Abilify interactions: Alcohol, medications, and other factors

In some cases, a factor or condition could prevent your doctor from prescribing Abilify due to the risk of harm. This is known as a contraindication. The contraindications of Abilify include:

Having had an allergic reaction to Abilify or any of its ingredients

If you’ve had an allergic reaction to Abilify or any of its ingredients, your doctor will likely not prescribe Abilify. Taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices.

Note: Before you start treatment with Abilify, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Abilify.

Alcohol does not affect the way Abilify works. However, both alcohol and Abilify can cause certain similar side effects.* You may have an increased risk of these side effects if you drink alcohol (such as wine, beer, or spirits) during Abilify treatment.

Both alcohol and Abilify may cause nausea, vomiting, sleepiness, and blurry vision. The substances can also cause headaches, dizziness, and low blood pressure.

If you drink alcohol, you can talk with your doctor about how much alcohol, if any, is safe for you to consume while taking Abilify.

* For more information about the side effects of Abilify, see this article.

Before you start treatment with Abilify, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Abilify. Keep in mind that this chart does not include all drugs that may interact with Abilify. Some of these interactions are described in detail just below in “Drug interactions in depth.” Your doctor can also advise you on whether there are medications that should not be taken with Abilify.

* For more information about the side effects of Abilify, see this article.

Here’s a closer look at certain drug interactions of Abilify.

Strong CYP3A4 and CYP2D6 inhibitors

CYP3A4 and CYP2D6 are enzymes in your liver that help remove certain drugs from your body. (An enzyme is a protein that helps chemical reactions occur.) CYP stands for cytochrome P450. Drugs that are strong CYP3A4 inhibitors or strong CYP2D6 inhibitors reduce the activity of these enzymes.

Interaction result. Taking Abilify with a strong CYP3A4 inhibitor or a strong CYP2D6 inhibitor can increase the risk of side effects of Abilify. These side effects can include low blood pressure and sleepiness. (For more information about Abilify’s side effects, see this article.)

Interaction explained. CYP3A4 and CYP2D6 help remove Abilify from your body. Drugs that are strong inhibitors of these enzymes slow down the removal of Abilify. This can cause Abilify to build up in your system, which may increase the risk of side effects from the drug.

Examples of strong CYP3A4 and CYP2D6 inhibitors. Here are some strong CYP3A4 and CYP2D6 inhibitor drugs that may interact with Abilify:

• certain antifungal drugs, such as:
  • itraconazole (Sporanox, Tolsura)
  • ketoconazole
  • posaconazole (Noxafil)
  • voriconazole (Vfend)
  • terbinafine
• the antibiotic clarithromycin
• certain HIV drugs, such as ritonavir (Norvir)
• certain antidepressants, such as:
  • bupropion (Wellbutrin SR, Wellbutrin XL, Aplenzin)
  • paroxetine (Paxil)
  • fluoxetine (Prozac)
• the heart drug quinidine

Steps you or your doctor may take. If you take Abilify or Abilify Mycite tablets with a strong CYP3A4 or strong CYP2D6 inhibitor, your doctor will likely prescribe a lower Abilify drug dosage.

However, if you receive Abilify Maintena* and take one of these inhibitors, your doctor will usually decrease the Abilify Maintena dosage only in a certain situation. The situation is if you take the inhibitor for longer than 14 days.

Long-term use of the inhibitor results in Abilify Maintena increasing above the therapeutic level in your body. A therapeutic level is the amount of drug in your system needed to properly treat your condition or disease. This means you could be at an increased risk for certain side effects.

If you need to take the inhibitor short term (less than 14 days), it will not impact how much Abilify Maintena you receive. During this time, the level of Abilify Maintena in your body will still be within the range required for treatment.

Your doctor or pharmacist can tell you more about Abilify and strong CYP3A4 and CYP2D6 inhibitors.

* Abilify Maintena is a form of Abilify that’s given as an intramuscular injection. It slowly releases the medication into your blood over a month.

Strong CYP3A4 inducers

CYP3A4 is an enzyme in your liver that helps remove certain drugs from your body. Drugs that are strong CYP3A4 inducers increase the activity of this enzyme.

