aripiprazole lauroxil

General information

• Class: Long-acting injectable antipsychotic
• Common US brands: ARISTADA, ARISTADA INITIO
• Typical dose range: Initiation requires bridging: either a multi-week oral aripiprazole overlap or a one-day initiation strategy using Aristada Initio per label.
• Long-acting injectable formulation available.
• Therapeutic drug monitoring not routinely recommended; reference range 120–270 ng/mL.
• Last reviewed: 2025-12-30

Dosing & forms

• Forms/strengths: Intramuscular injection (interval varies by strength): monthly, every 6 weeks, or every 2 months per labeled schedules.; Initiation adjunct: Aristada Initio (single-dose initiation product).
• Frequency: Maintenance interval depends on strength (monthly, every 6 weeks, or every 2 months in labeled schedules). Injection site and technique vary by dose and product instructions.
• Typical range: Initiation requires bridging: either a multi-week oral aripiprazole overlap or a one-day initiation strategy using Aristada Initio per label.
• Therapeutic range: 120–270 ng/mL

Mechanism (brief)

Long-acting injectable prodrug of aripiprazole (D2/D3 partial agonist with 5-HT1A partial agonism and 5-HT2A antagonism) designed for extended dosing intervals to support adherence in schizophrenia maintenance.

Metabolism & Half‑life

• Metabolism: CYP2D6, CYP3A4
• Half‑life: Steady-state range 1294–1373 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Reference range: 120–270 ng/mL

Long‑acting injectable (LAI)

Monitoring highlights

• Weight/BMI and waist circumference; fasting lipids and glucose/HbA1c at baseline and periodically.
• Movement disorder monitoring (akathisia, parkinsonism, tardive dyskinesia), especially after initiation.
• Blood pressure/orthostasis when clinically indicated (older adults, dehydration, antihypertensive co-use).
• Injection site assessment and documentation (dose, site, local reactions).

Sources

• ARISTADA (aripiprazole lauroxil) extended-release injectable suspension — Prescribing Information — DailyMed (2025)
• ARISTADA INITIO (aripiprazole lauroxil) extended-release injectable suspension — Prescribing Information — DailyMed (2025)
• The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia — American Psychiatric Association (2020)
• Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017 — Pharmacopsychiatry (2018)