Comparative Pharmacology
Head-to-head clinical analysis: ARIPIPRAZOLE versus LYBALVI.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARIPIPRAZOLE versus LYBALVI.
ARIPIPRAZOLE vs LYBALVI
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Partial agonist at D2 and 5-HT1A receptors; antagonist at 5-HT2A receptors.
LYBALVI is a combination of olanzapine and samidorphan. Olanzapine is an atypical antipsychotic with high affinity for serotonin 5-HT2A and 5-HT2C, dopamine D1-D4, histamine H1, and alpha1-adrenergic receptors. Samidorphan is an opioid receptor antagonist with high affinity for mu-opioid receptors, hypothesized to reduce olanzapine-associated weight gain by blocking opioid receptors in the central nervous system.
Oral: 10-15 mg once daily; initial and target dose 10-15 mg; maximum 30 mg/day. IM: 9.75 mg single dose, then 5.25-9.75 mg every 2 hours if needed; maximum 30 mg/day.
Olanzapine 10 mg / samidorphan 10 mg orally once daily.
None Documented
None Documented
Clinical Note
moderateAripiprazole + Torasemide
"Aripiprazole may increase the hypotensive activities of Torasemide."
Clinical Note
moderateAripiprazole + Etacrynic acid
"Aripiprazole may increase the hypotensive activities of Etacrynic acid."
Clinical Note
moderateAripiprazole + Furosemide
"Aripiprazole may increase the hypotensive activities of Furosemide."
Clinical Note
moderateAripiprazole + Bumetanide
"Aripiprazole may increase the hypotensive activities of Bumetanide."
Aripiprazole has a terminal elimination half-life of approximately 75 hours in extensive CYP2D6 metabolizers and about 146 hours in poor metabolizers. The active metabolite, dehydro-aripiprazole, has a half-life of about 94 hours. This long half-life allows for once-daily dosing and gradual achievement of steady state (14 days in extensive metabolizers).
Terminal half-life ~20-30 hours; supports once-daily dosing.
Aripiprazole is extensively metabolized primarily by the liver via CYP2D6 and CYP3A4. Approximately 25% of the dose is excreted unchanged in urine, and about 55% in feces. The major metabolite, dehydro-aripiprazole, accounts for about 40% of the AUC and is also excreted in urine and feces.
Renal: ~50% as unchanged drug and metabolites; Fecal: ~40%; Biliary: minor.
Category A/B
Category C
Atypical Antipsychotic
Atypical Antipsychotic