Vraylar is a brand-name prescription medication that’s FDA-approved to treat certain types of mental health conditions in adults:

  • Manic or mixed episodes of bipolar I disorder. With bipolar I disorder, you may have episodes of mania (high mood) that last at least 7 days or are severe enough to need treatment in a hospital. These are called manic episodes. A mixed episode is when you have symptoms of mania and depression (low mood) at the same time. Vraylar is used for acute treatment of manic or mixed episodes. “Acute” means short term.
  • Depressive episodes of bipolar I disorder. Vraylar can also be used to treat episodes of depression in bipolar I disorder. These episodes may be referred to as bipolar depression.
  • Schizophrenia. With schizophrenia, you may have psychotic symptoms such as hallucinations (seeing or hearing things that aren’t really there). You may also have delusions, which are beliefs that aren’t true.

Vraylar contains the active ingredient cariprazine and is a type of drug called an atypical (second-generation) antipsychotic. It can help improve your mood, thinking, and behavior.

Vraylar comes as a capsule that you swallow. You’ll likely take the drug once a day. Vraylar is available in four different strengths: 1.5 mg, 3 mg, 4.5 mg, and 6 mg.

Is Vraylar a controlled substance?

No, Vraylar isn’t a controlled substance.

Controlled substances are drugs that have a high potential for being misused. They also have a high risk for people becoming dependent on using the drug. (When you’re dependent on a drug, your body needs the drug to feel normal.) Because of these risks, there are special rules around how controlled substances are prescribed and dispensed. Vraylar doesn’t have these risks.

Effectiveness

Vraylar was found to be effective for treating schizophrenia in clinical studies. The drug was also found to be effective for treating manic, mixed, and depressive episodes of bipolar I disorder in clinical studies. To read about the results of these studies, see the “Vraylar uses” section below.

Vraylar is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Vraylar contains the active drug cariprazine.

Vraylar can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Vraylar. These lists don’t include all possible side effects.

Some side effects may not occur for several weeks after you start taking Vraylar or for several weeks after any dose increases.

For more information on the possible side effects of Vraylar, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Vraylar, you can do so through MedWatch.

Mild side effects

Mild side effects of Vraylar can include:*

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Vraylar. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Vraylar’s Medication Guide. Side effects may differ slightly between people with schizophrenia and people with bipolar I disorder.
† For more information on these side effects, see “Side effect details” below.

Serious side effects

Serious side effects from Vraylar aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include:

* Vraylar has boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.
† For more information on these side effects, see “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Vraylar. It’s not known how often this occurs.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Vraylar. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain

Some people may gain weight while taking Vraylar.

In clinical studies, people who took Vraylar gained, on average, between 0.88 to 2.2 pounds (0.4 to 1 kilograms) over periods of 3 to 8 weeks. The amount of weight gain depended on the condition treated and the dose taken. Over the same periods, people who took a placebo had an average change in their body weight ranging from 0.22 lb (0.1 kg) of weight loss to 0.66 lb (0.3 kg) of weight gain. (A placebo is a treatment that contains no active drug.)

In a longer term study in people with schizophrenia, people who took Vraylar gained an average of:

  • 2.65 lb (1.2 kg) after 12 weeks
  • 3.75 lb (1.7 kg) after 24 weeks
  • 5.51 lb (2.5 kg) after 48 weeks

Vraylar wasn’t compared with a different drug or a placebo in this study.

Your doctor will regularly check your weight while you take Vraylar. If you’re concerned about weight gain, talk with them about ways to manage your weight during your treatment.

Weight loss

Vraylar isn’t likely to cause weight loss. People didn’t report losing weight in clinical studies of the drug.

Feeling sleepy

Vraylar use can cause people to feel sleepy or tired.

In clinical studies, sleepiness was reported in 5% to 8% of people who took Vraylar, depending on the condition treated and dose taken. By comparison, sleepiness was reported in 4% to 5% of people who took a placebo.

If you find that Vraylar does make you sleepy, you shouldn’t drive or take part in other activities that could be dangerous. And if the sleepiness is bothersome to you, talk with your doctor. They may be able to suggest a different medication.

Akathisia and tardive dyskinesia

Conditions known as akathisia and tardive dyskinesia are possible side effects of Vraylar use.

Akathisia

Akathisia is one of the most common side effects of Vraylar. In clinical studies, it was reported in 6% to 20% of people who took Vraylar, depending on the condition treated and dose taken. By comparison, akathisia was reported in 2% to 5% of people who took a placebo.

Akathisia is an uncomfortable feeling of restlessness and the urge to move around. It can cause you to make repetitive movements, especially with your legs, to ease these feelings.

Symptoms of akathisia can include:

  • feeling very restless or tense
  • fidgeting
  • tapping your feet
  • rocking back and forth while standing or sitting
  • shifting weight from one leg to the other
  • walking in place
  • pacing
  • crossing and uncrossing your legs or swinging one leg while sitting

If you develop symptoms of akathisia while taking Vraylar, tell your doctor. Sometimes these symptoms can eased by lowering the dose of Vraylar. Or sometimes your doctor may prescribe a different medication to help relieve this side effect.

Tardive dyskinesia

It’s not known exactly how often tardive dyskinesia occurs with Vraylar. However, the condition tends to be more common in women and older adults. And it’s more likely to occur when you take a higher dose or use the medication for a long time.

Tardive dyskinesia describes involuntary, repetitive body movements that you can’t control. The movements usually occur in your face, tongue, or jaw, but can also develop in other parts of your body, such as your arms or legs. This side effect typically develops after you’ve been taking Vraylar for a long time. It can also develop after you’ve stopped using it. Tardive dyskinesia can sometimes be permanent.

