The injectable form of Aripiprazole (injection) is mostly given as an intramuscular (IM) injection by a healthcare professional. The two common formulations are:

• Abilify Maintena: Administered as an injection once a month. 

• Abilify MyCite: Administered as an injection every two weeks and has a smart pill system also mapping adherence to treatment. Here’s how Aripiprazole injection is usually used: 

• Administration: It is injected by a healthcare provider, usually in an intramuscular manner (this means into a muscle). This is usually done in either the gluteal muscle (buttocks) or the deltoid muscle (upper arm). 

• Starting treatment: If you were on oral Aripiprazole before, transitioning will usually involve taking a few doses of oral Aripiprazole to check tolerance of the drug prior to commencing the injection. Thereafter, the injection will be administered for maintenance therapy.

Aripiprazole operates at several bio-targets in the brain including receptors for dopamine and serotonin. 

Aripiprazole acts as a functional antagonist of dopamine D2 and serotonin 5-HT1A receptors. This means that unlike natural neurotransmitters, these Treaments provide a stimulus to the receptors but of a lesser intensity.

 This mechanism assists in balancing the levels of serotonin and dopamine oscillations in the system.

• Dopamine: Aripiprazole lowers dopamine levels which are often clamped in chlorpromazine resistant schizophrenia, bipolar with psychotic features and other disorders. This AD can intermittently activate a response through dopamine receptors, which in turn lessens the effects of hallucinations and delusions schizophrenia patients experience and works to stabilize patients who are Dopamine sensitive.

• Serotonin: Aripiprazole also affects the level of serotonin, which is known to regulate mood. It resolves depressive and anxious states in mixed bipolar disorder by interacting with the serotonin 5-HT1A receptor and antagonizing the 5-HT2A receptor.

As with all medications available, Aripiprazole injections, like other anti-psychotic drugs have their side effects. The most common side effects include:

• Injection site reactions: These are characterized by pain, swelling or redness at the site of injection.

• Restlessness or agitation: This is popularly known as akathisia, which refers to the feeling of being restless inside. 

• Drowsiness or fatigue: According to some people, they have experienced weariness or sleepiness after the administration of the injection. 

• Headache: It is common to have mild to moderate level of headache especially during the commencement of the treatment. 

• Dizziness: Several patients are noted to experience dizziness particularly while standing up after sitting down for a long time. Serious side effects are reported less often but may include the following: 

• Tardive dyskinesia: This is defined by random movements of body parts usually the face region. Tardive dyskinesia is common with older antipsychotic medications but thanks to the introduction of aripiprazole this is a rare condition.

Aripiprazole (injection) should not be taken before discussing your medical history with your doctor. Areas of focus include:

• Pregnancy and breastfeeding: Aripiprazole is in the C category for use in pregnant women. This categorization means that the medication should not be used unless the advantages outweigh the disadvantages. It is unclear whether Aripiprazole is excreted in breast milk therefore, inform your physician if you are pregnant, intending to get pregnant, or breastfeeding.

• Past medical history of the patient: when a patient has a past medical history of movement disorders, for instance, Parkinson’s disease, the dosage of the drug may require adjustments or affirmation with the patient would be more stringent to avoid side effects such as shaking or stiffening.

• Hepatic ability: Dosages of Aripiprazole may require modifications and stricter observation of patients due to the treatment in patients that have liver complications.

• Cardiovascular concerns: Heart rate and blood pressure may be altered upon taking Aripiprazole treatment. Cardiovascular burdened patients should be under observation throughout the period of treatment.

• Adolescents and children: Cases of the incidence with non-efficacy of Aripiprazole injection in children and adolescents have occurred for certain indications. A doctor’s recommendations should be strictly adhered to when dealing with a younger clientele.

Immediate-release injectable form: Usually administered in cases of acute agitation or for the rapid stabilization of patients. Dosage usually consists of 9.75 mg injected intramuscularly (IM) and is repeated if required. Injection is usually a single dose, although subsequent doses are considered depending on the condition of the patient.

Extended-release injectable form: Administered once a month for the maintenance treatment of schizophrenia or bipolar disorder. The usual dose is 400 mg once a month, but it may be adjusted based on the patient’s response and tolerability.

Drug Interactions:

CYP450 Enzyme Interactions: Similar to its oral formulation, Aripiprazole injections are metabolized by CYP3A4 and CYP2D6. Coadministration with strong CYP3A4 inhibitors (such as ketoconazole) or CYP2D6 inhibitors (such as fluoxetine, paroxetine) results in increased plasma levels of Aripiprazole. In such cases, a dose reduction may be needed to avoid side effects, such as sedation or akathisia.

Conversely, CYP3A4 inducers (e.g., carbamazepine, rifampin) may reduce Aripiprazole levels and decrease its effectiveness. In this case, dosage adjustment may be necessary to ensure therapeutic levels are maintained.

