What is a Patient Information Leaflet and why is it useful?

The Patient Information Leaflet (PIL) is the leaflet included in the pack with a medicine. It is written for patients and gives information about taking or using a medicine. It is possible that the leaflet in your medicine pack may differ from this version because it may have been updated since your medicine was packaged.

Below is a text only representation of the Patient Information Leaflet, the original can be viewed in PDF format using the link above.

The text only version may be available from RNIB in large print, Braille or audio CD. For further information call RNIB Medicine Leaflet Line on 0800 198 5000. The product code(s) for this leaflet is: EU/1/04/276/036.

Abilify 7.5 mg/ml solution for injection (intramuscular)

Package leaflet: Information for the user

ABILIFY 7.5 mg/ml solution for injection

aripiprazole

Read all of this leaflet carefully before you receive this medicine because it contains important information for you.

  • Keep this leaflet. You may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

1. What ABILIFY solution for injection is and what it is used for
2. What you need to know before you are given ABILIFY solution for injection
3. How ABILIFY solution for injection is given
4. Possible side effects
5. How to store ABILIFY solution for injection
6. Contents of the pack and other information

1. What ABILIFY solution for injection is and what it is used for

ABILIFY solution for injection contains the active substance aripiprazole and belongs to a group of medicines called antipsychotics. ABILIFY solution for injection is used to treat quickly symptoms of agitation and distressing behaviour that may occur in a disease characterised by symptoms such as:

  • hearing, seeing or sensing things which are not there, suspiciousness, mistaken beliefs, incoherent speech and behaviour and emotional flatness. People with this condition may also feel depressed, guilty, anxious or tense.
  • feeling "high", having excessive amounts of energy, needing much less sleep than usual, talking very quickly with racing ideas and sometimes severe irritability.

ABILIFY solution for injection is given when treatment with oral formulations is not appropriate. Your doctor will change your treatment to oral ABILIFY as soon as appropriate.

2. What you need to know before you are given ABILIFY solution for injection

Do not use ABILIFY solution for injection

  • if you are allergic to aripiprazole or any of the other ingredients of this medicine (listed in section 6).

Warnings and precautions

Talk to your doctor before you are given ABILIFY solution for injection.

Before treatment with ABILIFY solution for injectio, tell your doctor if you suffer from

  • high blood sugar (characterised by symptoms such as excessive thirst, passing of large amounts of urine, increase in appetite, and feeling weak) or family history of diabetes
  • fits (seizures) since your doctor may want to monitor you more closely
  • involuntary, irregular muscle movements, especially in the face
  • cardiovascular diseases (diseases of the heart and circulation), family history of cardiovascular disease, stroke or "mini" stroke, abnormal blood pressure
  • blood clots, or family history of blood clots, as antipsychotics have been associated with formation of blood clots
  • past experience of excessive gambling

If you notice you are gaining weight, develop unusual movements, experience somnolence that interferes with normal daily activities, any difficulty in swallowing or allergic symptoms, please tell your doctor.

If you are an elderly patient suffering from dementia (loss of memory and other mental abilities), you or your carer/relative should tell your doctor if you have ever had a stroke or "mini" stroke.

Tell the doctor or nurse if you feel dizzy or faint after the injection. You will probably need to lie down until you feel better. The doctor may also want to measure your blood pressure and pulse.

Tell your doctor immediately if you are having any thoughts or feelings about hurting yourself. Suicidal thoughts and behaviours have been reported during aripiprazole treatment.

Tell your doctor immediately if you suffer from muscle stiffness or inflexibility with high fever, sweating, altered mental status, or very rapid or irregular heart beat.

Children and adolescents

ABILIFY solution for injection is not for use in children and adolescents under 18 years. Ask your doctor or pharmacist for advice before taking ABILIFY solution for injection.

Other medicines and ABILIFY solution for injection

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.

Blood pressure-lowering medicines: ABILIFY solution for injection may increase the effect of medicines used to lower the blood pressure. Be sure to tell your doctor if you take a medicine to keep your blood pressure under control.

