What is Cariprazine?
Cariprazine is an antipsychotic that can be used to treat schizophrenia and certain types of bipolar disorder. It may also be added as a treatment for major depressive disorder. Cariprazine belongs to the atypical antipsychotic drug class.
Cariprazine may work by regulating brain chemicals (neurotransmitters), such as serotonin or dopamine. Cariprazine's mechanism of action is not known, but its effects may come from a combination of partial agonist and antagonist activity on central serotonin 5HT1A and dopamine D2 receptors.
Cariprazine is indicated for treating adults with:
- Schizophrenia
- Bipolar disorder is associated with acute manic or mixed episodes.
- Bipolar disorder and depressive episodes
- Addition of an antidepressant treatment (ADT) to the main depressive disorder (MDD).
Cariprazine, under the brand name Vraylar, became FDA-approved on September 17, 2015.
Side effects of Cariprazine
Cariprazine can cause a variety of side effects.
- Involuntary muscular movements
- Upset stomach, vomiting;
- Drowsiness
- Feeling restless
Serious cariprazine side effects
If you experience any of the following symptoms of an allergic reaction: hives, difficulty breathing, swelling of your lips, face, tongue, or throat, call 911 immediately.
If you experience:
- A sudden feeling of numbness or weakness on one side
- Problems with speech or vision
- Feeling dizzy as though they could faint.
- Severe distress or agitation
- A seizure;
- Uncontrolled facial movements (such as lip smacking and frowning; tongue movement or blinking);
- Trouble swallowing or accidentally inhaling foods or drinks;
- Low white blood cells (low white cell count): flu, chills, sore neck (sore throat), mouth sores, skin sores and sores on the lips and throat, difficulty breathing, feeling lightheaded.
- High blood sugar: increased thirst, increased urination, and a fruity breath smell;
- Severe nervous system reaction: very stiff muscles (rigid), high fever, sweating and confusion, rapid or uneven heartbeats Tremors. Feeling like you may pass out.
Cariprazine has a long-lasting effect on the body. Some side effects may persist for several weeks even after stopping the medication. You could also experience new side effects if your dose changes.
Other side effects may also occur. Call your physician if experiencing side effects; to report side effects call the FDA directly at 1-800-FDA-1088.
Warnings
Cariprazine has not been approved for older adults who have dementia-related psychosis. It can increase the risk of death in older adults who have dementia-related psychosis.
Children and young adults who take antidepressants are at increased risk for suicidal behaviour and thoughts. All antidepressant-treated patients should be closely monitored for clinical worsening and the emergence of suicidal thoughts and behaviors. This medicine has not been studied in paediatric patients.
Cariprazine can interfere with the body's ability to reduce core body temperatures. Increased body temperature can be caused by exposure to extreme heat, exercise, dehydration, and anticholinergic drugs. In these situations, use this medication with caution.
Before you take this drug
Cariprazine should not be used if you have an allergy to any of the ingredients in it. You can find a complete list of Vraylar's ingredients by clicking here. Cariprazine should not be used by anyone under the age of 18.
Tell your doctor about any of the following to ensure that cariprazine will not harm you:
- High cholesterol (or triglycerides, a type of fat found in the blood);
- A stroke or blood clot
- Heart disease
- Low white blood cell counts;
- High blood pressure
- Liver or kidney disease
- Diabetes;
- Have or have seizures (convulsions).
- If you are dehydrated.
Pregnancy
Inform your healthcare provider of any pregnancy plans if you are pregnant or plan to be pregnant. Cariprazine can harm your unborn child if taken while pregnant. Antipsychotic medication taken in the last three months of pregnancy can cause withdrawal symptoms in newborns. These include breathing problems, feeding difficulties, fussiness, and tremors. If you get pregnant, tell your doctor right away. Do not stop taking the medicine without consulting your doctor.
You may find your name on a registry for pregnant women to track the effects cariprazine has on the child.
Breastfeeding
Breastfeeding may not be recommended while taking this medication. Speak to your doctor about the best way for you to feed your child while taking cariprazine.
How to take cariprazine?
