Cariprazine (Oral)

Cariprazine is available as a capsule that's taken by mouth and doesn't come as a generic medication.

Overview:

Cariprazine helps treat schizophrenia and episodes of mixed or manic bipolar 1 disorder.

Schizophrenia is a mental illness that leads to altered thinking. It may cause inappropriate actions or emotions. If you develop schizophrenia, you can have delusions or hallucinations. A hallucination refers to something you hear or see that doesn't exist. On the other hand, a delusion is an untrue belief about reality.

Cariprazine (brand name Vraylar) is also taken to treat incidences of mixed or manic bipolar 1 disorder. People with bipolar disorder may have episodes of intense moods, which may include depression, mania, or a mix of both. Depression is an utterly sad or hopeless state while mania is an extremely excited and joyful state. These episodes may lead to drastic changes in your usual activity and behavior.

Cariprazine is in a drugs class known as atypical antipsychotics.

It is unclear how Vraylar works to treat bipolar 1 disorder or schizophrenia. If you suffer from these conditions, you may not have the right balance of chemicals known as serotonin and dopamine in your brain. Vraylar is believed to help rectify some of these imbalances. This helps relieve your symptoms of bipolar 1 disorder and schizophrenia.

Cariprazine only comes with a doctor's prescription.

Before you take Cariprazine, inform your healthcare professional about all medical conditions you have. Especially let your healthcare provider know if you have:

  • Heart disease
  • Heart failure
  • Dehydration
  • Circulation or blood vessel problems
  • Heart rhythm problems
  • Diabetes
  • Low blood amount (hypovolemia)
  • Stroke/history of stroke—may worsen side effects
  • Low blood pressure (hypotension)
  • High blood sugar (hyperglycemia)
  • Seizures/history of seizures
  • Fewer white blood cells (leukopenia)
  • Neuroleptic malignant syndrome or history of the same
  • Problem with swallowing—use Vraylar carefully. It may make this symptom worse.
  • Tardive dyskinesia (movement problems) or history of the same

Vraylar is not suitable for everybody. Don't take it if you're allergic to it.

This medication can make you drowsy, lightheaded, or dizzy especially when you take it for the first time or when your dose is adjusted. Don't drive or carry out any task that might be hazardous until you are aware of how Vraylar affects you. Sit or stand up slowly.

This medication can make you overheated. Take lots of water when exercising or during hot weather.

Your doctor will carry out lab tests regularly to assess the effects of Cariprazine on you. Honor all your appointments.

Keep all medicines beyond the reach of kids. Never share Cariprazine with anyone else.

Conditions treated:

  • Schizophrenia
  • Bipolar disorder-related mania
    Mixed bipolar 1 disorder episode

Type of medicine:

  •  Atypical antipsychotic

Side effects:

Along with its desirable effects, Cariprazine can cause several undesirable effects.

See your doctor as promptly as possible if you have any of these effects while using Cariprazine.

More common:

  • Fever
  • Chills
  • Blurred vision
  • Dizziness
  • Drooling
  • Headache
  • Restlessness
  • Inability to move eyes
  • Failure to sit still
  • Shuffling walk
  • Nervousness
  • Pounding in ears
  • Loss of control of balance
  • Increased spasms or blinking of eyelids
  • Stiffness, jerking, or muscle trembling
  • Desire to keep moving
  • Fast or slow heartbeat
  • Stiffness of limbs
  • Sticking out of tongue
  • Trouble with speaking, swallowing, or breathing
  • Twisting body movements
  • Unusual facial expressions
  • Uncontrolled movements, particularly of the neck, face, legs, or arms

Less common:

  • Sore throat
  • Cloudy or bloody urine
  • Bladder pain
  • Muscle aches
  • Unusual tiredness/weakness
  • Lower back/side pain
  • Stuffy/runny nose
  • Frequent urge to pass urine
  • Painful, difficult, or burning urination
  • Irregular, fast, or pounding heartbeat or pulse

Frequency unknown:

  • High fever
  • Convulsions
  • Confusion
  • Double vision
  • Increased sweating
  • Drooling
  • Puffiness of cheeks
  • Lip puckering or smacking
  • Muscle stiffness, trembling, or jerking
  • Severe muscle stiffness
  • Rapid/worm-like movements of tongue
  • Unusually pale skin
  • Uncontrolled chewing movements

Some Cariprazine side effects can occur that often don't require medical care. These effects may die out as your body adapts to Cariprazine. Your healthcare provider may also suggest ways to prevent or relieve some of these effects. See your healthcare provider if any of these effects are bothersome or persist or if you have queries about them.