Interaction result. Taking Abilify with a strong CYP3A4 inducer can make Abilify less effective at treating your condition.

Interaction explained. CYP3A4 helps remove Abilify from your body. Drugs that are strong inducers of this enzyme speed up the removal of Abilify. This can lower the level of Abilify in your system, which can make it less effective.

Examples of strong CYP3A4 inducers. Here are some strong CYP3A4 inducer drugs that may interact with Abilify:

• certain seizure medications, such as carbamazepine (Carbatrol, Equetro, Tegretol) and phenytoin (Dilantin)
• the antibiotic rifampin (Rifadin)

Steps you or your doctor may take. If you take Abilify tablets with a strong CYP3A4 inducer, your doctor may prescribe a dosage of Abilify that’s higher than usual.

If you’re prescribed Abilify Maintena,* your doctor will likely not have you take a strong CYP3A4 inducer for more than 14 days. Long-term use of the inducer results in Abilify Maintena dropping below the therapeutic level in your body. A therapeutic level is the amount of drug in your system needed to properly treat your condition or disease.

However, if you need to take a strong CYP3A4 inducer short term (less than 14 days), it will not impact how much Abilify Maintena you receive. During this time, the level of Abilify Maintena in your body will still be within the range required for treatment.

If you’d like to learn more about Abilify and strong CYP3A4 inducers, talk with your doctor or pharmacist.

* Abilify Maintena is a form of Abilify that’s given as an intramuscular injection. It slowly releases the medication into your blood over a month.

Certain antidepressants

Your doctor may prescribe an antidepressant with Abilify. In fact, if you take Abilify to treat depression, they’ll usually have you take an antidepressant as well.

Interaction result. Taking certain antidepressants with Abilify may increase your risk of side effects from Abilify. (For more information about Abilify’s side effects, see this article.)

Interaction explained. Certain antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil), can prevent Abilify from fully breaking down in your body. This can raise the level of Abilify in your system, which can increase your risk of side effects.

Also, certain other antidepressants may have side effects similar to those ofAbilify. Examples of these side effects include sleepiness and heart rhythm problems. Taking one of these antidepressants with Abilify could worsen these side effects or make you more likely to experience them.

Examples of certain antidepressants. Here are some antidepressants that may interact with Abilify:

• bupropion (Wellbutrin SR, Wellbutrin XL , Aplenzin)
• paroxetine (Paxil)
• fluoxetine (Prozac)
• venlafaxine (Effexor XR)
• sertraline (Zoloft)
• trazodone

Steps you or your doctor may take. If you take Abilify with paroxetine or fluoxetine, your doctor may prescribe an Abilify dosage that’s lower than usual. (To read more about this, see “Strong CYP3A4 and CYP2D6 inhibitors” above.)

If you take other antidepressants with Abilify, your doctor will likely monitor you for side effects. If needed, they may reduce your dosage of either medication.

If you have any questions about interactions between Abilify and antidepressants, talk with your doctor or pharmacist.

Abilify may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Abilify interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Abilify interactions with herbs

Your doctor will likely recommend that you do not take the herbal remedy St. John’s wort during Abilify treatment. Abilify can interact with the herb, which is a substance known as a strong cytochrome P450 3A4 (CYP3A4) inducer.

CYP3A4 is an enzyme (protein) in your liver that helps remove Abilify from your body. Strong inducers of this enzyme speed up the removal of Abilify. This can make Abilify less effective than usual at treating your condition.

Your doctor may be able to suggest another treatment other than St. John’s wort.

Abilify and vitamins

There are no specific reports of vitamins interacting with Abilify. However, it’s still important to check with your doctor or pharmacist before taking any of these products during Abilify treatment.

Abilify interactions with food

Your doctor may recommend that you avoid eating grapefruit and drinking grapefruit juice while taking Abilify. The drug can interact with this food and beverage. Grapefruit is a substance known as a strong CYP3A4 inhibitor.

CYP3A4 is an enzyme in your liver that helps remove Abilify from your body. Strong inhibitors of this enzyme slow down the removal of Abilify. This can cause Abilify to build up in your system, which may increase the risk of side effects from the drug. (For more information about the side effects of Abilify, see this article.)

