| Major Depressive Disorder

Abilify vs Fetzima

Side-by-side clinical, coverage, and cost comparison for major depressive disorder.
Deep comparison between: Abilify vs Fetzima 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 signalsFetzima has a higher rate of injection site reactions vs Abilify based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fetzima but not Abilify, including UnitedHealthcare
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Abilify
Fetzima
At A Glance
Oral
Once daily
Atypical antipsychotic
Oral
Once daily
SNRI
Indications
  • Schizophrenia
  • Bipolar I disorder
  • Major Depressive Disorder
  • Autistic Disorder
  • Gilles de la Tourette syndrome
  • Major Depressive Disorder
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.
Major Depressive Disorder Initiate at 20 mg once daily for 2 days, then increase to 40 mg once daily; may increase in 40 mg increments at intervals of 2 or more days; max 120 mg once daily, oral, with or without food.
Renal Impairment Severe (CrCl 15-29 mL/min): max 40 mg once daily; moderate (CrCl 30-59 mL/min): max 80 mg once daily; ESRD: not recommended.
Contraindications
  • History of hypersensitivity reaction to aripiprazole (reactions have ranged from pruritus/urticaria to anaphylaxis)
  • Hypersensitivity to levomilnacipran, milnacipran HCl, or any excipient in the formulation
  • Concomitant use with MAOIs intended to treat psychiatric disorders, or within 7 days of stopping FETZIMA
  • Use of FETZIMA within 14 days of stopping an MAOI intended to treat psychiatric disorders
  • Concomitant use with linezolid or intravenous methylene blue
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%) Nausea, constipation, hyperhidrosis, heart rate increased, erectile dysfunction, ejaculation disorder, tachycardia, vomiting, palpitations
Serious Suicidal thoughts and behaviors, serotonin syndrome, elevated blood pressure, elevated heart rate, increased risk of bleeding, angle closure glaucoma, urinary hesitation or retention, activation of mania/hypomania, seizure, discontinuation syndrome, hyponatremia, sexual dysfunction
Postmarketing Takotsubo cardiomyopathy, anosmia, hyposmia
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.
Levomilnacipran is a potent and selective serotonin and norepinephrine reuptake inhibitor (SNRI) that potentiates serotonin and norepinephrine neurotransmission in the central nervous system through inhibition of reuptake at their respective transporters, with no significant affinity for other receptors, ion channels, or transporters.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Abilify
  • Covered on 5 commercial plans
  • PA (10/12) · Step Therapy (10/12) · Qty limit (0/12)
View full coverage details ›
Fetzima
  • Covered on 5 commercial plans
  • PA (3/12) · Step Therapy (11/12) · Qty limit (12/12)
View full coverage details ›
UnitedHealthcare
Abilify
  • Covered on 4 commercial plans
  • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
View full coverage details ›
Fetzima
  • Covered on 4 commercial plans
  • PA (1/8) · Step Therapy (8/8) · Qty limit (6/8)
View full coverage details ›
Humana
Abilify
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
View full coverage details ›
Fetzima
  • Covered on 0 commercial plans
  • PA (3/3) · Step Therapy (3/3) · Qty limit (2/3)
View full coverage details ›
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Abilify.
No savings programs available for Fetzima.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.