Symptoms of tardive dyskinesia can include:

  • lip smacking
  • tongue twisting
  • chewing motions
  • puffing out your cheeks
  • grimacing
  • jerky movements of your arms, legs, or torso

If you develop symptoms of tardive dyskinesia while using Vraylar, tell your doctor right away. Sometimes the symptoms can be relieved by lowering the dose of the medication. Or your doctor may prescribe a different drug to help ease tardive dyskinesia. If these options don’t help, your doctor may suggest switching to a medication other than Vraylar.

Nausea

Some people may experience nausea while taking Vraylar.

In clinical studies, nausea was reported in 5% to 13% of people who took Vraylar, depending on the condition treated and dose taken. By comparison, nausea was reported in 3% to 7% of people who took a placebo.

If you have nausea while taking Vraylar, talk with your doctor about ways to manage it.

Increased risk of death in older adults with psychosis due to dementia

Older adults with psychosis (loss of contact with reality) due to dementia have a higher risk of death if they take antipsychotic medications such as Vraylar.* Dementia refers to problems with thinking, memory, and communication.

In clinical studies of older adults with dementia-related psychosis, about 4.5% of those who took an antipsychotic died over a 10-week period. By comparison, about 2.6% of those who took a placebo died over the same period of time.

Vraylar is not FDA-approved to treat psychosis that’s related to dementia in older adults.

* Vraylar has a boxed warning from the FDA regarding the increased risk of death in older adults with psychosis due to dementia. A boxed warning is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Suicidal thoughts and behaviors

People with a mental health condition, such as schizophrenia, bipolar disorder, or depression, have a raised risk of suicidal thoughts and behaviors.*In some cases, children and young adults have a higher risk of suicidal thoughts and actions while taking an antidepressant medication. Vraylar is an antipsychotic medication, but it also has an antidepressant effect when used for depression in bipolar I disorder.

Clinical studies have found the risk of suicidal thoughts and behaviors is higher in children and adults younger than age 25 years. This risk is highest during the first few months after starting an antidepressant treatment and after any dose changes.

Your doctor will monitor you closely for any signs of suicidal thoughts and behaviors during your Vraylar treatment.

While taking Vraylar, call your doctor right away if you:

  • feel that your depression is getting worse
  • have sudden changes in your mood, thoughts, or behaviors
  • have thoughts about dying or harming yourself
  • try to harm yourself or attempt suicide

Vraylar is not approved for use in children younger than 18 years.

* Vraylar has a boxed warning from the FDA regarding the increased risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

The Vraylar dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Vraylar to treat
  • your age
  • other medical conditions you may have
  • other medications you may be taking

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths (1.5 mg, 3 mg, 4.5 mg, and 6 mg)

Vraylar comes as a capsule that you swallow. It’s available in four different strengths: 1.5 mg, 3 mg, 4.5 mg, and 6 mg.

Dosage for depressive episodes in bipolar I disorder

To treat episodes of depression in bipolar I disorder, the typical starting dose of Vraylar is 1.5 mg. You’d take this once a day. If needed, on day 15 of treatment, your doctor may increase your dosage to 3 mg, once a day.

Dosage for manic or mixed episodes in bipolar I disorder

To treat manic or mixed episodes of bipolar I disorder, the typical dosage of Vraylar is between 3 mg and 6 mg, once a day.

You’ll usually start your treatment with a dose of 1.5 mg on day 1. This is followed by a dose of 3 mg on day 2. After this, your doctor may gradually increase your daily dose as needed, up to a maximum of 6 mg, once a day.

Dosage for schizophrenia

To treat schizophrenia, the typical dosage of Vraylar is between 1.5 mg and 6 mg, once a day.

You’ll usually start your treatment with a dose of 1.5 mg on day 1. On day 2, your doctor may increase the dose to 3 mg. After this, your doctor may gradually increase your daily dose as needed, up to a maximum of 6 mg, once a day.

Dosage adjustments based on side effects

Higher doses of Vraylar are associated with more side effects. Side effects can also become more severe with higher doses. (For details on side effects, see the “Vraylar side effects” section above.)

However, it takes a long time for Vraylar to build up in your body. This means that you may not have some side effects until several weeks after you start taking Vraylar or after your doctor increases your dose. They’ll monitor you closely for side effects after you start treatment and after any dose increases.

If you do develop side effects that are very bothersome, your doctor may lower your dose. This may not make the Vraylar side effects go away, but it might make them less severe. However, because Vraylar can stay in your body for a long time, it can take at least a week for side effects to begin to ease.

Don’t change your dose of Vraylar unless your doctor tells you to.

What if I miss a dose?

If you miss a dose of Vraylar, take it as soon as possible, unless it’s nearly time for your next dose. In this case, just skip the missed dose. Then take your next dose as usual. Don’t take two doses together to make up for a missed dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A medication timer may be useful, too.

Will I need to use this drug long term?

For bipolar I disorder, you’ll likely take Vraylar for a few weeks. Keep taking it for as long as your doctor recommends.

For schizophrenia, Vraylar is meant to be used as a long-term treatment. If you and your doctor determine that Vraylar is safe and effective for you, you’ll likely take it long term. Unless your doctor tells you otherwise, it’s important to keep taking Vraylar, even if you feel better. Vraylar doesn’t cure schizophrenia; the drug controls only your symptoms. Stopping Vraylar use could make your symptoms come back.

The Food and Drug Administration (FDA) approves prescription drugs such as Vraylar to treat certain conditions. Vraylar may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Vraylar for depressive episodes in bipolar I disorder

Vraylar is FDA-approved to treat depressive episodes of bipolar I disorder in adults. Bipolar I disorder may also be known as bipolar 1 disorder.