More common:

  • Diarrhea
  • Nausea
  • Abdominal/stomach pain
  • Difficulty with having bowel movements (defecation)
  • Trouble sleeping
  • Unusual drowsiness or sleepiness

Less common:

  • Irritability
  • Anxiety
  • Acid/sour stomach
  • Belching
  • Back pain
  • Cough
  • Reduced appetite
  • Dry mouth
  • Difficulty with moving
  • Indigestion
  • Heartburn
  • Muscle stiffness or pain
  • Rash
  • Pain in the legs, arms, or joints
  • Weight gain
  • Stomach upset or discomfort
  • Shaking

Other Cariprazine side effects are not listed above but may also happen in some people. If you have any other effects, see your healthcare provider promptly. You can call the FDA to report side effects at 1-800-FDA-1088.

Dosage:

Take Cariprazine exactly as instructed by your physician. Carefully follow the directions on the label.

Cariprazine is available in the form of a capsule and is normally taken once daily, with or without meals.

If you forgot a dose, take it immediately once you remember. Don't take double Cariprazine doses at once. If it's just about time for another dose, don't take the missed dose and follow your dosing schedule.

The Vraylar dose your doctor recommends will depend on these factors:

  • The medical problem being treated
  • The other medical problems you have
  • Other drugs you're using
  • How you react to Vraylar
  • Your age

The recommended range of dose for Vraylar for treating bipolar disorder in an adult is 3-6 milligrams a day.

The recommended range of dose for Vraylar for treating schizophrenia in an adult is 1.5-6 milligrams a day.

If you take excess Cariprazine, contact your poison control service or healthcare professional, or seek emergency treatment right away. Symptoms of a Cariprazine overdose include sedation, and feeling dizzy or lightheaded when getting up on your feet.

Interactions:

Although some medicines shouldn't be combined for treatment, in some situations two different medications can be combined even if there might be an interaction. In these situations, your healthcare provider may want to alter your dose or give you other precautions. When taking Cariprazine, it's especially vital that your healthcare provider knows if you're using any of the following medications. These interactions aren't necessarily all-inclusive and have been picked depending on their potential impact.

Using Cariprazine with any of these drugs isn't recommended. Your doctor can decide to not treat you with Cariprazine or alter some of the alternative medications you use.

  • Bromopride

Using Cariprazine with any of the medicines below is normally not advised, but in some cases it may be necessary. If both medications are recommended together, your doctor can alter your dose or how frequently you take both or one of the drugs.

  • Tramadol
  • Alfentanil
  • Cobicistat
  • Indinavir
  • Idelalisib
  • Boceprevir
  • Conivaptan
  • Codeine
  • Buprenorphine
  • Dihydrocodeine
  • Carbamazepine
  • Fentanyl
  • Butorphano
  • Clarithromycin
  • Hydrocodone
  • Fosphenytoin
  • Ketoconazole
  • Itraconazole
  • Oxycodone
  • Morphine
  • Morphine Sulfate Liposome
  • Nefazodone
  • Lopinavir
  • Methadone
  • Hydromorphone
  • Nelfinavir
  • Meperidine
  • Oxymorphone
  • Voriconazole
  • St John's Wort
  • Remifentanil
  • Sufentanil
  • Tapentadol
  • Rifampin
  • Telithromycin
  • Ritonavir
  • Saquinavir
  • Posaconazole
  • Phenytoin
  • Telaprevir
  • Pentazocine

This isn't a comprehensive list of Vraylar interactions. Be sure to ask your healthcare providers for more information.

Warnings:

Before taking Cariprazine:

Tell all your healthcare givers if you're allergic to this medication, any of its ingredients, or any other medications you are using. Ask for a list of Cariprazine ingredients from your pharmacist and doctor.

Tell all your healthcare givers what vitamins, minerals, nutritional supplements, as well as non-prescription and prescription medicines you're taking or intend to take. Make sure to point out any of these:
Anticholinergics like Atropine (Duodote, Enlon-Plus, Atropen), Dicyclomine (Bentyl), Propantheline (Pro-Banthine), Glycopyrrolate (Robinul), Benztropine (Cogentin), Hyoscyamine, and Transderm Scop (Scopolamine).

Be sure to also mention Carbamazipine (Carbatrol, Teril, Tegretol, Epitol, Equetro), Itraconazole (Sporanox, Onmel), medicines for blood pressure, Ketoconazole, and Rimfapin (Rifater, Rifamate, Rifadin, Rimactane). Your healthcare giver may need to monitor you closely or change your doses of medications. Many other medications can interact with Cariprazine as well, so make sure to inform your healthcare giver about all the medicines you take, even those that aren't in this list.

