Cariprazine

Reviewed on 12/20/2021

Brand Name: Vraylar

Generic Name: Cariprazine

Drug Class: Antipsychotics, 2nd Generation; Bipolar Disorder Agents

What Is Cariprazine and How Does It Work?

Cariprazine is a prescription medication used to treat Schizophrenia and Bipolar I Disorder

  • Cariprazine is available under the following different brand names: Vraylar

What Are Dosages of Cariprazine?

Adult dosage

Capsule

  • 1.5mg
  • 3mg
  • 4.5mg
  • 6mg

Schizophrenia

Adult dosage

  • 1.5 mg orally once daily initially; may increase to 3 mg/day on Day 2. 
  • Depending upon clinical response and tolerability, further dose adjustments can be made in 1.5 to 3-mg increments; the dosing range is 1.5-6 mg orally once daily. 

Bipolar I Disorder

Adult dosage

Manic or mixed episodes

  • Day 1: 1.5 mg orally
  • Day 2: Increase to 3 mg orally
  • Day 3 and thereafter: Depending on clinical response and tolerability, further dose adjustments can be made in 1.5 to 3-mg increments; the dosing range is 3-6 mg orally once daily; not to exceed 6 mg/day. 

Depressive episodes

  • 1.5 mg orally once daily initially
  • Depending upon clinical response and tolerability, the dosage can be increased to 3 mg once daily on Day 15; not to exceed 3 mg once daily. 

Dosage Considerations – Should be Given as Follows: 

  • See “Dosages”.

QUESTION

Schizophrenia is the most disabling mental illness. See Answer

What Are Side Effects Associated with Using Cariprazine?

Common side effects of Cariprazine include:

Serious side effects of Cariprazine include:

  • hives
  • difficulty breathing
  • swelling of the face, lips, tongue, or throat
  • sudden numbness or weakness (especially on one side of the body), 
  • problems with vision or speech, 
  • lightheadedness
  • severe distress, 
  • agitation, 
  • seizure
  • uncontrolled muscle movements in the face (chewing, lip-smacking, frowning, tongue movement, blinking or eye movement), 
  • trouble swallowing, 
  • accidentally inhaling food or drink, 
  • fever
  • chills
  • sore throat
  • mouth sores, 
  • skin sores, 
  • sore throat, 
  • cough
  • increased thirst, 
  • increased urination, 
  • dry mouth
  • fruity breath odor, 
  • very stiff (rigid) muscles, 
  • high fever, 
  • sweating
  • confusion, 
  • fast or uneven heartbeats, and
  • tremors

Rare side effects of Cariprazine include:

  • none 
This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

What Other Drugs Interact with Cariprazine?

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

  • Cariprazine has severe interactions with at least 22 other drugs. 
  • Cariprazine has serious interactions with at least 19 other drugs.
  • Cariprazine has moderate interactions with at least 85 other drugs.
  • Cariprazine has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drugs interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What are warnings and precautions for Cariprazine?

Contraindications

  • Hypersensitivity to Cariprazine 

Effects of drug abuse

  • None

Short-Term Effects

  • See “What Are Side Effects Associated with Using Cariprazine?”

Long-Term Effects

  • See “What Are Side Effects Associated with Using Cariprazine?”

Cautions

Drug interactions overview

  • Coadministration with a strong CYP3A4 inhibitor increases the exposures of Cariprazine and its major active metabolite, didesmethylcariprazine (DDCAR), compared to the use of Cariprazine alone (see Dosage Modifications)
  • The effect of CYP3A4 inducers on the exposure of Cariprazine has not been evaluated, and the net effect is unclear

Metabolic changes

  • Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, reported; assess fasting plasma glucose before or soon after initiation of antipsychotic medication, and monitor periodically
  • Lipids alteration has occurred; obtain a fasting lipid profile at baseline and monitor periodically during treatment before or soon after initiation of antipsychotic medication
  • Weight gain observed; monitor weight at baseline and frequently thereafter

Suicidal thoughts or behaviors

  • Pooled analyses of placebo-controlled trials of anti-depressive drugs showed an increased risk of suicidal thoughts or behavior in patients aged 24 years or younger taking these drugs for any indication; monitoring for emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior
  • Inform patients, their caregivers, and families of the increased the risk of suicidal thoughts and behavior; advice to be alert for the emergence or worsening of signs and symptoms

Pregnancy and Lactation

  • Neonates exposed to antipsychotic drugs during the third trimester of pregnancy are at risk for extrapyramidal symptoms or withdrawal symptoms after delivery; these complications vary in severity, with some being self-limited and others requiring ICU support and prolonged hospitalization

Pregnancy exposure registry

  • Report exposure during pregnancy to the National Pregnancy Registry for Atypical Antipsychotics 1-866-961-2388 OR, http://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/. 
  • Unknown if distributed in human breast milk.  
  • Present in rat milk. 
  • Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for the drug, and any potential adverse effects on the breastfed infant from the drug or the underlying maternal condition.

SLIDESHOW

Schizophrenia: Symptoms, Types, Causes, Treatment See Slideshow
References
Medscape. Cariprazine.

https://reference.medscape.com/drug/vraylar-cariprazine-999874

Health Solutions From Our Sponsors