Jeffrey Panko NP Psychiatry · Patient education
Cariprazine
Vraylar / Oral capsules
A guide for adults taking cariprazine.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Capsules are taken once daily. Medication and active metabolites accumulate over weeks; taking extra doses can create problems that persist.
What it is used for
Cariprazine treats schizophrenia, manic or mixed episodes and depressive episodes of bipolar I disorder, and is added to an antidepressant for major depression. Doses differ by indication.
How it works
It partially activates dopamine D3 and D2 receptors and affects serotonin receptors. Active breakdown products stay in the body for a long time, so dose changes have delayed effects.
What to expect over time
Benefit and side effects can change for several weeks after starting or adjusting the dose. Restlessness may emerge later rather than on the first day.
Keep follow-up appointments after dose changes and after stopping or switching treatment.
Taking your medication
- Take once daily, with or without food, following your prescribed dose.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Do not increase the dose early because an effect seems delayed.
- Report side effects even if the most recent dose change was several weeks ago.
When to get help
Emergency symptoms. Get emergency care for fever with severe muscle stiffness and confusion, a seizure, fainting with an irregular heartbeat, or trouble breathing. Fever and stiffness can signal neuroleptic malignant syndrome, a rare but serious reaction.
Prompt medical advice. Contact your provider promptly for new involuntary movements, trouble swallowing, severe restlessness, or symptoms of high blood sugar such as unusual thirst and frequent urination.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Restlessness or an inner urge to move
- Stiffness, tremor, or slowed movement
- Nausea or constipation
- Sleep changes; weight or blood-sugar changes
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Expect periodic checks of weight, blood pressure, blood sugar, cholesterol, and movement symptoms. Some changes, such as higher blood sugar, may occur before you feel different.
Report new mouth, tongue, face, or limb movements. Tardive dyskinesia is a movement disorder that can persist after medication is stopped.
Report distressing restlessness early. When used with an antidepressant, pay close attention to worsening mood or suicidal thoughts, especially under age 25.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss diabetes, heart-rhythm problems, fainting, seizures, low blood counts, swallowing difficulties, and kidney or liver disease. Antipsychotics increase the risk of death in older adults with dementia-related psychosis.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Strong or moderate CYP3A inhibitors may require a dose change. CYP3A inducers, such as carbamazepine or rifampin, are not recommended with cariprazine.
Review grapefruit, alcohol, other sedatives, and blood-pressure medicines. Effects of interaction changes may persist because the medication clears slowly.
Everyday tips
Stand up slowly. Avoid driving until you know how the medication affects alertness and coordination.
Stay hydrated and take breaks in hot weather. Some antipsychotics interfere with temperature regulation.
Discuss appetite or weight changes early, and keep scheduled monitoring visits.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment may prevent symptoms from returning. Abrupt stopping can cause withdrawal symptoms or a relapse.
What if I cannot sit still?
An inner urge to keep moving can be akathisia, a medication side effect. Tell your provider promptly; it can be mistaken for worsening anxiety.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.