| Bipolar I disorder
Lybalvi vs Abilify Maintena
Side-by-side clinical, coverage, and cost comparison for bipolar i disorder.Deep comparison between: Lybalvi vs Abilify Maintena 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 signalsAbilify Maintena has a higher rate of injection site reactions vs Lybalvi based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Abilify Maintena but not Lybalvi, including UnitedHealthcare
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Category
Lybalvi
Abilify Maintena
At A Glance
Oral
Once daily
Atypical antipsychotic + opioid antagonist
IM injection
Every 4 weeks
Dopamine D2 partial agonist
Indications
- Schizophrenia
- Bipolar I disorder
- Schizophrenia
- Bipolar I disorder
Dosing
Schizophrenia Initiate at 5 or 10 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
Bipolar I disorder - monotherapy (manic or mixed episodes) Initiate at 10 or 15 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
Bipolar I disorder - adjunct to lithium or valproate Initiate at 10 mg/10 mg orally once daily; recommended dose 10, 15, or 20 mg/10 mg once daily; maximum 20 mg/10 mg once daily.
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
- Current opioid use
- Acute opioid withdrawal
- Known hypersensitivity to aripiprazole
Adverse Reactions
Most common (>=5%) Weight increased, somnolence, dry mouth, headache
Serious Neuroleptic malignant syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), metabolic changes (hyperglycemia, dyslipidemia, weight gain), tardive dyskinesia, orthostatic hypotension and syncope, leukopenia, neutropenia, agranulocytosis, dysphagia, seizures
Postmarketing Anaphylactoid reaction, angioedema, cholestatic or mixed liver injury, hepatitis, jaundice, diabetic coma, diabetic ketoacidosis, DRESS, fecal incontinence, hyperlipidemia, neutropenia, pancreatitis, priapism, rash, rhabdomyolysis, SIADH, somnambulism, stuttering, venous thromboembolic events
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
The efficacy of olanzapine in schizophrenia and bipolar I disorder may be mediated through combined dopamine and serotonin type 2 (5HT2) antagonism; samidorphan is an opioid antagonist whose mechanism could be mediated through mu-, kappa-, and delta-opioid receptor antagonism.
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
Lybalvi
- Covered on 5 commercial plans
- PA (1/12) · Step Therapy (6/12) · Qty limit (10/12)
Abilify Maintena
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Lybalvi
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (1/8) · Qty limit (1/8)
Abilify Maintena
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Lybalvi
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Abilify Maintena
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Schizophrenia - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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.