Tell your healthcare giver what herbal medications you're using, especially one known as St John's wort.

If you have fewer white blood cells, let your doctor know right away. Also tell them if you've ever had fewer white blood cells after taking a certain medication. Some medicines' side effects include reduced white blood cells. Inform your physician if you have seizures or have had them before; a ministroke, a stroke, heart failure, a heart attack, trouble maintaining your balance, irregular heartbeat, trouble swallowing, or kidney, heart, or liver disease. Also notify your physician if you have diarrhea, severe vomiting, or symptoms of dehydration right now, or if you get these symptoms any time in the course of treatment.

Tell your healthcare professional if you're having a baby, especially if you're in the latter months of pregnancy, or you plan to try for a baby or are nursing an infant. If you get pregnant during Cariprazine treatment, give your doctor a call. Cariprazine may cause issues in newborns after delivery if it's used in the final months of pregnancy.

You need to know that Vraylar may cause drowsiness, and may hinder your ability to make decisions, think clearly, and react quickly. During your Vraylar treatment, please don't drive or use heavy machines until you understand how Vraylar affects you.

You need to know that your blood sugar levels can rise when using Cariprazine (this is also called hyperglycemia). This can happen even if you don't already suffer from diabetes. If you're suffering from schizophrenia, you're more likely to get diabetes than someone who is receiving Cariprazine and doesn't have schizophrenia. Using similar medicines may also increase this risk.

Notify your physician as soon as you notice any of these symptoms while receiving Cariprazine: extreme hunger, extreme thirst, frequent urination, weakness, or blurred vision. It is vitally important to call your physician as soon as you experience any of the above symptoms as high blood sugar may cause a very serious condition known as ketoacidosis. This condition may be potentially fatal if it's not attended to in the early stages. Some ketoacidosis symptoms include nausea and vomiting, dry mouth, shortness of breath, fruity-smelling breath, and reduced consciousness.

You need to know that Vryalar may cause fainting, dizziness, or lightheadedness when you suddenly get up on your feet from a lying/sitting position. This commonly occurs when you start taking Vraylar for the first time. To avoid this, slowly get out of your bed, rest your feet for a couple of minutes and then stand up.

You need to know that Cariprazine can make it more difficult for you to cool down in times of extreme heat. Tell your healthcare professional if you're going to stay around extreme heat or plan to work out vigorously. Make sure to take lots of water and give your doctor a call as soon as you have any of these symptoms: sweating heavily, feeling very hot, not sweating even in extreme heat, decreased urination, or excessive thirst.

Storage:

Keep Vraylar at room temperate and in a tightly sealed container. Remember to keep Vraylar away from direct light, and excess heat and moisture.

Do not freeze Vraylar and keep it away from your kids. If your Vraylar is out of date or you no longer use it, throw it away. If you are unsure, ask your healthcare giver how Vraylar can be disposed of safely.

Summary:

Cariprazine (Vraylar) is available in the form of a capsule that's taken orally (by mouth). It is normally taken once daily with or without meals. Make sure to take the medicine at exactly the same time daily. Carefully follow the instructions on the label, and ask your healthcare professionals to explain whatever you don't understand about Cariprazine.

Take Vraylar exactly as ordered by your physician. Please don't take less or more of Vraylar, don't take Vraylar for longer than instructed, and don't take it more times than prescribed. If you do so, you may up your risk of side effects.

Your doctor is likely to get you started on a low Cariprazine dose. He or she will then increase your dose gradually, depending on the effects you experience, and how well you respond to the medication.

Cariprazine may help to manage symptoms of your schizophrenia or bipolar disorder but won't cure the medical condition. You may have to wait several weeks or so to fully benefit from Cariprazine. Continue using the medication even if you start to feel better. Don't stop using Cariprazine without consulting your doctor. If you feel like you're not getting better while being treated with Cariprazine, speak to your doctor.

Vraylar isn't approved by the FDA for treating behavioral conditions in seniors suffering from dementia. Please talk to the healthcare professional who prescribed Vraylar if you, someone in your family, or someone you love suffers from dementia and is receiving Cariprazine treatment. For more information, log on to the FDA site.

Keep all of your laboratory and doctor appointments. Your doctor may arrange some laboratory tests to assess your body's reaction to Vraylar.

This medication can be used for other reasons, so be sure to ask for more information from your healthcare providers.

Talk about the good and bad of using Vraylar with your doctor. Unless you're told otherwise by your doctor, continue your usual diet while taking Vraylar.

Resources
Last Reviewed:
December 22, 2017
Last Updated:
April 04, 2018