Follow the directions on your prescription label and read all medication guides or instruction sheets. Read all the instructions and directions that come with your prescription. Sometimes your doctor will change the dose.
Take one capsule of cariprazine daily, with or without food. Your symptoms may not improve for several weeks. Continue to take the medication according to instructions, and inform your doctor if you do not see improvement in your symptoms.
Tell your doctor immediately if you notice any weight changes while taking this medication. You will also need frequent blood tests to check your heart rate and blood pressure. Blood tests may be required frequently.
This medicine, taken in high doses for long periods of time, may cause serious movement disorders that are not reversible. This disorder is more likely to occur if you take this medication for a long time, particularly if you're an older adult. This disorder is characterised by tremors and other uncontrollable movements of the muscles.
Details on dosage
The usual adult dose for schizophrenia is:
Initial Dose: 1,5 mg orally, once per day.
Titration Regimen: On Day 2, the dose can be increased by 1.5 mg to 3mg. Further dose adjustments are made in increments of 1.5–3 mg based on effectiveness and tolerance.
Maintenance Dose: 1,5 to 6 mg orally, once daily.
Maximum dose: 6 mg/day.
Bipolar I: Adult Dosage for Manic or Mixed Episodes
Initial Dose: 1,5 mg orally, once per day.
Titration Regimen: On Day 2, the dose should be increased by 1.5 mg to 3mg. Further dose adjustments can be made based on effectiveness and tolerance.
Maintenance Dose: Orally, 3 to 6 mg once daily.
Maximum dose: 6 mg/day
Bipolar Depression in Adults:
Initial Dose: 1,5 mg orally, once per day.
Titration Regimen: Based on effectiveness and tolerance, the dose may be increased by 3 mg to once daily on Day 15.
Maintenance Dose: 1,5 mg to 3mg orally, once per day.
Maximum dose: 3 mg/day
Use the usual adult dose for adjunctive therapy to antidepressants in MDD:
Initial Dose: 1,5 mg orally, once per day.
Titration Regimen: Based on effectiveness and tolerability, the dose can be increased from 3 mg to 1 mg per day on Day 15. In clinical trials, dosage titrations at intervals less than 14 days were associated with a higher rate of adverse reactions.
Maintenance Dose: 1,5 mg to 3mg orally, once per day.
Maximum dose: 3 mg/day.
Comments:
- Monitor for adverse reactions or treatment responses for several weeks following the start of therapy.
- The doses above 6mg per day did not show an increased efficacy sufficient to overcome adverse effects related to the dosage.
- You will need to adjust the dosage for CYP3A4 inhibitors and inducers.
- For more information about cariprazine dosage, click the link below.
What happens if I miss the dose?
If you are almost due for your next dose, skip the missed one. Never take two doses of any medicine at the same time. This could have adverse side effects.
What happens if I overdose?
Call 1-800-222-1222 immediately if you suspect being poisoned and seek immediate medical advice or call our help line on 1800222-1222 if symptoms indicate taking poison may have caused any harm to the body.
What should be avoided?
Do not drive or engage in any hazardous activities until you have experienced the effects of this medication. You may feel dizzy if you get up quickly from a lying or sitting position. Drowsiness or dizziness can lead to accidents or serious injuries. You may be more sensitive than usual to extreme temperatures, such as extremely hot weather. Avoid overheating or becoming dehydrated. Be sure to drink plenty of fluids during hot weather or when exercising.
Interaction with other drug
At times it may not be safe to combine certain medications. Some drugs may affect the blood levels of drugs that you are taking, increasing side effects or making them less effective. Cariprazine can have dangerous side effects or even cause death. Before taking opioids, sleeping pills, muscle relaxers, or medicines for seizures, ask your doctor.
Tell your doctor if you are taking any medicines that are CYP3A4 inducers or inhibitors. To check for possible interactions, click on the link below.
Cariprazine can interact with many drugs. These include all medications you are currently taking (prescription and over-the-counter medicines, vitamins, and herbal products), any new ones you start taking and any possible interactions among them. It is essential that your physician be informed about all medicines taken including any new ones taken since this list does not encompass every possible interaction.