Using ABILIFY solution for injection with some medicines may need to change your dose of ABILIFY solution for injection. It is especially important to mention the following to your doctor:

  • Medicines to correct heart rhythm
  • Antidepressants or herbal remedy used to treat depression and anxiety
  • Antifungal agents
  • Certain medicines to treat HIV infection
  • Anticonvulsants used to treat epilepsy

Medicines that increase the level of serotonin: triptans, tramadol, tryptophan, SSRIs (such as paroxetine and fluoxetine), tricyclics (such as clomipramine, amitriptyline), pethidine, St John’s Wort and venlafaxine. These medicines increase the risk of side effects; if you get any unusual symptom taking any of these medicines together with ABILIFY solution for injection, you should see your doctor.

A combination of ABILIFY solution for injection with medicines taken for anxiety might make you feel drowsy or dizzy. Only take other medicines while you are on ABILIFY solution for injection if your doctor tells you that you can.

ABILIFY solution for injection with food, drink and alcohol

ABILIFY solution for injection can be administered regardless of meals.

Alcohol should be avoided.

Pregnancy, breast-feeding and fertility

If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.

The following symptoms may occur in newborn babies, of mothers that have used ABILIFY solution for injection in the last trimester (last three months of their pregnancy): shaking, muscle stiffness and/or weakness, sleepiness, agitation, breathing problems, and difficulty in feeding. If your baby develops any of these symptoms you may need to contact your doctor.

Be sure to tell your doctor immediately if you are breast-feeding.

If you are taking ABILIFY solution for injection, you should not breast-feed.

Driving and using machines

Do not drive or use any tools or machines if you feel drowsy after receiving ABILIFY solution for injection.

3. How ABILIFY solution for injection is given

Your doctor will decide how much ABILIFY solution for injection you need and how long you need it for. The recommended dose is 9.75 mg (1.3 ml) for the first injection. Up to three injections in 24 hours may be given. The total dose of ABILIFY (all formulations) should not exceed 30 mg per day.

ABILIFY solution for injection is ready to use. The correct amount of solution will be injected into your muscle by your doctor or nurse.

If you are given more ABILIFY solution for injection than you need

This medicine will be given to you under medical supervision; it is therefore unlikely that you will be given too much. If you see more than one doctor, be sure to tell them that you are receiving ABILIFY solution for injection.

If you miss an injection of ABILIFY solution for injection

It is important not to miss your dose. If you miss an injection, you should contact your doctor to arrange your next injection as soon as you can.

If you stop receiving ABILIFY solution for injection

Do not stop your treatment just because you feel better. It is important that you carry on receiving ABILIFY solution for injection for as long as your doctor has told you to.

If you have any further questions on the use of this medicine, ask your doctor or nurse.

4. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Common side effects (may affect up to 1 in 10 people):

  • diabetes mellitus,
  • difficulty sleeping,
  • feeling anxious,
  • feeling restless and unable to keep still, difficulty sitting still,
  • uncontrollable twitching, jerking or writhing movements, restless legs,
  • trembling,
  • headache,
  • tiredness,
  • sleepiness,
  • light-headedness,
  • shaking and blurred vision,
  • decreased number of or difficulty making bowel movements,
  • indigestion,
  • feeling sick,
  • more saliva in mouth than normal,
  • vomiting,
  • feeling tired.

Uncommon side effects (may affect up to 1 in 100 people):

  • increased blood levels of the hormone prolactin,
  • too much sugar in the blood,
  • depression,
  • altered or increased sexual interest,
  • uncontrollable movements of mouth, tongue and limbs (tardive dyskinesia),
  • muscle disorder causing twisting movements (dystonia),
  • double vision,
  • fast heart beat,
  • increased diastolic blood pressure,
  • a fall in blood pressure on standing up which causes dizziness, light-headedness or fainting,
  • hiccups,
  • dry mouth.

