How Aristada Is Administered in a Clinical Setting
Aristada (aripiprazole lauroxil), a long-acting injectable antipsychotic for schizophrenia, is given intramuscularly (IM) by healthcare professionals only. It requires deep IM injection into the gluteal or deltoid muscle using a safety needle. Administration occurs in a clinic or hospital under supervision, never by patients themselves.[1]
Required Initial Dosing Steps
Patients must first receive either oral aripiprazole or Aristada Initio (another aripiprazole lauroxil injection) on the same day as the first Aristada dose. This supplements the extended-release formulation until it activates, typically within 3 weeks via enzymatic conversion to aripiprazole.[1][2]
Available Doses and Injection Sites
- Gluteal muscle: Supports 441 mg, 662 mg, 882 mg, or 1064 mg doses using a 2-inch needle.
- Deltoid muscle: Limited to 441 mg or 662 mg using a 1-inch needle.
Doses are monthly for most patients, or every 6-8 weeks at higher strengths (882 mg or 1064 mg).[1]
| Dose (mg) | Gluteal Volume | Deltoid Volume |
|-----------|----------------|---------------|
| 441 | 1.75 mL | 1.75 mL |
| 662 | 2.62 mL | 2.62 mL |
| 882 | 3.50 mL | Not available|
| 1064 | 4.20 mL | Not available|
Step-by-Step Administration Process
1. Confirm patient eligibility and recent oral tolerance.
2. Shake pre-filled syringe vigorously for at least 30 seconds to suspend particles.
3. Attach safety needle (do not use other needles).
4. Prime by tapping and expelling air.
5. Inject slowly (over 10-20 seconds for deltoid, longer for gluteal) at a 90-degree angle.
6. Activate needle safety mechanism post-injection and discard.[1][2]
No reconstitution needed; syringes are ready-to-use but refrigerated until 30 minutes before injection.
Timing Between Doses and Monitoring
Monthly doses start day 1 after initiation. Allow a 5-week window for delays; oral supplementation covers gaps. Monitor for injection-site reactions like pain or swelling, which affect <5% of patients.[1]
What If a Dose Is Missed or Overdosed?
- Missed: Administer as soon as possible, then resume schedule. Use oral aripiprazole if >6 weeks late.
- Overdose: No specific antidote; treat symptoms supportively in a clinical setting.[1]
[1]: Aristada Prescribing Information (Alkermes)
[2]: Drugs.com - Aristada Administration Guide