| Bipolar I disorder

Igalmi vs Abilify Maintena

Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.
Deep comparison between: Igalmi vs Abilify Maintena with Prescriber.AI
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Safety signalsAbilify Maintena has a higher rate of injection site reactions vs Igalmi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Abilify Maintena but not Igalmi, including UnitedHealthcare
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Igalmi
Abilify Maintena
At A Glance
Sublingual or buccal film
As needed (acute use)
Alpha-2 adrenergic receptor agonist
IM injection
Every 4 weeks
Dopamine D2 partial agonist
Indications
  • Schizophrenia
  • Bipolar I disorder
  • Bipolar Disorder Type 2
  • Schizophrenia
  • Bipolar I disorder
Dosing
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.
Schizophrenia, Bipolar I disorder 400 mg IM injection monthly (deltoid or gluteal); reduce to 300 mg if adverse reactions occur; initiate via 1-day (two 400 mg injections + single oral aripiprazole 20 mg) or 14-day (one 400 mg injection + 14 days oral aripiprazole) protocol; CYP2D6 poor metabolizers start and maintain at 300 mg monthly.
Contraindications
—
  • Known hypersensitivity to aripiprazole
Adverse Reactions
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.
Most common (>=5%) Increased weight, akathisia, injection site pain, sedation
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, seizures, orthostatic hypotension
Postmarketing Anaphylactic reaction, angioedema, laryngospasm, pruritus/urticaria, oropharyngeal spasm, pathological gambling, hiccups, blood glucose fluctuation, DRESS, fecal incontinence
Pharmacology
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.
Aripiprazole is an atypical antipsychotic whose efficacy may be mediated through a combination of partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
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Most Common Insurance
Anthem BCBS
Igalmi
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (1/12) · Qty limit (11/12)
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Abilify Maintena
  • Covered on 5 commercial plans
  • PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
View full coverage details ›
UnitedHealthcare
Igalmi
  • Covered on 4 commercial plans
  • PA (2/8) · Step Therapy (1/8) · Qty limit (0/8)
View full coverage details ›
Abilify Maintena
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Humana
Igalmi
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (0/3) · Qty limit (1/3)
View full coverage details ›
Abilify Maintena
  • Covered on 0 commercial plans
  • PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Igalmi.
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.