The following side effects have been reported since the marketing of oral aripiprazole but the frequency for them to occur is not known:

  • low levels of white blood cells,
  • low levels of blood platelets,
  • allergic reaction (e.g. swelling in the mouth, tongue, face and throat, itching, hives),
  • onset or worsening of diabetes, ketoacidosis (ketones in the blood and urine) or coma,
  • high blood sugar,
  • not enough sodium in the blood,
  • loss of appetite (anorexia),
  • weight loss,
  • weight gain,
  • thoughts of suicide, suicide attempt and suicide,
  • excessive gambling,
  • feeling aggressive,
  • agitation,
  • nervousness,
  • combination of fever, muscle stiffness, faster breathing, sweating, reduced consciousness and sudden changes in blood pressure and heart rate, fainting (neuroleptic malignant syndrome),
  • seizure,
  • serotonin syndrome (a reaction which may cause feelings of great happiness, drowsiness, clumsiness, restlessness, feeling of being drunk, fever, sweating or rigid muscles),
  • speech disorder,
  • sudden unexplained death,
  • life-threatening irregular heart beat,
  • heart attack,
  • slower heart beat,
  • blood clots in the veins especially in the legs (symptoms include swelling, pain and redness in the leg), which may travel through blood vessels to the lungs causing chest pain and difficulty in breathing (if you notice any of these symptoms, seek medical advice immediately),
  • high blood pressure,
  • fainting,
  • accidental inhalation of food with risk of pneumonia (lung infection),
  • spasm of the muscles around the voice box,
  • inflammation of the pancreas,
  • difficulty swallowing,
  • diarrhoea,
  • abdominal discomfort,
  • stomach discomfort,
  • liver failure,
  • inflammation of the liver,
  • yellowing of the skin and white part of eyes,
  • reports of abnormal liver tests values,
  • skin rash,
  • sensitivity to light,
  • baldness,
  • excessive sweating,
  • abnormal muscle breakdown which can lead to kidney problems,
  • muscle pain,
  • stiffness,
  • involuntary loss of urine (incontinence),
  • difficulty in passing urine,
  • withdrawal symptoms in newborn babies in case of exposure during pregnancy,
  • prolonged and/or painful erection,
  • difficulty controlling core body temperature or overheating,
  • chest pain,
  • swelling of hands, ankles or feet,
  • in blood tests: increased or fluctuating blood sugar, increased glycosylated haemoglobin.

In elderly patients with dementia, more fatal cases have been reported while taking aripiprazole. In addition, cases of stroke or "mini" stroke have been reported.

Additional side effects in children and adolescents

Adolescents aged 13 years and older experienced side effects that were similar in frequency and type to those in adults except that sleepiness, uncontrollable twitching or jerking movements, restlessness, and tiredness were very common (greater than 1 in 10 patients) and upper abdominal pain, dry mouth, increased heart rate, weight gain, increased appetite, muscle twitching, uncontrolled movements of the limbs, and feeling dizzy, especially when getting up from a lying or sitting position, were common (greater than 1 in 100 patients).

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme, Website: www.mhra.gov.uk/yellowcard. By reporting side effects you can help provide more information on the safety of this medicine.

5. How to store ABILIFY solution for injection

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and on the vial after EXP. The expiry date refers to the last day of that month.

Keep the vial in the outer carton in order to protect from light.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. Contents of the pack and other information

What ABILIFY solution for injection contains

  • The active substance is aripiprazole.
    Each ml contains 7.5 mg aripiprazole.
    A vial contains 9.75 mg (1.3 ml) aripiprazole.
  • The other ingredients are sulfobutylether β-cyclodextrin (SBECD), tartaric acid, sodium hydroxide, and water for injections.

What ABILIFY solution for injection looks like and contents of the pack

The ABILIFY solution for injection is a clear, colourless, aqueous solution.

Each carton contains one single-use type I glass vial with a rubber butyl stopper and a "flip-off" aluminium seal.

Each carton contains one single-use type I glass vial with a rubber butyl stopper and a "tear-off" aluminium seal.

Marketing Authorisation Holder

Otsuka Pharmaceutical Europe Ltd.
Gallions
Wexham Springs
Framewood Road
Wexham
SL3 6PJ
United Kingdom

Manufacturer

Bristol-Myers Squibb S.r.l.
Contrada Fontana del Ceraso
I-03012 Anagni-Frosinone
Italy

Zambon S.p.A.
Via della Chimica, 9
I-36100 Vicenza(VI)
Italy

For any information about this medicine, please contact the local representative of the Marketing Authorisation Holder:

United Kingdom
Otsuka Pharmaceuticals (UK) Ltd.
Tel: +44 (0)203 747 5300

This leaflet was last revised in 09/2016

Other sources of information

Detailed information on this medicine is available on the European Medicines Agency web site: http://www.ema.europa.eu.