Interactions Between Abilify (Aripiprazole) and Strattera (Atomoxetine)

Pharmacokinetic Interactions

• Atomoxetine is primarily metabolized through the cytochrome P450 2D6 (CYP2D6) pathway, which can be affected by other medications that use the same metabolic pathway 2
• Approximately 7% of the population are poor metabolizers of atomoxetine, resulting in significantly higher plasma levels and longer half-lives, which may increase the risk of adverse effects when combined with aripiprazole 2
• The combination may lead to competitive inhibition of the CYP2D6 pathway, potentially increasing blood levels of one or both medications 1

Potential Side Effects to Monitor

• The combination may increase the risk of cognitive impairment, as antipsychotic polypharmacy has been associated with cognitive effects 1
• The combination may increase the risk of increased global side-effect burden 1

Clinical Management Recommendations

• Consider genetic testing for CYP2D6 metabolizer status before initiating this combination, especially in patients with previous adverse reactions to either medication 1, 2
• Be vigilant for signs of increased side effects that might indicate elevated blood levels of either medication 1

Contraindications

• Avoid this combination in patients with significant cardiac abnormalities or cardiovascular disease 2
• Avoid this combination in patients with concurrent use of other medications that strongly inhibit or induce CYP2D6 1, 2