lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Oral solution
CAUTIONARY AND ADVISORY LABELS 2
▶Amisulpride (Non-proprietary)
Amisulpride 100 mg per 1 mlAmisulpride 100 mg/ml oral solution
sugar free sugar-free| 60 mlP£ 36. 00 DT = £ 36. 00
▶Solian(Sanofi)
Amisulpride 100 mg per 1 mlSolian 100 mg/ml oral solution sugar-
free| 60 mlP£ 33. 76 DT = £ 36. 00
Tablet
CAUTIONARY AND ADVISORY LABELS 2
▶Amisulpride (Non-proprietary)
Amisulpride 50 mgAmisulpride^50 mg tablets|^60 tabletP
£ 22. 76 DT = £ 1. 61
Amisulpride 100 mgAmisulpride 100 mg tablets| 60 tabletP
£ 39. 48 DT = £ 3. 24
Amisulpride 200 mgAmisulpride 200 mg tablets| 60 tabletP
£ 66. 00 DT = £ 5. 59
Amisulpride 400 mgAmisulpride 400 mg tablets| 60 tabletP
£ 132. 00 DT = £ 35. 21
▶Solian(Sanofi)
Amisulpride 50 mgSolian 50 tablets| 60 tabletP£ 22. 76 DT =
£ 1. 61
Amisulpride 100 mgSolian 100 tablets| 60 tabletP£ 35. 29 DT
=£ 3. 24
Amisulpride 200 mgSolian 200 tablets| 60 tabletP£ 58. 99 DT
=£ 5. 59
Amisulpride 400 mgSolian 400 tablets| 60 tabletP£ 117. 97
DT = £ 35. 21
eiiiiF 244Aripiprazole
lDRUG ACTIONAripiprazole is a dopamine D 2 partial
agonist with weak 5 -HT 1 apartial agonism and 5 -HT 2 A
receptor antagonism.
lINDICATIONS AND DOSE
Schizophrenia
▶BY MOUTH
▶Child 15–17 years (under expert supervision):Initially 2 mg
once daily for 2 days, increased to 5 mg once daily for
2 days, then increased to 10 mg once daily, then
increased in steps of 5 mg if required; maximum 30 mg
per day
Treatment of mania (under expert supervision)
▶BY MOUTH
▶Child 13–17 years:Initially 2 mg once daily for 2 days,
increased to 5 mg once daily for 2 days, then increased
to 10 mg once daily, increased in steps of 5 mg if
required, maximum duration of treatment 12 weeks,
doses above 10 mg daily should only be used in
exceptional cases; maximum 30 mg per day
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶Manufacturer advises double the dose with concurrent
use of potent inducers of CYP 3 A 4 —no specific
recommendation made for children. Manufacturer
advises reduce dose by half with concurrent use of
potent inhibitors of CYP 3 A 4 or CYP 2 D 6 —no specific
recommendation made for children.IMPORTANT SAFETY INFORMATION
When prescribing, dispensing, or administering, check
that the correct preparation is used—the preparation
usually used in hospital for the rapid control of anacute
episode(solution for injection containing aripiprazole
7. 5 mg/mL) shouldnotbe confused with depot
preparations (aripiprazole 400 -mg vial with solvent),
which are usually used in the community or clinics for
maintenance treatment.lCONTRA-INDICATIONSCNS depression.comatose state.
phaeochromocytoma
lCAUTIONSCerebrovascular disease
lINTERACTIONS→Appendix 1 : aripiprazole
lSIDE-EFFECTS
▶Common or very commonAnxiety.appetite abnormal.
diabetes mellitus.extrapyramidal symptoms.fatigue.
gastrointestinal discomfort.headache.hypersalivation.
nausea.postural hypotension.sedation.vision disorders.
vomiting
▶UncommonDepression.hiccups.sexual dysfunction
▶Frequency not knownAggression.alopecia.bradycardia.
cardiac arrest.chest pain.diabetic hyperosmolar coma.
diarrhoea.dysphagia.generalised tonic-clonic seizure.
hepatic disorders.hyperhidrosis.hypersensitivity.
hypertension.hyponatraemia.laryngospasm.
musculoskeletal stiffness.myalgia.oropharyngeal spasm.
pancreatitis.pathological gambling.peripheral oedema.
photosensitivity reaction.pneumonia aspiration.
rhabdomyolysis.serotonin syndrome.speech disorder.
suicidal tendencies.syncope.temperature regulation
disorder.thrombocytopenia.urinary incontinence.
weight decreased
SIDE-EFFECTS, FURTHER INFORMATIONIncreased incidence
of side-effects associated with doses of 30 mg daily; doses
above 10 mg daily should only be used in exceptional cases
and with close clinical monitoring.
lPREGNANCYUse only if potential benefit outweighs risk.
lBREAST FEEDINGManufacturer advises avoid—present in
milk.
lHEPATIC IMPAIRMENTUse with caution in severe
impairment.
lMONITORING REQUIREMENTSAripiprazole does not affect
blood pressure to the same extent as other antipsychotic
drugs and so blood pressure monitoring is not mandatory
for this drug.
lDIRECTIONS FOR ADMINISTRATIONOrodispersible tablets
should be placed on the tongue and allowed to dissolve, or
be dispersed in water and swallowed.
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer aripiprazole
orodispersible tablets.
Medicines for Children leaflet: Aripiprazole for schizophrenia,
bipolar disorder and movement disorderswww.medicinesfor
children.org.uk/aripiprazole-schizophrenia-bipolar-disorder-
and-movement-disorders
lNATIONAL FUNDING/ACCESS DECISIONS
NICE decisions
▶Aripiprazole for the treatment of schizophrenia in people aged
15 to 17 years (January 2011 )
Aripiprazole is recommended as an option for the
treatment of schizophrenia in adolescents aged 15 to
17 years who have not responded adequately to, or who are
intolerant of, risperidone, or for whom risperidone is
contra-indicated.
http://www.nice.org.uk/TA213
▶Aripiprazole for the treatment of moderate to severe manic
episodes in adolescents with bipolar I disorder (July 2013 )
Aripiprazole is recommended as an option for the
treatment of moderate to severe manic episodes for up to
12 weeks in adolescents aged over 13 years with bipolar I
disorder.
http://www.nice.org.uk/TA292
ABILIFY®ORAL SOLUTION
Scottish Medicines Consortium (SMC) Decisions
TheScottish Medicines Consortium, has advised (August
2013 ) that oral aripiprazole (Abilify®) is accepted for
restricted use within NHS Scotland for the treatment of
moderate to severe manic episodes in Bipolar I Disorder in
adolescents aged 13 years and older for a period of up toBNFC 2018 – 2019 Psychoses and schizophrenia 249
Nervous system4