| Bipolar I disorder
Abilify vs Igalmi
Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.Deep comparison between: Abilify vs Igalmi with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsIgalmi has a higher rate of injection site reactions vs Abilify based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Igalmi but not Abilify, including UnitedHealthcare
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Category
Abilify
Igalmi
At A Glance
Oral
Once daily
Atypical antipsychotic
Sublingual or buccal film
As needed (acute use)
Alpha-2 adrenergic receptor agonist
Indications
- Schizophrenia
- Bipolar I disorder
- Major Depressive Disorder
- Autistic Disorder
- Gilles de la Tourette syndrome
- Schizophrenia
- Bipolar I disorder
- Bipolar Disorder Type 2
Dosing
Schizophrenia - adults Starting dose 10-15 mg/day, target 10-15 mg/day, max 30 mg/day, once daily without regard to meals.
Schizophrenia - adolescents (13-17 yrs) Starting dose 2 mg/day, titrated to 5 mg after 2 days and target of 10 mg/day after 2 additional days, max 30 mg/day, once daily.
Bipolar I disorder - adults, monotherapy Starting dose 15 mg/day, target 15 mg/day, up to 30 mg/day based on clinical response, once daily.
Bipolar I disorder - adults, adjunct to lithium or valproate Starting dose 10-15 mg/day, target 15 mg/day, max 30 mg/day, once daily.
Bipolar I disorder - pediatric (10-17 yrs) Starting dose 2 mg/day, titrated to 5 mg/day after 2 days and target of 10 mg/day after 2 additional days, max 30 mg/day, once daily.
Major Depressive Disorder - adults, adjunct to antidepressants Starting dose 2-5 mg/day, recommended range 2-15 mg/day, max 15 mg/day, once daily.
Autistic Disorder - pediatric (6-17 yrs), irritability Starting dose 2 mg/day, target 5-10 mg/day, max 15 mg/day, once daily.
Gilles de la Tourette syndrome - pediatric (6-18 yrs) Starting dose 2 mg/day; target 5 mg/day for patients <50 kg (max 10 mg/day) or 10 mg/day for patients >=50 kg (max 20 mg/day), once daily.
Schizophrenia, Bipolar I disorder, Bipolar Disorder Type 2 - Adults Mild or moderate agitation: 120 mcg initial dose SL or buccal; severe agitation: 180 mcg initial; up to 2 additional doses (60-90 mcg) at least 2 hours apart; maximum 240-360 mcg/day.
Mild or Moderate Hepatic Impairment Mild or moderate agitation: 90 mcg initial; severe agitation: 120 mcg initial; optional additional doses of 60 mcg at least 2 hours apart; maximum 210-240 mcg/day.
Severe Hepatic Impairment Mild or moderate agitation: 60 mcg initial; severe agitation: 90 mcg initial; optional additional doses of 60 mcg at least 2 hours apart; maximum 180-210 mcg/day.
Geriatric Patients (>=65 years) 120 mcg initial dose regardless of agitation severity; optional additional doses of 60 mcg at least 2 hours apart; maximum 240 mcg/day.
Contraindications
- History of hypersensitivity reaction to aripiprazole (reactions have ranged from pruritus/urticaria to anaphylaxis)
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Adverse Reactions
Most common (>=10%) - adults nausea, vomiting, constipation, headache, dizziness, akathisia, anxiety, insomnia, restlessness
Most common (>=10%) - pediatric somnolence, headache, vomiting, extrapyramidal disorder, fatigue, increased appetite, insomnia, nausea, nasopharyngitis, weight increased
Serious NMS, tardive dyskinesia, metabolic changes, pathological gambling, orthostatic hypotension, leukopenia, neutropenia, agranulocytosis, seizures, cerebrovascular adverse events, suicidal thoughts and behaviors
Postmarketing anaphylactic reaction, angioedema, DRESS, blood glucose fluctuation, hiccups, oculogyric crisis, pathological gambling, fecal incontinence
Most common (>=5%) Somnolence, oral paresthesia or oral hypoesthesia, dizziness, dry mouth, hypotension, orthostatic hypotension.
Serious Hypotension, orthostatic hypotension, bradycardia, QT interval prolongation, somnolence, withdrawal reactions, tolerance and tachyphylaxis.
Postmarketing Arrhythmia, atrial fibrillation, cardiac arrest, bradycardia, convulsion, apnea, bronchospasm, agitation, delirium, hallucination, hypertension, rash, urticaria.
Pharmacology
Aripiprazole is an atypical antipsychotic whose efficacy may be mediated through a combination of partial agonist activity at D2 and 5-HT1A receptors and antagonist activity at 5-HT2A receptors; it also exhibits high affinity for D3, moderate affinity for D4, 5-HT2C, 5-HT7, alpha1-adrenergic, and H1 receptors.
Dexmedetomidine is an alpha-2 adrenergic receptor agonist whose mechanism of action in acute agitation is thought to involve activation of presynaptic alpha-2 adrenergic receptors; it also exhibits concentration-dependent QT prolongation.
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Most Common Insurance
Anthem BCBS
Abilify
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
Igalmi
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (11/12)
UnitedHealthcare
Abilify
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Igalmi
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (1/8) · Qty limit (0/8)
Humana
Abilify
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Igalmi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (1/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Abilify.
No savings programs available for Igalmi.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.