cariprazine VRAYLAR

Class: Second Generation Antipsychotic
FDA Indications: Schizophrenia, Bipolar Mania
Off-Label Use: Behavioral And Psychological Symptoms Of Dementia
Forms: 1.5, 3, 4.5, 6mg capsule
Dose Range: 1.5-6 mg/day
Starting: 1.5 mg qd, then titrate up to 3-6 mg qd
Stopping: Taper 6-8 weeks, rapid d/c can lead to rebound psychosis

NAMI drug fact sheet

Serious Side Effects: , , ,
Not in CredibleMeds's database at this time.
Side Effects: EPS, akathisia, dyspepsia, vomiting, sedation/somnolence, restlessness, insomnia, dizziness, constipation
1° MOA: D3-preferring D3/D2 receptor partial agonist
Target: Partial agonism at: Antagonism at:
t½: 48 (31-69)° TMAX: 3-4°
Substrate of: 3A4; 2D6
Inhibits: ∅ ; Induces:
Active Metabolites: desmethyl-cariprazine (DCAR) & didesmethyl-cariprazine (DDCAR)
  • - t½ of combined drug (parent compound and its 2 active metabolites) is ~1 week
  • - shows preference for D3 receptors over D2 receptors
  • - minimal effect on prolactin
  • - relative lack of effect on metabolic parameters, including weight
Special Populations

Category Not assigned.—There are no available data on VRAYLAR use in pregnant women to inform any drug-associated risks for birth defects or miscarriage.

It is not known if cariprazine is excreted in breast milk.

All atypicals may increase mortality in elderly patients by 1.7 times greater than placebo.

2019 BEE℞S Recommendation: Avoid, except in schizophrenia or bipolar disorder. Increased risk of CVA and greater rate of cognitive decline and mortality in persons with dementia. Avoid antipsychotics for behavioral problems of dementia or delirium unless nonpharmacological options have failed or are not possible and the older adult is threatening substantial harm to self or others.

No dosage adjustment necessary

Mild to moderate impairment: No dosage adjustment necessary; Severe impairment: Use not recommended


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.