Abilify Maintena
Abilify Maintena (aripiprazole) is a long-acting injection that helps treat schizophrenia and bipolar 1 disorder in adults. It's a type of medication called an atypical antipsychotic. People usually get one dose injected into the muscle once a month at a medical office. Some side effects include weight gain, feeling like you can't sit still, and injection site reactions.
What is Abilify Maintena (aripiprazole)?
What is Abilify Maintena (aripiprazole) used for?
Schizophrenia in adults
Bipolar 1 disorder in adults
How Abilify Maintena (aripiprazole) works
Abilify Maintena (aripiprazole) is an atypical antipsychotic. It's thought to work by balancing the dopamine and serotonin activity in the brain. This might help regulate your thoughts, mood, and behaviors.
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What are the side effects of Abilify Maintena (aripiprazole)?
Common Side Effects
- Weight gain (17%)
- Restlessness (11%)
- Constipation (10%)
- Pain at injection site (5%)
- Sleepiness (5%)
Other Side Effects
- Dry mouth
- Joint pain
- Back pain
- Muscle pain
- Tremor
- Dizziness
- Diarrhea
- Vomiting
- Stomach upset
- Stuffy nose
- Upper respiratory tract infection
- Weight loss
Serious Side Effects
- Neuroleptic malignant syndrome (NMS): high fever, sweating a lot, muscle stiffness, confusion, irregular pulse, fast heartbeat
- Uncontrolled muscle movements: involuntarily sticking out your tongue, puffing out your cheeks, puckering your mouth, lip smacking, chewing, or foot tapping
- Extremely high blood sugar levels: feeling very hungry or thirsty, urinating more often, stomach pain, weakness, fruity-smelling breath
- Impulse control problems: strong urges for gambling, shopping, binge eating, or engaging in sexual activity
- Infection: fever, chills, sore throat, cough, weakness
- Seizures
- Trouble swallowing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Pain or trouble swallowing
- Prolonged or painful erection
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
- Uncontrolled and repetitive body movements, muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, restlessness, shuffling walk, which may be signs of extrapyramidal symptoms (EPS)
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
- Urges to engage in impulsive behaviors such as gambling, binge eating, sexual activity, or shopping in ways that are unusual for you
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Constipation
- Drowsiness
- Pain, redness, or irritation at injection site
- Weight gain
Pros and cons of Abilify Maintena (aripiprazole)
Pros
Given once a month
Dose can be adjusted if you're having side effects
Okay for people with liver or kidney problems to take
Cons
Has to be injected by a healthcare professional
Can cause weight gain and soreness at the injection site
Not yet studied in people 18 years and younger
Pharmacist tips for Abilify Maintena (aripiprazole)
If you've never taken aripiprazole before, you might need to start treatment with aripiprazole tablets (Abilify) first. This helps you and your prescriber see how well your body responds to it without starting with a long-acting form of the medication right off the bat. When your prescriber decides it's okay for you to switch to Abilify Maintena (aripiprazole), you'll need to continue taking aripiprazole tablets (Abilify) for 2 weeks after your first injection.
Be sure to get your Abilify Maintena (aripiprazole) injections regularly. Mark your calendar or set reminders for your injection appointments. If possible, plan ahead for when you're out of town.
If you missed your appointment, call your healthcare team as soon as you can to reschedule. Depending on when your last injection was, you might need to also take aripiprazole tablets (Abilify) to help you get back on track with your treatment.
Abilify Maintena (aripiprazole) can make it harder for your body to cool down. Make sure to stay hydrated if you're working out or if the weather is hot. Try not to stay out in the sun for too long or do other things that can raise your body temperature.
Let your care team know if you notice any sudden urges you can't control, like shopping too much, gambling, strong sexual feelings, or binge eating. Abilify Maintena (aripiprazole) might be causing this. Your prescriber can lower your dose or change your medication to see if it helps.
Abilify Maintena (aripiprazole) can sometimes make you have movements that you can't control. They can happen in the face, tongue, or other parts of the body. Tell your care team if you have any movement problems while taking this medication.
Abilify Maintena (aripiprazole) can raise your blood sugar. Tell your prescriber if you get extremely thirsty or hungry or if you urinate more than usual. These can be signs of high blood sugar.
Talk to your prescriber if you're pregnant or planning to get pregnant. Antipsychotics like Abilify Maintena (aripiprazole) can sometimes harm your baby if taken while pregnant. Some problems can include uncontrolled muscle movement or withdrawal symptoms after birth. Your prescriber can review the risks and benefits of taking this medication during pregnancy. You're encouraged to join the National Pregnancy Registry for Psychiatric Medications if you take it while expecting. This program helps researchers learn more about how safe antipsychotics are during pregnancy.
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Frequently asked questions about Abilify Maintena (aripiprazole)
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What are the risks and warnings for Abilify Maintena (aripiprazole)?
Abilify Maintena (aripiprazole) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Higher risk of death in older adults with dementia-related psychosis
People who over 65 or older with dementia might sometimes have hallucinations or delusions. This is called dementia-related psychosis.
