Abilify Maintena, made simple.
Abilify Maintena is a long-acting medicine for schizophrenia and for bipolar I disorder. Instead of a daily pill, it is one injection a month, given by your care team. This guide explains how it works, what to expect, and what to watch for. A Mississippi pharmacist wrote it for you, with care.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Abilify Maintena is and why your doctor gave it to you
Abilify Maintena is a medicine for schizophrenia and for the long-term care of bipolar I disorder in adults. Its other name is aripiprazole.
It is a long-acting injection. Instead of a daily pill, you get one injection, given by a nurse or your provider, about once a month. The medicine then releases slowly over the weeks between visits.
Abilify Maintena works a little differently than some other antipsychotic injections. It tends to cause less weight gain and fewer changes to blood sugar and cholesterol than some alternatives, though it has its own things to watch, which are covered below.
The simple version: Abilify Maintena is a once a month injection that keeps your treatment steady and lowers the chance of a relapse, without a daily pill to remember.
How Abilify Maintena works
Schizophrenia and bipolar I disorder involve brain chemicals being out of balance, especially one called dopamine.
Aripiprazole, the medicine in Abilify Maintena, works in a balancing way. Rather than simply blocking dopamine, it steadies the signal, calming it where it is too high and supporting it where it is too low. It also works on serotonin, another brain chemical.
Given as a long-acting injection, the medicine releases a little at a time across the month, keeping a steady level without the peaks and dips of a missed or doubled pill.
Your dose, and how the injections work
Abilify Maintena is given by your care team, not by you at home. Your doctor decides your dose. This page will not tell you what dose you should be on.
There is one thing to know about the start. For about the first 2 weeks after your first injection, you will also take aripiprazole in pill form. This is normal. The pills make sure enough medicine is in your system quickly while the injection builds up. After those first weeks, the injection alone does the job.
After that, it settles into one injection about once a month, and no sooner than 26 days after the last one.
Your monthly appointment, and what to do if you miss one
Because Abilify Maintena is given on a schedule by your care team, the most important habit is to keep your monthly injection appointments. Put each one on your calendar before you leave the clinic.
If you have to miss an appointment, the most important thing is what to do next.
If you miss a dose:
- If you cannot make an injection appointment, call your clinic right away. Do not just wait for the next month.
- If too much time passes between injections, your treatment may need to be restarted, and the exact window depends on how many injections you have already had.
- The sooner your clinic knows, the simpler the fix.
- Fairview can help if cost or a ride is the obstacle. Call us before the date, not after.
Side effects, what is normal and what is not
Common, and usually manageable.
- Soreness or a firm spot where the injection was given.
- Feeling drowsy or sleepy.
- Some weight gain, though often less than with some other antipsychotics.
- Restlessness, or a feeling that you need to keep moving. Tell your care team if this happens.
Call your doctor if you notice:
- New urges that are hard to control, such as gambling, shopping, eating, or sexual urges. This can happen with aripiprazole, it is treatable, and it is important to mention.
- Signs of higher blood sugar, or notable weight gain.
- Feeling dizzy or faint, especially when you stand up.
- New movements you cannot control, of the face, tongue, or hands.
Go to the emergency room right away if:
- You have a high fever, very stiff muscles, sweating, and confusion all together.
- You have a fast or irregular heartbeat, or you faint.
- You have a fever with a sore throat and mouth sores.
What to be careful with
One side effect of aripiprazole is worth its own mention, because it surprises people. In some patients it can trigger strong urges that are hard to control, most often gambling, but also shopping, eating, or sexual urges. If you or your family notice this, it is not a character flaw and it is not your fault. It is a known effect of the medicine, and it eases when the dose is adjusted. Tell your prescriber.
On other medicines: certain antifungal and antibiotic medicines can raise the level of aripiprazole in your body, and certain seizure medicines can lower it. Your doctor may adjust the dose around those.
The simple rule: tell every doctor and every pharmacist that you get Abilify Maintena injections, and mention any new medicine or supplement before you start it. Every single time.
Alcohol can add to drowsiness and dizziness, so it is best avoided or kept minimal. At Fairview, we keep your medicine list and check new prescriptions against it.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Abilify Maintena works best alongside some regular checks that keep you safe and confirm the medicine is helping.
Your doctor should check, now and then:
- Your weight, your blood sugar, and your cholesterol.
- Whether any new compulsive urges have appeared.
- Your blood pressure, including whether you feel dizzy standing up.
- Any new movements you cannot control.
Your pharmacist can help by:
- Keeping your full medicine list and checking new prescriptions against it.
- Answering questions about side effects between appointments.
- Helping with cost and assistance programs.
- Keeping your information private, always.
At Fairview, we keep an eye on our Abilify Maintena patients between appointments. Your care is handled discreetly and with respect.
Special situations
Not for older adults with dementia.
There is an FDA warning that all medicines in this group, including Abilify Maintena, raise the risk of death when used in older adults who have dementia. Abilify Maintena is approved for schizophrenia and bipolar I disorder, not for dementia. If a loved one with dementia has been prescribed it, ask the prescriber about this directly, so the decision is made with full information.
Compulsive urges.
This is the special situation most worth knowing about. Aripiprazole can, in some people, cause strong urges to gamble, shop, eat, or have sex. It is a side effect, not a moral failing. If you or someone close to you notices it, tell the prescriber. Adjusting the dose usually settles it.
Driving and machinery.
This medicine can cause drowsiness or dizziness, especially at first. Until you know how it affects you, do not drive or use heavy machinery.
Kidney problems.
Unlike some other antipsychotic injections, Abilify Maintena does not need a dose change for reduced kidney function. Still, always tell your prescriber about any kidney condition.
Pregnancy.
If you are pregnant, planning to become pregnant, or breastfeeding, tell your doctor. Babies exposed to antipsychotic medicines late in pregnancy can have muscle stiffness or withdrawal signs after birth. Treatment is planned carefully with your doctor.
Cost should never be the reason you stop.
There is a manufacturer savings program, and an assistance program for people with limited income. If cost is a worry, call Fairview before you miss an appointment.
How Fairview helps Abilify Maintena patients
When Fairview is part of your Abilify Maintena care, here is what you get. This is normal care for us, and it is always private.
When you start:
- We check all your other medicines and supplements against Abilify Maintena.
- We explain the first few weeks, including the starter pills.
- We talk through cost and help you find any program you qualify for.
Along the way:
- We answer questions about side effects between appointments.
- We check any new prescription against your medicine list.
- We help you keep your appointments on track.
On our own, without being asked:
- If we see a medicine that does not mix well, we call your doctor.
- We check your cost regularly to keep it as low as possible.
- We keep your care discreet and respectful, always.
Questions people ask about Abilify Maintena
It treats schizophrenia, and it helps maintain stability in bipolar I disorder, in adults. It is given as an injection about once a month by your care team.
Related guides
Have a question about your Abilify Maintena? Ask a pharmacist you can trust.
Steady treatment protects the progress you have made, and a once a month injection makes that easier to keep. Fairview is here to support you and your family through it, privately and without judgment.