symptoms, mood, and overall functioning
- Injection Administration: A healthcare professional will administer the injection into the deltoid or gluteal muscle
- Site Rotation: Injection sites are rotated between visits
- Monitoring: Blood pressure and other vital signs may be checked
- Observation Period: You may rest briefly after the injection before returning to your normal activities
Ongoing Monitoring
Regular monitoring includes:
- Weight checks at each visit
- Periodic blood pressure monitoring
- Annual blood glucose and lipid panel assessments
- Assessment for movement disorders or tardive dyskinesia
- White blood cell count monitoring if risk factors present
- Evaluation of medication effectiveness and any new or worsening symptoms
Common Side Effects
The most commonly reported side effects in clinical trials include:
- Weight gain (mean weight gain approximately 3.5 kg over 12 weeks in clinical trials)
- Restlessness or akathisia (inner sense of needing to move)
- Injection site pain (typically mild and temporary)
- Sedation or sleepiness
- Dry mouth
- Gastrointestinal issues (constipation, diarrhea, abdominal discomfort)
- Tremor or muscle stiffness
- Dizziness
- Upper respiratory tract infections
- Muscle or joint pain
Most mild side effects are temporary and may resolve within days to weeks. Inform your healthcare provider if side effects persist or become bothersome.
Serious Side Effects and Warnings
FDA Black Box Warning
Increased Mortality Risk in Elderly Patients with Dementia-Related Psychosis
Elderly patients with dementia-related psychosis treated with antipsychotic medications, including Abilify Maintena, have an increased risk of death (1.6 to 1.7 times higher) compared to placebo. Abilify Maintena is not approved for treating dementia-related psychosis.
Other Serious Side Effects
Neuroleptic Malignant Syndrome (NMS)
A rare but potentially life-threatening condition characterized by:
- High fever (hyperpyrexia)
- Severe muscle rigidity
- Changes in mental status
- Unstable vital signs (irregular pulse, blood pressure fluctuations, rapid heartbeat)
If NMS symptoms develop, seek immediate medical attention. Treatment involves discontinuation of the medication and intensive supportive care.
Tardive Dyskinesia (TD)
- Involuntary repetitive movements that may develop with long-term antipsychotic use
- Risk increases with duration of treatment and total cumulative dose
- TD may be irreversible and can develop even after discontinuation
- Healthcare providers monitor for early signs and recommend the lowest effective dose
Other Serious Conditions to Report
- Difficulty swallowing or aspiration risk
- Seizures (especially in patients with seizure history)
- Significant changes in blood pressure, particularly upon standing (orthostatic hypotension)
- Temperature regulation problems or unusually high body temperature
- Low white blood cell counts (leukopenia/neutropenia)
- New or worsening diabetes or elevated blood sugar
- Increased cholesterol or triglyceride levels
- Increased risk of falls (especially in elderly patients)
- Unusual urges (gambling, sexual, shopping, eating)
Important Precautions
Abilify Maintena should be used cautiously in patients with:
- Cardiovascular or cerebrovascular disease
- History of seizures
- Diabetes or family history of diabetes
- Metabolic syndrome
- Low white blood cell counts or history of drug-induced low counts
- Risk factors for aspiration or swallowing difficulties
- Conditions affecting temperature regulation
Pregnancy and Breastfeeding: Discuss potential risks and benefits with your healthcare provider before taking Abilify Maintena if you are pregnant, planning pregnancy, or breastfeeding.
Missed Dose Guidelines
If you miss an injection appointment, specific protocols apply:
If 4+ weeks to 6 weeks have passed:
Administer the injection as soon as possible and resume monthly schedule.
If more than 6 weeks have passed:
Contact your healthcare provider to restart treatment using the initiation regimen with oral overlap.
Important
Regular appointment scheduling is essential to maintain therapeutic medication levels. Contact CarePoint Infusion immediately if you need to reschedule your appointment.
Why Choose Abilify Maintena at CarePoint Infusion?
Professional Care
Our experienced clinical team administers Abilify Maintena in a comfortable, clinical environment with healthcare professionals who understand psychiatric medications and treatment.
Consistent Adherence
Monthly injections eliminate the daily burden of pill-taking, helping you maintain consistent medication levels and better symptom control.
Comprehensive Support
We provide clinical assessments, vital sign monitoring, medication management support, patient education, and coordination with your prescribing psychiatrist.
Flexible Scheduling
We work with your schedule to ensure consistent monthly injections that fit your lifestyle.
Patient-Centered Approach
Our team treats each patient with respect and dignity, providing a judgment-free environment focused on your mental health and recovery.
Serving Northeast Ohio Communities
CarePoint Infusion Center provides professional Abilify Maintena injection administration for schizophrenia and bipolar I disorder throughout Northeast Ohio. We serve patients from Cleveland, Beachwood, Akron, and surrounding communities in Cuyahoga County, Summit County, and beyond.
We conveniently serve patients from:
And throughout Cuyahoga County, Summit County, Mahoning County, and Northeast Ohio. Contact us today to schedule your consultation.
Insurance and Financial Assistance
CarePoint Infusion works with most major insurance plans. Our team will:
- Verify your insurance coverage before your first appointment
- Help you understand your out-of-pocket costs
- Provide information about manufacturer copay assistance programs
- Work with you to explore all available financial assistance options
Patient Support Programs
Abilify Maintena has patient assistance programs that may help reduce your out-of-pocket costs. For commercially insured patients, the Abilify Maintena Savings Card may allow you to pay as little as $10 per month. Ask our staff about eligibility and enrollment.
Getting Started
If your doctor has prescribed Abilify Maintena, CarePoint Infusion is here to provide your treatment in a supportive, professional setting. We coordinate directly with your prescribing physician to ensure seamless care.
Contact CarePoint Infusion today to schedule a consultation or your first injection appointment:
- Phone: 216-755-4044
- Address: 23215 Commerce Park Suite 318, Beachwood, OH 44122
- Hours: Monday-Friday, 9:00 AM - 5:00 PM
Visit our Contact page to send us a message or request an appointment.
Additional Resources
Learn more about mental health treatment and services:
- Ketamine Therapy - Treatment for treatment-resistant depression, PTSD, and anxiety
- Our Services - Comprehensive infusion and injection services
- Patients / Guests - Information for patients and their families
- About Us - Meet our team and learn about our facility
Important Safety Information & Disclaimer
WARNING: Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at increased risk of death compared to placebo. Abilify Maintena is not approved for treating dementia-related psychosis.
This information is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Abilify Maintena® is a registered trademark of Otsuka Pharmaceutical Co., Ltd. CarePoint Infusion is not affiliated with Otsuka.
For complete information, please see the Full Prescribing Information, including Boxed Warning, and Medication Guide for Abilify Maintena, or visit www.abilifymaintena.com.
Report side effects to Otsuka America Pharmaceutical, Inc. at 1-800-438-9927 or to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.