Bipolar disorder is a mental health condition in which you have episodes of mania (high mood) and episodes of depression. Episodes of mania may be called manic episodes, and episodes of depression may be called depressive episodes. With bipolar I disorder, your manic episodes last at least 7 days or are severe enough to need treatment in a hospital. To read more about manic episodes, see “Vraylar for manic or mixed episodes in bipolar I disorder” below.

With depressive episodes of bipolar I disorder, your mood becomes very low. Symptoms can include:

  • extreme sadness or gloom
  • hopelessness
  • guilt
  • anxiety
  • trouble sleeping or extreme tiredness
  • lack of energy
  • memory problems
  • short attention span
  • feeling easily irritated

You may also have psychotic symptoms with severe episodes of depression. These symptoms include hallucinations (seeing or hearing things that aren’t really there) and delusions, which are beliefs that aren’t true.

Vraylar works to help improve your mood, thinking, and behavior.

Effectiveness for depressive episodes

Vraylar was found to be effective for treating depressive episodes of bipolar I disorder in three clinical studies. One study lasted 8 weeks, and two studies lasted 6 weeks.

In these studies, Vraylar was compared with a placebo (a treatment containing no active drug).

Researchers measured the effect of treatment using a scale called the Montgomery-Asberg Depression Rating Scale (MADRS). With this scale, 10 symptoms of a depressive episode are scored according to how severe the symptom is. The total score can range from 0 to 60, with higher scores representing more severe illness. A decrease in the MADRS score shows an improvement in illness.

Before treatment, the people in these studies had an average MADRS score of about 30 to 31. Researchers found that:

  • After 6 weeks of treatment, MADRS scores for people who took Vraylar were, on average, 13.7 to 15.6 points lower than before treatment.
  • By comparison, MADRS scores for people who took a placebo were, on average, 11.1 to 12.4 points lower than before treatment.

Vraylar for manic or mixed episodes in bipolar I disorder

Vraylar is FDA-approved to treat manic or mixed episodes of bipolar I disorder in adults. Vraylar is used for acute (short-term) treatment of these episodes.

Bipolar disorder is a mental health condition in which you have episodes of mania and episodes of depression. With bipolar I disorder, your manic episodes last at least 7 days or are severe enough to need treatment in a hospital.

With manic episodes of bipolar I disorder, your mood becomes very high. Symptoms can include:

  • feeling euphoric and exhilarated
  • feeling restless, wired, and jittery
  • having racing thoughts
  • talking excessively
  • having excessive self-confidence
  • having impaired judgment
  • having a reduced sense of risk
  • engaging in risky behavior

People in a manic episode often believe that nothing is wrong with them.

With severe manic episodes you may also have psychotic symptoms. These include hallucinations (seeing or hearing things that aren’t really there) and delusions, which are beliefs that aren’t true.

Mixed episodes of bipolar I disorder involve having manic and depressive symptoms at the same time. To learn about depressive symptoms, see “Vraylar for depressive episodes in bipolar I disorder” above.

Vraylar works to help improve your mood, thinking, and behavior.

Effectiveness for manic or mixed episodes

Vraylar was found to be effective for treating manic or mixed episodes of bipolar I disorder in three clinical studies that lasted 3 weeks. In these studies, Vraylar was compared with a placebo.

Researchers measured the effect of treatment using a scale called the Young Mania Rating Scale (YMRS). With this scale, 11 symptoms of a manic episode are scored according to how severe the symptom is. The total score can range from 0 to 60, with higher scores representing more severe illness. A decrease in YMRS score shows an improvement in illness.

The people in these studies had an average YMRS score of about 30 to 33 before treatment. Researchers found that:

  • After 3 weeks of treatment, YMRS scores for people who took Vraylar were, on average, 15 to 19.6 points lower than before treatment.
  • By comparison, YMRS scores for people who took a placebo were, on average, 8.9 to 15.3 points lower than before treatment.

Vraylar for schizophrenia

Vraylar is FDA-approved to treat schizophrenia in adults.

Schizophrenia is a chronic (long-term) mental health condition. Typically, schizophrenia has positive symptoms and negative symptoms. Positive symptoms may also be called psychotic symptoms.

Positive symptoms are thoughts and behaviors that you didn’t have before you became ill. These may include hallucinations (seeing or hearing things that aren’t really there) and delusions, which are beliefs that aren’t true. Also, you may have paranoia, an irrational fear of a threat toward yourself.

Negative symptoms are thoughts and behaviors that you have less of since you became ill. So you may have less energy or less interest in things you used to enjoy. And you may be less able to concentrate, remember, plan, express emotion, or communicate with others.

Vraylar is an antipsychotic medication that works to help to restore your mood, thinking, and behavior.

Effectiveness for schizophrenia

Vraylar was found to be effective for treating schizophrenia in several studies.

Studies lasting 6 weeks

In three clinical studies that lasted 6 weeks, Vraylar was compared with a placebo in people with schizophrenia.

Researchers measured the effect of treatment using a scale called the Positive and Negative Syndrome Scale (PANSS). With this scale, 30 different schizophrenia symptoms are scored from 1 to 7, according to how severe the symptom is. The total score can range from 30 to 210, with higher scores representing more severe illness. A decrease in PANSS score shows an improvement in illness.

The people in these studies had an average PANSS score of about 96 before treatment. Researchers found that:

  • After 6 weeks of treatment, PANSS scores for people who took Vraylar were, on average, 19.4 to 23 points lower than before treatment.
  • By comparison, PANSS scores for people who took placebo were, on average, 11.8 to 16 points lower than before treatment.