Avoiding grapefruit products while taking Abilify helps prevent the level of the drug in your body from becoming too high.

No other foods have been specifically reported to interact with Abilify. If you’d like to learn more about eating certain foods during treatment with the medication, talk with your doctor.

Abilify and vaccines

There are no specific reports of Abilify interacting with vaccines. Keep in mind that you should still talk with your doctor or pharmacist before getting vaccines during Abilify treatment.

Abilify and lab tests

Abilify has not been reported to interact with lab tests. However, if you have any lab tests done during treatment, be sure to tell the healthcare professional that you’re taking Abilify.

Abilify and cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Abilify. However, as with any drug or supplement, talk with your doctor before taking cannabis in combination with Abilify. The impact of cannabis may affect how well you stick to your Abilify treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Abilify. Before you take Abilify, be sure to talk with your doctor about your health history. Abilify may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Abilify include the following.

Low blood pressure. Abilify can sometimes cause low blood pressure, especially when getting up from sitting or lying down. This could cause dizziness or fainting. If you already have low blood pressure or take blood pressure medication, you may have an increased risk of this side effect. Your doctor may monitor your blood pressure while you take Abilify.

Dehydration. Antipsychotics such as Abilify can sometimes make it harder for your body to manage its core body temperature. This can increase your risk of hyperthermia or heat stroke, such as in hot weather or when doing vigorous exercise.

Becoming dehydrated while taking Abilify can increase your risk of hyperthermia. Dehydration can make low blood pressure more likely to occur. (For more information, see “Low blood pressure” above.) To avoid dehydration while taking Abilify, be sure to drink plenty of fluids.

Heart problems or stroke. Abilify can sometimes cause low or high blood pressure.If you have a heart problem or have had a stroke, blood pressure changes could cause a heart attack or stroke in rare cases. To see whether Abilify is right for you, talk with your doctor.

Diabetes. Antipsychotic medications such as Abilify can sometimes increase blood sugar levels. If you have diabetes, this could make your blood sugar harder to manage. As a result, your doctor may want to check your blood sugar more often while you take Abilify. If needed, they may adjust the dosages of your diabetes medications.

Your doctor may also check your blood sugar frequently while you take Abilify if you have obesity or prediabetes. If your blood sugar becomes too high, your doctor may prescribe medication to help lower it.

High cholesterol or triglycerides. Antipsychotic medications such as Abilify can sometimes increase blood levels of cholesterol and other fats called triglycerides. If you already have high cholesterol or triglyceride levels, taking Abilify could make your condition worse.

Your doctor may monitor your cholesterol and triglyceride levels while you take Abilify. If needed, they can prescribe medication to lower them. If you already take cholesterol or triglyceride medication, your doctor may adjust your dosage.

Low white blood cell count. Abilify can sometimes lower white blood cell counts, which can increase the risk of infection. If you already have a low white blood cell count or have had it in the past, you may have an increased risk of the condition with Abilify. Your doctor can advise you on whether Abilify is right for you. If they prescribe the drug, they’ll likely monitor your white blood cell count during treatment.

Seizures. Abilify can sometimes cause seizures. If you’ve had seizures in the past, you may have an increased risk of seizures with Abilify. To see whether Abilify is an option for you, talk with your doctor.

CYP2D6 poor metabolizers. CYP2D6 is an enzyme in your liver that helps break down certain drugs in your body. If your CYP2D6 enzyme does not work correctly, your body may not metabolize CYP2D6 as it should. The condition can cause certain drugs, including Abilify, to build up in your body and lead to serious side effects.* If your body doesn’t metabolize CYP2D6 as it should, your doctor will likely prescribe a dosage of Abilify that’s lower than usual.

Pregnancy. It’s not known if Abilify is safe to take during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about the possible risks and benefits of Abilify.

Breastfeeding. Abilify may pass into breast milk. If you’re breastfeeding or plan to breastfeed, talk with your doctor. They can advise you on other ways to feed your child and whether Abilify is right for you.

