| Schizophrenia
Aristada & Aristada Initio vs Invega Sustenna
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Aristada 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 Aristada based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Invega Sustenna but not Aristada, including UnitedHealthcare
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Category
Aristada
Invega Sustenna
At A Glance
IM injection
Monthly to every 2 months
Dopamine D2 partial agonist
IM injection
Every 4 weeks
D2/5HT2A antagonist
Indications
- Schizophrenia
- Schizophrenia
- Schizoaffective Disorder
Dosing
Schizophrenia 441 mg, 662 mg, or 882 mg monthly, 882 mg every 6 weeks, or 1064 mg every 2 months via IM injection into the deltoid (441 mg only) or gluteal muscle; initiate with ARISTADA INITIO 675 mg plus a single 30 mg oral aripiprazole dose, or supplement with 21 consecutive days of oral aripiprazole concomitant with the first injection.
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
- Known 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 (>=5%) Akathisia
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, seizures, orthostatic hypotension
Postmarketing Anaphylactic reaction, angioedema, pathological gambling, drug reaction with eosinophilia and systemic symptoms (DRESS), oculogyric crisis, 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 lauroxil is a prodrug of aripiprazole that, following IM injection, undergoes enzyme-mediated hydrolysis to yield aripiprazole, which exerts its effects through partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at serotonin 5-HT2A 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
Aristada
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (4/12) · Qty limit (11/12)
Invega Sustenna
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (11/12)
UnitedHealthcare
Aristada
- 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
Aristada
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
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
$10/fillfill
Aristada Co-pay Savings ProgramCommercial 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.