Study of long-term treatment

Another study found long-term treatment with Vraylar to be effective for keeping schizophrenia under control. This study involved people whose schizophrenia symptoms were stable after taking Vraylar for 20 weeks.

The people were split into two groups. One group kept taking Vraylar for another 72 weeks while the other group were switched to a placebo for the same time. This was a double-blind study, which means the people didn’t know if they were taking Vraylar or a placebo.

After 1 year, researchers found that:

  • Schizophrenia symptoms relapsed (came back or get worse) in 35% of people who kept taking Vraylar.
  • By comparison, symptoms relapsed in 56% of people who switched to a placebo.
  • People who kept taking Vraylar were 48% less likely to have their schizophrenia symptoms relapse than people who switched to a placebo.

Vraylar for other conditions

In addition to the uses listed above, Vraylar may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder if Vraylar is used for certain other conditions. Below is information on other possible uses for Vraylar.

Vraylar for autism (under study)

Vraylar isn’t FDA-approved to treat autism, but the drug is currently being studied for people with this condition.

Autism is a group of conditions that are caused by problems with brain development in childhood. People with autism have problems with how they communicate, interact, and behave with other people. These problems can affect learning ability, emotions, and self-control.

Some people with autism can develop severe problems with aggressive, impulsive, or self-harming behavior. And certain atypical (second-generation) antipsychotics can help treat these types of behavioral problems. Those drugs approved for this use include aripiprazole (Abilify) and risperidone (Risperdal).

Further research is needed before it’s known whether Vraylar is effective for autism. Talk with your doctor if you are interested in using Vraylar for autism.

Vraylar for bipolar II disorder (not an approved use)

Vraylar isn’t FDA-approved for treating bipolar II disorder, which is also known as bipolar 2 disorder. The drug isn’t included in current U.S. treatment guidelines for bipolar disorder. However, these guidelines haven’t been updated since 2005, and Vraylar was approved in 2015.

Bipolar disorder is a mental health condition in which a person has episodes of mania and episodes of depression. (For details on manic and depressive episodes, see “Vraylar for depressive episodes in bipolar I disorder” and “Vraylar for manic or mixed episodes in bipolar I disorder” above.) With bipolar II disorder, you have episodes of hypomania, rather than “full” manic episodes. Hypomania is a milder version of mania.

Very little research has been done into the treatment of bipolar II disorder. Further study is needed before it’s known whether Vraylar is effective for people with this condition.

If you have bipolar II disorder, talk with your doctor about which treatments are right for you.

Vraylar and children

Vraylar isn’t FDA-approved for treating schizophrenia or bipolar I disorder in children.* The safety and effectiveness of Vraylar haven’t been fully studied in this age group.

An ongoing study is looking at the use of Vraylar in children with schizophrenia. However, much more research is needed before it’s known if Vraylar is safe and effective for children.

Vraylar hasn’t been studied in children with bipolar disorder or other psychotic disorders. It’s not known known if Vraylar is safe and effective for children with these conditions.

If your child has schizophrenia or bipolar I disorder and you’d like to learn more about Vraylar and other treatments, talk with your child’s doctor.

* Vraylar has a boxed warning from the FDA regarding the increased risk of suicidal thoughts and behaviors. This risk affects children and adults younger than age 25 years. A boxed warning is the most serious warning from the FDA. For more information, see “FDA warnings” at the beginning of this article.

Vraylar can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Vraylar and other medications

Below are lists of medications that can interact with Vraylar. These lists don’t contain all drugs that may interact with Vraylar.

Before taking Vraylar, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Vraylar and certain drugs to treat infections

Taking Vraylar with certain drugs to treat infections can cause the level of Vraylar to build up in your body. This can raise your risk for side effects from Vraylar. (To learn more, see “Vraylar side effects” above.)

Examples of antimicrobial drugs that can raise the risk of side effects with Vraylar include:

  • certain antibiotics, such as:
    • clarithromycin
    • erythromycin
  • certain antifungals, such as:
    • ketoconazole (Nizoral)
    • itraconazole (Sporanox)
    • posaconazole (Noxafil)
    • voriconazole (Vfend)
  • certain medications for HIV, such as:
    • atazanavir (Reyataz)
    • cobicistat (Tybost)
    • ritonavir (Norvir)
    • indinavir (Crixivan)
    • nelfinavir (Viracept)
    • saquinavir (Invirase)

If you need to take one of these drugs with Vraylar, your doctor may have you take a dose of Vraylar that’s lower than usual.

Using Vraylar with certain other drugs to treat infections can lower the level of Vraylar in your body. This could make Vraylar less effective, so you shouldn’t take these drugs with Vraylar.

Examples of these drugs include:

  • rifabutin (Mycobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

If you’re taking any medication to treat an infection, talk with your doctor before taking Vraylar. They can adjust your treatment plan as needed.

Vraylar and certain seizure medications

Taking Vraylar with certain seizure medications could make Vraylar less effective. So you shouldn’t take these drugs with Vraylar.

Examples of seizure medications that could make Vraylar less effective include:

  • carbamazepine (Carbatrol, Equetro, Tegretol)*
  • fosphenytoin (Cerebyx)
  • phenobarbital
  • phenytoin (Dilantin, Phenytek)
  • primidone (Mysoline)

* This drug is also used off-label as a mood stabilizer for bipolar disorder.

If you’re using any of these medications, talk with your doctor before taking Vraylar. They can adjust your treatment plan as needed.