Allergic reaction. If you’ve had an allergic reaction to Abilify or any of its ingredients, your doctor will likely not prescribe Abilify. To learn more, see “When to avoid Abilify” above.

Older age. Doctors typically will not prescribe Abilify to older people who have psychosis that’s related to dementia. Antipsychotic medications such as Abilify can increase the risk of death in this group of people.† Abilify is not approved to treat psychosis that’s related to dementia.

In addition, older people may have a greater risk of low blood pressure with antipsychotics such as Abilify. Low blood pressure can cause dizziness, which could increase the risk of falls in this age group. To learn more, see “Low blood pressure” above.

You can also talk with your doctor for more information about Abilify and older adults.

Age younger than 25 years. Abilify is used to treat several mental health conditions, including depression. These conditions may increase the risk of suicidal thoughts and behaviors.

Studies show that antidepressants can increase the risk of suicidal thoughts and behaviors in children and adults younger than age 25 years.† (Abilify is often prescribed in combination with an antidepressant to treat depression.) The risks are higher early in treatment and after dose changes. Abilify is not approved to treat depression in people younger than age 18 years.

Whatever condition you take Abilify for, talk with your doctor right away if you notice symptoms of suicidal thoughts and behaviors. These can include any new or sudden changes in your mood, feelings, thoughts, or behavior. Be sure to ask people close to you to watch for these changes as well.

* For more information about the side effects of Abilify, see this article.
† Abilify has a boxed warning about the risk of this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). The warning alerts doctors and patients about drug effects that may be dangerous.

Here are some frequently asked questions about Abilify and possible interactions.

Is there an interaction between Abilify and Vyvanse?

Abilify has not been reported to interact with lisdexamfetamine dimesylate (Vyvanse), which is a stimulant medication. Vyvanse is prescribed to treat attention deficit hyperactivity disorder (ADHD) and binge eating disorder.

Taking Abilify with Vyvanse is not known to affect how these medications work in your body. However, both medications can cause some similar side effects. These include headaches, dizziness, trouble sleeping, and anxiety. So, taking these drugs together could increase the risk of these side effects.

If you have additional questions about Abilify and Vyvanse, talk with your doctor or pharmacist.

Does Abilify interact with thyroid medications?

No, Abilify is not known to interact with thyroid medications.

The thyroid gland helps manage your metabolism* by producing certain hormones. If your body does not make enough natural thyroid hormones, your doctor may prescribe thyroid medication such as levothyroxine (Synthroid).

Abilify can cause changes in your metabolism that lead to an increase in blood sugar and cholesterol levels. However, these changes do not involve your thyroid hormones. Abilify does not affect the way thyroid medications work.

Your doctor and pharmacist can tell you more about Abilify and thyroid drugs.

* Your metabolism refers to the chemical processes in your body that convert food and oxygen into energy for cells.

Does caffeine interact with Abilify?

Caffeine has not been reported to interact with Abilify.

Abilify can sometimes cause sleepiness. Caffeine, on the other hand, is a stimulant that can increase alertness. It’s found in drinks such as coffee, tea, and cola, as well as in foods such as chocolate. Caffeine is also found in certain medications.

Consuming caffeine with Abilify may reduce the sleepiness that Abilify can cause. However, both caffeine and Abilify can sometimes cause heart palpitations. So, you may have an increased risk of this side effect if you take caffeine with Abilify.

You can talk with your doctor about whether you can safely take caffeine with Abilify.

You can take certain steps to help prevent interactions with Abilify. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan the following:

• Let them know if you drink alcohol or take cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Abilify and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Abilify by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Abilify. These resources might help:

• Overview of Abilify. For a general overview of Abilify, you can see this article.
• Side effects. If you’re interested in learning about the side effects of Abilify, see this article. Another option is to refer to the prescribing information for Abilify, Abilify Maintena, and Abilify Mycite.
• Dosage specifics. To learn about the dosage of Abilify, see this article.
• Cost. If you’d like to learn about Abilify and cost, see this article.
• Drug comparison. Learn how Abilify compares with Abilify Maintena, Rexulti, and Latuda.
• Facts about your condition. To learn more about your condition, see our:
  • mental health hub
  • bipolar disorder hub
  • autism hub

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.