Abilify Maintena (aripiprazole) shouldn't be used to treat dementia-related psychosis. There's a higher risk of death in people with dementia-related psychosis who take this medication. In studies, most causes of death were from heart problems, stroke, or infections.
Tell your prescriber if you have dementia before starting Abilify Maintena (aripiprazole). If you're a caregiver, make sure the prescriber knows the person you care for has dementia.
Neuroleptic malignant syndrome
Antipsychotic medications like Abilify Maintena (aripiprazole) can sometimes cause a reaction called neuroleptic malignant syndrome (NMS). This is rare, but it can be life-threatening if it happens. Look out for symptoms like a high fever, heavy sweating, stiff muscles, confusion, or an irregular heartbeat. If you have any of these symptoms, stop taking Abilify Maintena (aripiprazole) and get emergency medical help.
Difficulty controlling muscle movements (tardive dyskinesia)
Risk factors: Older adults | Female who's 65 years or older | Taking high doses of antipsychotic medications | Taking Abilify Maintena (aripiprazole) for a long time
Abilify Maintena (aripiprazole) might cause muscle movements that you can't control. This is called tardive dyskinesia (TD). Sometimes, it goes away after you stop taking the medication. But your risk for TD and the chance it could be permanent is higher if you take this medication for a long time. The risk could also be higher if you take more than one antipsychotic medication at the same time.
Tell your prescriber if you have any movements you can't control in your face, tongue, or other parts of your body while taking Abilify Maintena (aripiprazole).
High blood sugar, high cholesterol, and weight gain
Risk factors: History of diabetes | History of high cholesterol | Considered obese
Abilify Maintena (aripiprazole) can raise your blood sugar. In some cases, it can get so high that it becomes dangerous and could lead to coma or even death. If you check your blood sugar at home and it stays higher than usual, tell your care team. Also let them know if you feel very hungry or thirsty, urinate more often, have stomach pain, feel weak, or have fruity-smelling breath. These can be signs of high blood sugar.
Abilify Maintena (aripiprazole) can also cause high cholesterol and weight gain. Your prescriber will check your weight, blood sugar levels, and cholesterol levels regularly to make sure it's safe for you. Talk to your healthcare team if you're concerned about your weight or lab results.
Intense urges
Some people had strong urges that were hard to control while taking Abilify Maintena (aripiprazole). Let your care team know if you notice any new urges or habits, like gambling, sexual urges, shopping too much, or binge eating. If you start doing things without thinking or feel like you can't stop certain urges, also tell your prescriber. They might need to adjust or stop your medication.
Risk of falls
Risk factors: Older adults | Dehydration | Medical conditions that cause balance problems | Taking medications that lower blood pressure or cause balance problems
Abilify Maintena (aripiprazole) can make you sleepy or lose your balance. It can also lower your blood pressure when you stand up. These effects can make it easier to fall and possibly get hurt. Let your prescriber know if you have any other conditions or take medications that also affect your balance or blood pressure and could put you at risk of falls.
Problems focusing
Risk factors: Drinking alcohol | Taking other medications that cause sleepiness
Abilify Maintena (aripiprazole) can make you sleepy and make it harder to focus. This can be worse if you drink alcohol or take other medications that also make you sleepy. Don't drive or do anything that needs your full attention until you know how Abilify Maintena (aripiprazole) affects you.
Higher risk of infections
Risk factors: History of low white blood cell counts | Taking medications that lower the white blood cell count
Some people who take Abilify Maintena (aripiprazole) can have a low white blood cell (WBC) count. When you have low WBC levels, your body has a harder time fighting off germs. This puts you at a risk for infections.
You might need to get lab work done regularly during treatment to make sure your WBC count is in a safe range. If the levels are too low, your prescriber might stop your medication.
Talk to your care team right away if you have symptoms of an infection, such as fever, weakness, or sore throat, while taking this medication.
Use with caution in people who've had seizures
Let your prescriber know if you've had a seizure in the past before starting Abilify Maintena (aripiprazole). This medication can raise the chance of having a seizure. Get medical help right away if you have a seizure while taking Abilify Maintena (aripiprazole).
Abilify Maintena (aripiprazole) dosage forms
Typical dosing for Abilify Maintena (aripiprazole)
Abilify Maintena (aripiprazole) is an intramuscular (IM) injection that's administered by a healthcare professional.
The typical dose is 400 mg injected into the arm or buttock muscle once a month. If you have side effects with this dose, your prescriber might lower it to 300 mg.
Your dose might be different if you have certain genetics or take certain medications that make your body have trouble breaking down Abilify Maintena (aripiprazole).
How much does Abilify Maintena (aripiprazole) cost?
Abilify Maintena (aripiprazole) contraindications
Allergy to other aripiprazole medications
What are alternatives to Abilify Maintena (aripiprazole)?
Schizophrenia in adults
Bipolar 1 disorder in adults
Schizophrenia in adults
Bipolar 1 disorder in adults
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References
Best studies we foundDean, L., et al. (2025). Aripiprazole therapy and CYP2D6 genotype. Medical Genetics Summaries.
MedlinePlus. (2024). Psychosis.
Otsuka America Pharmaceutical, Inc. (2025). Abilify Maintena- aripiprazole kit [package insert]. DailyMed.
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