Vraylar and stimulants

Stimulants are drugs that are mainly used to treat attention deficit hyperactivity disorder (ADHD), but they’re sometimes misused. Examples of these drugs include amphetamine and dextroamphetamine (Adderall) and lisdexamfetamine (Vyvanse).

Stimulants should typically be avoided in people with mental health conditions such as bipolar disorder or schizophrenia. This is because stimulants can cause new psychotic or manic symptoms, and make these conditions worse. (For information in these symptoms, see the “Vraylar uses” section above.)

Taking stimulants with Vraylar could also raise your risk for having certain side effects, especially involuntary muscle movements, such as tremors, twitches, or tics. (To learn more about these side effects, see “Vraylar side effects” above.)

If you’re taking a stimulant, talk with your doctor before you start using Vraylar. They can recommend the best treatment options for you.

Vraylar and antidepressants

Antidepressants are sometimes used to treat depression in people with schizophrenia or bipolar disorder. And they may sometimes be used in combination with Vraylar.

Taking an antidepressant with Vraylar is typically fine, but the combination may raise your risk for side effects. These include feeling sleepy, dizziness when getting up, and seizures.

Using both an antidepressant and Vraylar can also affect your ability to make decisions, think clearly, or react quickly. So it’s important that you know how your medications affect you before driving.

Examples of antidepressants that might be used with Vraylar include:

If your doctor has prescribed you an antidepressant to take with Vraylar, they’ll closely monitor you for possible side effects. Talk with them if you’re concerned about any side effects you may have from taking these medications together.

Vraylar and mood stabilizers

Mood stabilizers are medications that are used in bipolar disorder to help prevent future episodes of mania and depression. You may sometimes start taking a mood stabilizer while you’re using Vraylar to treat an episode of mania or depression.

Taking a mood stabilizer with Vraylar is typically fine; however, the combination may raise your risk for certain side effects. These include feeling sleepy, dizziness when getting up, and confusion.

Using both a mood stabilizer and Vraylar can also affect your ability to make decisions, think clearly, or react quickly. So it’s important that you know how your medications affect you before driving.

Examples of mood stabilizers that may be used with Vraylar include:

If your doctor has prescribed you a mood stabilizer to take with Vraylar, they’ll closely monitor you for possible side effects. Talk with them if you’re concerned about any side effects you may have from taking these medications together.

Vraylar and anticholinergic drugs

Anticholinergic drugs are sometimes used to treat involuntary body movements that can be a side effect of Vraylar. Anticholinergic drugs are also sometimes used to treat chronic obstructive pulmonary disease (COPD), asthma, and an overactive bladder.

If you take anticholinergic drugs with Vraylar, you may be more likely to have other side effects. These can include constipation, dry mouth, blurred vision, and problems controlling your body temperature.

Examples of anticholinergic drugs that may increase the risk of side effects if taken with Vraylar include:

If you need to take one of these medications with Vraylar, your doctor will monitor you closely. Tell them if you notice any side effects, such as blurred vision or a dry mouth. And take care to avoid getting too hot.

Vraylar and herbs and supplements

Taking St. John’s wort with Vraylar may lower the level of Vraylar in your body. You shouldn’t use St. John’s wort with Vraylar, as it could make Vraylar less effective.

Vraylar and caffeine and foods

There aren’t any foods that have been specifically reported to interact with Vraylar. If you have any questions about eating certain foods with Vraylar, talk with your doctor.

Vraylar and caffeine

Caffeine isn’t known to interact with Vraylar. Caffeine is a type of stimulant found in foods as well as beverages such as coffee, tea, and energy drinks. (For more information on how stimulants can affect Vraylar, please see the “Vraylar and stimulants” section above.)

However, caffeine can affect your ability to fall asleep, which may lead to bipolar mood swings and mania.

If you have questions about consuming caffeine while taking Vraylar, talk with your doctor.

Vraylar and grapefruit juice

Consuming grapefruit or grapefruit juice can raise the levels of some medications in your blood. This can increase the risk of side effects from the medication. So in theory, eating grapefruit or drinking grapefruit juice with Vraylar could increase the level of Vraylar in your body. However, there haven’t been any studies on this.

If you want to eat grapefruit or drink grapefruit juice with Vraylar, talk with your doctor about whether this is safe for you. If you have increased side effects with the combination, avoid consuming grapefruit products with Vraylar in the future.

Vraylar is an atypical (second-generation) antipsychotic that’s used for schizophrenia and bipolar I disorder.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Vraylar, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for depressive episodes in bipolar I disorder

Examples of other drugs that may be used to treat depressive episodes in bipolar I disorder include:

Alternatives for manic or mixed episodes in bipolar I disorder

Examples of other drugs that may be used to treat manic or mixed episodes in bipolar I disorder include:

  • lithium
  • divalproex (Depakote)
  • other atypical antipsychotics, such as:
    • aripiprazole (Abilify, Abilify Mycite)
    • asenapine (Saphris)
    • olanzapine (Zyprexa, Zyprexa Zydis)
    • quetiapine (Seroquel)
    • risperidone (Risperdal)
    • ziprasidone (Geodon)
  • typical (first-generation) antipsychotics, such as chlorpromazine

Alternatives for schizophrenia

Examples of other drugs that may be used to treat schizophrenia include:

  • other atypical antipsychotics, such as:
    • aripiprazole (Abilify, Abilify Mycite)
    • asenapine (Saphris)
    • lurasidone (Latuda)
    • olanzapine (Zyprexa, Zyprexa Zydis, Zyprexa Relprevv)
    • paliperidone (Invega, Invega Sustenna, Invega Trinza)
    • quetiapine (Seroquel)
    • risperidone (Risperdal, Risperdal Consta, Perseris)
    • ziprasidone (Geodon)
  • typical (first-generation) antipsychotics, such as:
    • chlorpromazine
    • fluphenazine, fluphenazine decanoate
    • haloperidol, haloperidol decanoate
    • perphenazine

You may wonder how Vraylar compares with other medications that are prescribed for similar uses. Here we look at how Vraylar and Abilify are alike and different.

