| Schizophrenia
Abilify vs Invega Sustenna
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Abilify vs Invega Sustenna 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 signalsInvega Sustenna has a higher rate of injection site reactions vs Abilify based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Invega Sustenna but not Abilify, including UnitedHealthcare
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Category
Abilify
Invega Sustenna
At A Glance
Oral
Once daily
Atypical antipsychotic
IM injection
Every 4 weeks
D2/5HT2A antagonist
Indications
- Schizophrenia
- Bipolar I disorder
- Major Depressive Disorder
- Autistic Disorder
- Gilles de la Tourette syndrome
- Schizophrenia
- Schizoaffective 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.
Schizophrenia Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; recommended monthly maintenance 117 mg (range 39-234 mg) in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Schizoaffective Disorder Initiation: 234 mg deltoid on Day 1, 156 mg deltoid on Day 8; monthly maintenance 78-234 mg adjusted for tolerability and/or efficacy in deltoid or gluteal muscle; maximum monthly dose 234 mg.
Mild renal impairment (creatinine clearance >=50 mL/min) Initiation: 156 mg deltoid on Day 1, 117 mg deltoid on Day 8; monthly maintenance 39-156 mg; maximum monthly dose 156 mg.
Contraindications
- History of hypersensitivity reaction to aripiprazole (reactions have ranged from pruritus/urticaria to anaphylaxis)
- Known hypersensitivity to paliperidone, risperidone, or any excipient in the INVEGA SUSTENNA formulation
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%) Injection site reactions, somnolence/sedation, dizziness, akathisia, extrapyramidal disorder
Serious Increased mortality in elderly patients with dementia-related psychosis, cerebrovascular adverse reactions, neuroleptic malignant syndrome, QT prolongation, tardive dyskinesia, metabolic changes, orthostatic hypotension and syncope, leukopenia/neutropenia/agranulocytosis, hyperprolactinemia, seizures
Postmarketing Angioedema, anaphylactic reaction, catatonia, ileus, somnambulism, swollen tongue, thrombotic thrombocytopenic purpura, urinary incontinence, urinary retention
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.
Paliperidone palmitate is hydrolyzed to paliperidone, the major active metabolite of risperidone; its therapeutic effect in schizophrenia may be mediated through a combination of central dopamine Type 2 (D2) and serotonin Type 2 (5HT2A) receptor antagonism, with additional antagonist activity at histamine H1 and alpha-1/alpha-2 adrenergic receptors.
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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)
Invega Sustenna
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (11/12)
UnitedHealthcare
Abilify
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Invega Sustenna
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Abilify
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Invega Sustenna
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Abilify.
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.