Abilify Maintena® Long-Acting Injection for Schizophrenia Maintenance

What Abilify Maintena Is and How It Works

Abilify Maintena® is a once-monthly long-acting injectable form of aripiprazole. It is used for maintenance treatment of schizophrenia in adults and, in some regions, for maintenance treatment of bipolar I disorder in adults. The medicine is given as an intramuscular injection in the deltoid or gluteal muscle. Abilify Maintena builds steady aripiprazole levels to help reduce relapse risk over time.

YouDrugstore is a licensed Canadian pharmacy headquartered in Manitoba; prescriptions are reviewed by licensed pharmacists before dispensing. We serve US patients at Canadian prices and ship directly to your address.

Aripiprazole is a dopamine D2 and serotonin 5-HT1A partial agonist and a 5-HT2A antagonist. This balanced activity helps stabilize dopamine and serotonin signaling. Patients stabilized on oral aripiprazole may transition to the long-acting injection for ongoing maintenance.

Abilify Maintena comes as a vial kit or prefilled dual-chamber syringe that is reconstituted into a ready-to-inject suspension. The typical maintenance dose is 400 mg once monthly (no sooner than 26 days between doses). Some patients use 300 mg monthly based on tolerability or interactions.

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Dosage and Usage

• Initiation: give 400 mg intramuscularly once, then continue oral aripiprazole for 14 consecutive days to maintain therapeutic levels.
• Alternative start (where approved): two separate 400 mg intramuscular injections on day 1 plus a single 20 mg oral aripiprazole dose, then continue with monthly injections.
• Maintenance: 400 mg intramuscularly every month; reduce to 300 mg if adverse reactions occur or when interacting medicines require adjustment.
• Sites: inject into the deltoid or gluteal muscle only. Do not give intravenously or subcutaneously. Alternate injection sites each month.
• Reconstitution: healthcare professionals reconstitute the suspension per the kit directions and shake vigorously before injection to ensure uniform dosing.
• Needle selection: use the needle provided in the kit that matches the chosen site and patient build.
• Volume: the 400 mg dose corresponds to 2 mL of the reconstituted suspension (200 mg/mL).
• Missed second or third dose: if 4 to 5 weeks have passed since the last injection, administer as soon as possible. If more than 5 weeks have elapsed, restart with 14 days of oral aripiprazole supplementation (or the approved alternative start).
• Missed fourth or later dose: if 4 to 6 weeks have passed, give the dose as soon as possible. If more than 6 weeks have elapsed, resume with 14 days of oral aripiprazole supplementation (or the approved alternative start).
• Drug interactions: strong CYP3A4 or CYP2D6 inhibitors may require a reduced monthly dose (for example, 300 mg). Avoid use with chronic strong CYP3A4 inducers, as exposure may be inadequate.

• Storage (unmixed): store the kit at 20–25 °C (68–77 °F). Short excursions between 15–30 °C (59–86 °F) are acceptable. Keep in the original carton. Do not freeze.
• After reconstitution: the suspension should be used promptly. If needed, keep at room temperature and use within 4 hours.
• Travel: keep your medicine in original packaging. Protect from heat above 30 °C (86 °F). Do not freeze.
• Transport: use an insulated pouch in hot climates. Do not leave the kit in a parked car.
• At your appointment: bring the entire Abilify Maintena kit so a healthcare professional can prepare and inject it.

Benefits and Savings

Once-monthly dosing supports adherence and may reduce relapse and hospitalization risk compared with missed daily tablets. Aripiprazole has a neutral effect on prolactin for many patients, and the long-acting form can deliver steady exposure with fewer daily fluctuations. Many patients appreciate the predictable clinic schedule and the convenience of not taking a daily antipsychotic.

Ordering from Canada often lowers costs. You may see 60–80% savings compared with typical US retail pricing, especially for multi-month supplies. You can set gentle reorder reminders in your account so you never run short, and bulk promotions can lower the per-month cost.

For extra savings, see our promotions page for an abilify maintena manufacturer coupon.