Ingredients

Vraylar contains the active drug cariprazine, while Abilify contains the active drug aripiprazole.

Uses

Vraylar is approved to treat:

Abilify is approved to treat:

Drug forms and administration

Vraylar comes as a capsule that you swallow, and you’ll likely take the medication once a day.

Abilify comes as a tablet that you swallow, and you’ll likely take the drug once a day. Abilify used to come in other forms, but they’re not available any more.

Side effects and risks

Vraylar and Abilify both contain an atypical (second-generation) antipsychotic drug. They can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

This list contains up to 10 of the most common mild side effects that can occur with both Vraylar and Abilify (when taken individually):

Serious side effects

These lists contain examples of serious side effects that can occur with Vraylar, with Abilify, or with both drugs (when taken individually).

* Both Vraylar and Abilify have boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

Vraylar and Abilify have different FDA-approved uses, but they’re both used to treat manic and mixed episodes of bipolar I disorder, and schizophrenia.

These drugs haven’t been directly compared in clinical studies, but studies have found both Vraylar and Abilify to be effective for treating these conditions.

Both drugs are recommended as treatment options for schizophrenia in guidelines from the American Psychiatric Association.

If you’re interested in taking Vraylar or Abilify, talk with your doctor about which one is right for you.

Costs

According to estimates on GoodRx.com, costs of Vraylar and Abilify will vary depending on your treatment plan. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Vraylar and Abilify are both brand-name drugs. There’s currently no generic form of Vraylar. Generic forms of Abilify are available under the name aripiprazole. Brand-name medications usually cost more than generics.

Like Abilify (above), the drug Latuda has uses similar to those of Vraylar. Here’s a comparison of how Vraylar and Latuda are alike and different.

Ingredients

Vraylar contains the active drug cariprazine, while Latuda contains the active drug lurasidone.

Uses

Vraylar is approved to treat:

Latuda is approved to treat:

  • depressive episodes of bipolar I disorder (Latuda can be used on its own in adults as well as children ages 10 years and older, or with lithium or valproate in adults.)
  • schizophrenia in adults as well as children ages 13 years and older

Drug forms and administration

Vraylar comes as a capsule, while Latuda comes as a tablet. Both medications are swallowed. You’ll likely take Vraylar or Latuda once a day.

Side effects and risks

Vraylar and Latuda both contain an atypical (second-generation) antipsychotic drug. They can cause some similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Vraylar, with Latuda, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Vraylar, with Latuda, or with both drugs (when taken individually).

* Both Vraylar and Latuda have boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

Vraylar and Latuda have different FDA-approved uses, but they’re both used to treat depressive episodes of bipolar I disorder and schizophrenia.

These drugs haven’t been directly compared in clinical studies, but studies have found both Vraylar and Latuda to be effective for treating these conditions.

Both drugs are recommended as treatment options for schizophrenia in guidelines from the American Psychiatric Association.

If you’re interested in taking Vraylar or Latuda, talk with your doctor about which one is right for you.

Costs

According to estimates on GoodRx.com, Vraylar capsules and Latuda tablets generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Vraylar and Latuda are both brand-name drugs. There’s currently no generic form of Vraylar. A generic form of Latuda called lurasidone has been approved by the FDA, but may not be available in your area. Brand-name medications usually cost more than generics.

It’s unlikely that you’ll have withdrawal symptoms or side effects after stopping Vraylar treatment. Withdrawal symptoms are side effects that occur if you stop taking a drug that your body has become dependent on.

However, if you stop taking Vraylar, the symptoms of your condition may return. So you shouldn’t stop using Vraylar without talking with your doctor first. If you and your doctor agree that it’s right for you to stop taking Vraylar, then they will explain how to do this.

It’s important to note that newborns whose mothers took an atypical antipsychotic in the last 3 months of pregnancy can be at risk for withdrawal symptoms. (Vraylar is an atypical antipsychotic.) See the “Vraylar and pregnancy” section below to learn more.

Vraylar abuse

Vraylar hasn’t been studied for the possibility of drug abuse. However, misuse of Vraylar can lead to serious side effects. (Please see “Serious side effects” in the “Vraylar side effects” section above for details.) Be sure to take the medication only as prescribed by your doctor. And don’t give Vraylar to anyone else to use.

Drinking alcohol with Vraylar can raise your risk for certain side effects, such as feeling sleepy, dizziness, and nausea.

Drinking alcohol can also make your depression symptoms worse.

If you drink alcohol, talk with your doctor about whether it’s safe for you to keep drinking while you’re taking Vraylar.

Here are answers to some frequently asked questions about Vraylar.

Can Vraylar be used for anxiety?

It’s unlikely. Vraylar, a type of antipsychotic drug, isn’t specifically used for treating anxiety disorders. Anxiety disorders are typically treated with medications such as benzodiazepines, certain antidepressants, or beta-blockers.

If treatments like these don’t work, antipsychotics other than Vraylar might be used on occasion. For instance, a recent review of studies found quetiapine (Seroquel) to be effective for treating generalized anxiety disorder. However, because antipsychotics can cause some serious side effects, other anxiety treatments are usually a better option.

Keep in mind that if anxiety is one of the symptoms of your schizophrenia or bipolar I disorder, it may ease as your condition improves with Vraylar treatment.

