Aripiprazole

What is Aripiprazole for?

Aripiprazole belongs to a class of medications known as atypical (second-generation) antipsychotics. It is used to treat and prevent the return of symptoms in Schizophrenia and other mental health related conditions such as:

• Hearing, seeing or sensing things that are not real
• Having mistaken beliefs
• Uncontrolled anger
• Being overly suspicious

It can be used to treat symptoms in bipolar disorder such as:

• Very high mood
• Irritability
• Increased activity and energy
• Depression/ low mood

It can also be used to treat (in combination with other medications) symptoms of depression (low mood) such as:

• Feeling sad
• Feeling hopeless or useless
• Feeling bad about yourself
• Thoughts of ending your life
• Poor sleep, energy or appetite

Aripiprazole may be used for other conditions such as irritability relating to autism (a type of developmental condition) and Tourette’s Disorder (a movement or muscle related condition). Check with your healthcare professional if you are unsure why you are given this medicatio

How should I take or use Aripiprazole?

For Aripiprazole tablet/ oral solution:

• Take your medication according to the instructions stated on the medication label.
• Aripiprazole may be taken with or without food.
• Do not stop taking or adjust the dose of this medication without checking with your doctor.
• Aripiprazole needs to be taken regularly for a few weeks before you can feel its full benefits. You should not stop taking this medication even if you do not feel better at the beginning. Continue to take this medication even after you feel better to prevent your symptoms from returning.
• Do check with your doctor on how long you will have to be on this medication.

For Aripiprazole depot injection:

• Aripiprazole is injected into your upper arm or buttocks.

What should I do if I forget to take or use Aripiprazole?

For Aripiprazole tablet/oral solution:

• If you forget to take a dose, take it as soon as you remember. However, if more than half of the time to the next dose has passed, skip the missed dose and take the next dose at your usual timing.
• For example, for a medication to be taken two times daily at 8am and 8pm, and you missed your first dose at 8am, skip the first dose if it is after 2pm, and take your second dose at the usual timing at 8pm. Do not take two doses to make up for the missed dose.

For Aripiprazole depot injection:

Please call up your doctor to arrange an appointment visit.

What precautions should I take when taking or using Aripiprazole?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side effects with you and should you have further questions or concerns, do consult your doctor.
• You are taking any other medications (including those that can be bought without a prescription), supplements, traditional Chinese medicine and herbal products. Some of them may affect how this medication works or cause serious drug interactions.
• You have diabetes. Aripiprazole may sometimes worsen blood sugar control in diabetes. Maintain regular check-ups with your doctor.
• You have or have ever had:
  • Other drug allergies
  • Medical conditions such as:
    • Liver disease, irregular heartbeat or other heart problems, stroke, history of blood clots
    • Dementia, seizure (fits), high or low blood pressure, high cholesterol/ fats in the blood, swallowing difficulties, blood disorders

What food or medication should I avoid when I take or use Aripiprazole?

Avoid drinking alcohol while taking Aripiprazole as it can cause excessive sleepiness.

What are some common side effects of Aripiprazole?

The mentioned side effects generally affect up to 10% of patients.

• Nausea, vomiting
  • Take the medication with or after food
  • Take small but more frequent meals, and avoid fatty or spicy food
• Constipation
  • Drink more water (if you do not have any fluid restriction), eat more high-fibre foods, and exercise regularly
  • Speak to your doctor or pharmacist if you need a medication to help with your constipation
• Difficulty sleeping
  • Discuss with your doctor if you can take your medication at a different time of the day
  • Listen to relaxing music at bedtime
  • Avoid eating or drinking too much before bedtime
  • Limit your caffeine intake (such as coffee, tea or energy drinks) at least 8 hours before bedtime
• Drowsiness or feeling tired
  • Avoid driving or taking part in activities that require concentration
  • Discuss with your doctor if you can take your medication at a different time of the day
• Dizziness
  • Get up slowly from a sitting or lying down position
• Uncontrollable shaking of limbs (tremors) and/or restlessness or need to keep moving constantly (akathisia)
• Increase in appetite, weight gain
  • Exercise regularly and eat a healthy and balanced diet
• Mild pain, itchiness, redness or swelling at the injection site (For Aripiprazole depot injection only)

Most of the side effects listed here will improve with time. Speak with your doctor if any of them continues, worsens or affects your daily life.

What are some rare but serious side effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Rarely this medication may cause:

• Confusion, high fever, severe muscle stiffness, irregular blood pressure (signs and symptoms of neuroleptic malignant syndrome)
• Muscle movement side effects (extrapyramidal side effects) – do speak to your doctor for further management. Examples include:
  • Muscle stiffness and spasms (such as in the face, neck and back), twitching or difficulty in speaking or swallowing (symptoms of dystonia)
  • Uncontrollable movements (such as in the face, tongue, jaw or other parts of the body) (tardive dyskinesia)
• Difficulty in passing urine (urinary retention)
• Fast or irregular heartbeat, fainting episodes (signs and symptoms of an abnormal heart beating rhythm (prolonged QTc interval))
• Fever, chills, sore throat and/or mouth ulcers that do not go away (symptoms of blood dyscrasias)
• Severe chest pain, difficulty breathing, or severe pain or swelling in either of the legs (symptoms of venous thromboembolism)
• Sudden weakness or numbness in the face, arms or legs, and speech or vision problems (signs and symptoms of stroke)
• Excessive hunger, unusual increase in thirst or passing large amount of urine (symptoms of high blood sugar)
• Seizures (fits)
• Uncontrollable excessive urges and behaviours such as gambling, excessive eating, shopping or having sex
• Increased prolactin hormone in the body (hyperprolactinemia):
  • Changes in menstrual cycle in females (Irregular or stopping of menstrual periods) and/or
  • Abnormal breast swelling, soreness or secretion (in both men and women)

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

IMPORTANT:

In some cases, particularly in young people below the age of 25 years, this medication may cause the following changes to a person’s mental condition, especially in the first few weeks of treatment or during dose changes:

• New or worsening thoughts of harming yourself or ending your life
• Worsening agitation, restlessness, violent behaviour, or
• Other changes in mood or behaviour

Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own.

Do not stop taking this medication on your own without discussing with your doctor.

It is important to note that your doctor has prescribed this medication as he/she feels you will benefit more from taking this medication over the possible risks that it may cause. Most people will have taken this medication without having any of such problems.

How should I store Aripiprazole?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away Aripiprazole safely?

For Aripiprazole tablet/oral solution:

Pack this medication into a trash bag and seal it tightly before throwing into the rubbish chute or bin.

For Aripiprazole depot injection:

If used at home, you may throw this injection away along with the used needles, into a metal tin, or glass jar or thick plastic container (e.g. detergent bottles) before throwing into the rubbish chute or bin to prevent any needle stick injury.