We ship to the US with prompt, express handling. Your order is discreetly packed and tracked. Support is available by online chat during posted hours.

Side Effects and Safety

• Injection-site pain, redness, or swelling
• Akathisia or restlessness
• Headache or dizziness
• Somnolence or insomnia
• Nausea, vomiting, or constipation
• Anxiety or agitation
• Tremor or extrapyramidal symptoms
• Weight change and appetite change
• Orthostatic lightheadedness
• Fatigue

Serious but less common risks include neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes (hyperglycemia and dyslipidemia), seizures, leukopenia/neutropenia, and impulse-control issues. Elderly patients with dementia-related psychosis treated with antipsychotic drugs have an increased risk of death; Abilify Maintena is not approved for this use. Avoid alcohol or other sedatives that increase drowsiness. Report concerning symptoms promptly.

Onset Time

Some patients notice symptom improvements within 1 to 2 weeks after the first injection, especially if stabilized on oral aripiprazole before switching. Levels build gradually with each monthly dose. Steady state is typically reached after about 4 monthly injections. Clinical benefits often consolidate over 4 to 12 weeks, with continued stabilization thereafter.

Weight and metabolic parameters change slowly. Your care team may monitor weight, glucose, and lipids over months to guide care.

Compare With Alternatives

Invega Sustenna (paliperidone palmitate) is a once-monthly injection with a two-dose initiation day 1/day 8 and no oral overlap. It may suit patients who respond to paliperidone or risperidone but can raise prolactin and cause weight gain in some.

Risperdal Consta (risperidone long-acting injection) is dosed every 2 weeks and requires a 3-week oral overlap at initiation. It has extensive real-world experience but involves more frequent clinic visits.

Aristada (aripiprazole lauroxil) is available in several dosing intervals (monthly to every 2 months). It uses a prodrug of aripiprazole. Initiation strategies differ, and dose selection depends on prior response and tolerability.

Your clinician will weigh prior response, tolerability, clinic visit schedules, and comorbidities when selecting a long-acting antipsychotic.

Combination Therapy

• With oral aripiprazole during initiation (14 days) to maintain levels.
• With mood stabilizers (lithium or valproate) for bipolar maintenance as clinically indicated.
• With antidepressants when treating comorbid depression, monitoring for activation or akathisia.
• With benzodiazepines short term for agitation or insomnia, watching for additive sedation.
• Adjust doses when using strong CYP3A4 or CYP2D6 inhibitors; avoid chronic strong CYP3A4 inducers.
• Reassess anticholinergics if extrapyramidal symptoms occur; use the minimal effective dose.

Patient Suitability and Cost-Saving Tips

Good candidates include adults diagnosed with schizophrenia who have responded to aripiprazole, and those who prefer or need a scheduled clinic injection over daily tablets. Adults with bipolar I disorder on maintenance therapy may be candidates where approved. Patients who struggle to remember daily doses often benefit from a monthly plan.

Abilify Maintena is not for dementia-related psychosis. Do not use in patients with known hypersensitivity to aripiprazole. Caution is advised in those with a history of seizures, significant cardiovascular disease, or metabolic risk factors. Pregnancy and breastfeeding require individualized risk–benefit assessment with the prescriber.

Hepatic or renal impairment usually does not require dose changes, but concomitant medicines can. Poor CYP2D6 metabolizers or those on strong CYP3A4 or CYP2D6 inhibitors may need a reduced monthly dose. Avoid use with chronic strong CYP3A4 inducers due to reduced aripiprazole exposure.

To manage costs, consider a multi-month supply when allowed by your prescription. This can lower the per-month total with bulk promotions. You can turn on reorder reminders in your account so you can plan clinic visits and avoid gaps. You can place your order online or by phone during posted hours.

Authoritative Sources

Manufacturer product page for Abilify Maintena

FDA Prescribing Information for Abilify Maintena

Health Canada Drug Product Database: Abilify Maintena

Order Abilify Maintena® from Youdrugstore: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This content is educational and does not replace advice from your healthcare professional. Always follow the guidance of your prescriber and pharmacist.