If you have anxiety, talk with your doctor about what treatments are right for you.

Is Vraylar an SSRI?

No, Vraylar isn’t an SSRI, which stands for selective serotonin reuptake inhibitor. SSRIs are a particular type of antidepressant medication.

Vraylar is an atypical (second-generation) antipsychotic medication.

Can Vraylar treat major depression?

It’s possible. The Food and Drug Administration (FDA) has approved Vraylar to treat episodes of depression in bipolar I disorder. The drug isn’t approved for treating major depression, but it is being studied for this use.

Antidepressants don’t work for some people with major depression. However, sometimes adding an antipsychotic medication to antidepressant treatment can be helpful.

Researchers have studied the effect of adding Vraylar to antidepressant treatment that isn’t working in people with major depression. But the research has produced some conflicting results. A 2016 study found that depression improved more in people who took Vraylar with their antidepressants than in those who took a placebo with their antidepressants. (A placebo is a treatment containing no active drug.)

A 2018 study had similar results. However, a different 2018 study didn’t find Vraylar to be more effective than a placebo for improving depression when added to antidepressants.

Research is ongoing in this area. Talk with your doctor if you’re interested in taking Vraylar to treat major depression.

Does Vraylar cause sexual side effects?

No. Vraylar, a type of antipsychotic medication, isn’t known to cause sexual side effects. These problems weren’t reported in clinical studies of the drug. However, sexual problems are known to occur with other antipsychotics. And sexual problems can also be associated with the conditions that Vraylar treats.

Talk with your doctor if you have sexual problems that are a concern to you. They may be able to recommend a suitable treatment.

Why do I have to avoid getting too hot while taking Vraylar?

Vraylar can reduce sweating and cause problems with how your body controls its core temperature. The drug makes it harder for your body to cool down if you get too hot. This is especially a problem in hot weather or when exercising. If you can’t cool down properly, you could develop heatstroke (overheating).

While using Vraylar, you should avoid strenuous exercise and wearing too much warm clothing. Be sure to drink plenty of water to avoid dehydration (losing too much fluid). And in hot weather, stay in a cool place out of the sun.

You can also talk with your doctor for other tips on how to avoid getting too hot during your Vraylar treatment.

Will I be able to drive during my Vraylar treatment?

Probably. Most people are able to drive while taking Vraylar. However, you need to be aware that Vraylar can make some people feel sleepy. And the drug could affect your ability to make decisions, think clearly, or react quickly.

Make sure you know how Vraylar affects you before driving. And be sure to drive only if you can do so safely.

Vraylar is used to treat schizophrenia as well as manic, mixed, and depressive episodes of bipolar I disorder.

What happens in schizophrenia and bipolar disorder

With schizophrenia and bipolar disorder, there is an imbalance of neurotransmitters in the brain. This imbalance typically affects dopamine and serotonin.

Neurotransmitters are natural body chemicals that are involved in passing messages between nerve cells and other cells in the body. Dopamine and serotonin are involved in passing messages in the brain that help control mood, thinking, perception, and behavior.

An imbalance of serotonin and dopamine can lead to depressive, manic, and psychotic symptoms. Psychotic symptoms include hallucinations (seeing or hearing things that aren’t really there) and delusions, which are beliefs that aren’t true.

What Vraylar does

Vraylar is a type of drug called an atypical (second-generation) antipsychotic. These drugs work by rebalancing the way that dopamine and serotonin work in the brain. But the exact way Vraylar works is not fully understood.

Vraylar helps reduce psychotic symptoms such as hallucinations, delusions, and paranoia. The drug also helps reduce manic symptoms, such as extreme agitation, racing thoughts, and feeling wired or jittery.

Vraylar also helps ease symptoms of depression. These may include feelings of extreme sadness, gloom, hopelessness, and guilt.

In addition, Vraylar can help improve other symptoms associated with schizophrenia and bipolar disorder, such as anxiety, trouble sleeping, and a lack of energy. The medication can also help improve problems with memory, concentration, and communication.

How long does it take to work?

Vraylar starts working in the first few days of treatment. Symptoms such as hallucinations and agitation tend to improve first. Other symptoms can take longer to improve, and it can take several weeks for Vraylar to have its full effect.

It’s important to keep taking Vraylar for as long as your doctor recommends, even if it doesn’t seem to make much difference at first.

How long does Vraylar stay in your system?

Vraylar can stay in your body for several weeks after you stop taking it.

Vraylar has a half-life of about 1 week. The half-life of a drug is the length of time it takes for the drug level in your body to be reduced by half. So 1 week after stopping Vraylar use, the drug level in your body will be reduced to half. After another week, the level will be reduced to a quarter, after a further week it will be reduced to an eighth, and so on.

It’s generally considered that it takes 5.5 half-lives for the drug level to be so low that it no longer has an effect. So for Vraylar, this would be about 5.5 weeks. However, small amounts of the drug may still be detectable for longer than this in blood tests.

Vraylar hasn’t been studied in pregnant women. Studies in animals suggest that the drug could cause fetal harm if taken during pregnancy. However, animal studies don’t always predict what will happen in humans.

It’s known that newborns whose mothers took an atypical antipsychotic in the last 3 months of pregnancy can be at risk for withdrawal symptoms. (Vraylar is an atypical antipsychotic.) These symptoms are short term and may include:

  • abnormal body movements, such as a tremor or twitching
  • stiff or floppy muscles
  • sleepiness
  • problems with breathing or feeding

However, it’s important to know that an untreated mental health condition during pregnancy can also lead to serious consequences for both the mother and baby.