Sedation and Other CNS Depressants:

Aripiprazole should be used with extreme caution when administered with other CNS depressants (e.g., benzodiazepines, opioids, alcohol), as these agents may enhance sedation or drowsiness. Patients who receive the injectable form should be closely monitored for excessive sedation and other adverse effects.

Neuroleptic Malignant Syndrome (NMS) Risk:

Like other antipsychotics, NMS (rare but serious) has been reported with Aripiprazole injections. The risk may be enhanced if combined with other dopamine antagonists or antipsychotics. In cases of NMS, drug should be stopped immediately and appropriate medical treatment started right away. Injection Site Reactions:

Intramuscular injections can cause site reactions such as pain, redness, or swelling. Other medications that cause tissue irritation or poor blood circulation may worsen these effects.

Missed Dose for Injectable Form:

If the extended-release injection is missed, it is usually administered as soon as possible. However, the timing of the next dose should be adjusted, so a healthcare provider should assess the patient and recommend an appropriate schedule. For immediate-release injections, doses can be administered more frequently if required but should not exceed the recommended dosing schedule.

The dosage will be determined based on the condition being treated. 

• Schizophrenia: Usually once a month 400 mg is administered as Abilify Maintena after two weeks of oral Aripiprazole therapy to give time for tolerance to develop.
• Bipolar Disorder: The usual initial dose of 400mg Injection/Once A Month is similar to Abilify Maintena which may be increased depending the response from the patient.
• Usage: Your doctor may have to alter your dose at any point in order to properly minimize or eliminate the target symptom completely. Fluctuations in dosage are permissible according to clinical improvement, side effects noticed and the objectives of treatment, respectively.

Aripiprazole (injection) is a medicament that cannot be obtained without a prescription and only a qualified health professional may issue such a prescription. Your doctor will decide whether this medication

1. What is Aripiprazole injection used for?
   Aripiprazole injection is primarily used to treat schizophrenia, bipolar disorder, and as an adjunctive treatment for major depressive disorder.

2. How is Aripiprazole injection administered?
   It is typically administered as an intramuscular injection by a healthcare professional.

3. What are the common side effects of Aripiprazole injection?
   Common side effects may include sedation, akathisia, anxiety, headache, and nausea.

4. How often is Aripiprazole injection given?
   The frequency of injections can vary; some formulations are given once a month, while others may be given every two weeks.

5. Is Aripiprazole injection safe during pregnancy?
   The safety of Aripiprazole injection during pregnancy is not well established. Patients should discuss risks and benefits with their healthcare provider.

6. Can Aripiprazole injection be used in children?
   Aripiprazole injection can be prescribed to adolescents aged 13 and older for certain conditions, but its use in younger children should be closely monitored.

7. What should I do if I miss a dose of Aripiprazole injection?
   If a dose is missed, contact your healthcare provider for guidance on when to reschedule the injection.

8. Are there any drug interactions with Aripiprazole injection?
   Yes, Aripiprazole can interact with other medications, including antidepressants, mood stabilizers, and certain antifungals. Always inform your doctor of all medications you are taking.

9. What are the serious side effects of Aripiprazole injection?
   Serious side effects may include neuroleptic malignant syndrome (NMS), tardive dyskinesia, and cardiovascular problems. Seek medical attention if any severe symptoms occur.

10. How does Aripiprazole injection work in the brain?
    Aripiprazole acts as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors, helping to stabilize mood and thought processes.

11. Can Aripiprazole injection cause weight gain?
    Weight gain is a potential side effect of Aripiprazole, but it is generally considered to be less common than with other antipsychotics.

12. What should I avoid while receiving Aripiprazole injection?
    Alcohol should be avoided as it can increase drowsiness and decrease the effectiveness of the medication. Be cautious with other sedatives as well.

13. Is Aripiprazole injection long-acting?
    Yes, there are long-acting formulations of Aripiprazole designed for extended release, which help maintain stable medication levels.

14. Can I stop taking Aripiprazole injection abruptly?
    No, abrupt discontinuation can lead to withdrawal symptoms or a relapse of the underlying condition. Always consult your healthcare provider before stopping.

15. Does Aripiprazole injection affect cognitive function?
    Aripiprazole is less likely to impair cognitive function compared to some other antipsychotics, but individual responses can vary.

16. What monitoring is required during treatment with Aripiprazole injection?
    Regular follow-ups are needed to monitor mental health status, weight, and potential side effects. Blood tests may also be required in some cases.

17. Can Aripiprazole injection be given with food?
    Yes, Aripiprazole injection does not have specific dietary restrictions, but discuss any concerns with your healthcare provider.

18. What if I experience severe anxiety or agitation while on Aripiprazole injection?
    Contact your healthcare provider immediately, as these may be symptoms of a serious side effect or need for medication adjustment.

19. Is it possible to develop a tolerance to Aripiprazole injection?
    Tolerance can develop over time in some individuals, but not everyone. Regular assessments by your healthcare provider are important.

20. Where can I find more information about Aripiprazole injection?
    For more detailed information, consult healthcare professionals, package inserts, or reputable medical websites like the FDA or CDC.