If you’re pregnant or want to plan a pregnancy, talk with your doctor about the possible risks and benefits of taking Vraylar during pregnancy. If you get pregnant while taking Vraylar, let your doctor know right away. It’s important that you don’t suddenly stop taking Vraylar unless your doctor advises this. Stopping treatment could make your symptoms come back.

Vraylar pregnancy registry

If you decide to take Vraylar during pregnancy, talk with your doctor about being enrolled in the pregnancy exposure registry for this drug.

The registry collects health information about pregnant mothers taking antipsychotics and their babies. The data collected can help identify effects that may occur when antipsychotics are used during pregnancy. This information can help other pregnant women make informed decisions when they’re deciding whether or not to take Vraylar.

It’s not known if Vraylar is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re taking Vraylar.

For more information about taking Vraylar during pregnancy, see the “Vraylar and pregnancy” section above.

It’s not known if Vraylar passes into breast milk or if it can affect breast milk production. And it’s not known if the drug can affect children who are breastfed.

If you’re currently breastfeeding or plan to breastfeed during your treatment, talk with your doctor about whether Vraylar is right for you.

Do not use more Vraylar than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Vraylar

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

You should take Vraylar according to your doctor’s or healthcare provider’s instructions.

When to take

You’ll likely take Vraylar once a day. You should take the medication at the same time each day. You can take Vraylar at any time of day, so pick the best time for you to take Vraylar. Sticking to a routine will help you remember to take the drug.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A medication timer may be useful, too.

Taking Vraylar with food

You can take Vraylar either with or without food.

Can Vraylar be crushed, split, or chewed?

No, you should swallow Vraylar capsules whole. Taking them with a drink can make this easier for you. If you have trouble swallowing Vraylar, ask your doctor or pharmacist for advice.

As with all medications, the cost of Vraylar can vary. To find current prices for Vraylar in your area, check out GoodRx.com.

The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Vraylar, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Vraylar, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Vraylar, or if you need help understanding your insurance coverage, help is available.

Allergan, the manufacturer of Vraylar, offers the Vraylar Savings Program and the Allergan Patient Assistance Program. For more information and to find out if you’re eligible for support, call 800-678-1605 and select option 5 or visit the drug website.

Generic version

Vraylar isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death in older adults with psychosis due to dementia. Older adults with dementia can sometimes develop psychosis (loss of contact with reality). In some cases, antipsychotic medications such as Vraylar can raise the risk of death in these people. The Food and Drug Administration (FDA) has not approved Vraylar to treat psychosis that’s related to dementia in older adults.

Suicidal thoughts and behaviors. In some cases, antidepressant medications can increase the risk of suicidal thoughts and behaviors in children and adults younger than age 25 years. Vraylar is an antipsychotic medication but it also has an antidepressant effect when used for depression in bipolar I disorder. While you take Vraylar, your doctor may monitor you closely for any signs of suicidal thoughts and behaviors. Vraylar is not approved for use in children younger than age 18 years.

Other precautions

Before taking Vraylar, talk with your doctor about your health history. Vraylar may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Vraylar or any of its ingredients, you shouldn’t take Vraylar. Ask your doctor what other medications are better options for you.
  • Kidney problems. Vraylar hasn’t been studied in people with severe kidney problems. Talk with your doctor about whether Vraylar is right for you.
  • Liver problems. Vraylar hasn’t been studied in people who have severe liver problems. Talk with your doctor about whether Vraylar is a good option for you.
  • Older age. If you’re older than age 65 years, you could have a higher risk for certain side effects of Vraylar. These include dizziness when getting up, falls, tardive dyskinesia (late-onset involuntary movements), and problems controlling your body temperature. Older adults are typically prescribed a lower dose of Vraylar to minimize any risks from the drug. Your doctor will monitor you for side effects.
  • Diabetes. Vraylar can cause high blood sugar levels and diabetes. If you already have diabetes, taking Vraylar can make your blood sugar harder to control. Talk with your doctor about whether Vraylar is right for you. If you do take Vraylar, your blood sugar may need to be checked more often than usual. If your blood sugar gets too high, your doctor may need to increase the dose of your diabetes medication.
  • High cholesterol or triglyceride levels. Vraylar may increase the levels of fats called cholesterol and triglycerides in your blood. If you already have high levels of these fats, Vraylar could raise them further. While you take Vraylar, your doctor will regularly order blood tests to check your cholesterol and triglyceride levels. If the levels get too high, you may need treatment for them.
  • Low white blood cell count. Vraylar can lower your white blood cell count. You could be more at risk of this if a medication has lowered your white blood cell count in the past. And if your white blood cell count is already low, Vraylar could make it worse. In both cases, your doctor will regularly order blood tests to check your white blood cell levels while you take Vraylar. If your white blood cell count drops too low, you may need to stop the medication.
  • Dehydration. If you get dehydrated (lose too much fluid) while taking Vraylar, this can raise your risk for certain side effects. These include dizziness when getting up and problems controlling your body temperature. To avoid getting dehydrated, be sure to drink plenty of water while taking Vraylar. This is especially important in hot weather and when exercising.
  • Heart disease or stroke. Vraylar can cause your blood pressure to drop for a time if you get up too quickly. This could be dangerous if you have a history of stroke or heart problems, such as angina, heart attack, or heart failure. Vraylar hasn’t been studied in people with unstable heart disease or in people who have recently had a heart attack. If you have a history of any of these problems, talk with your doctor about whether Vraylar is right for you. If you do take Vraylar, tell your doctor if you feel dizzy or faint while using it.
  • Seizures. Vraylar can sometimes cause seizures. You’re more likely to have seizures with Vraylar if you have epilepsy or you’ve had seizures in the past. Talk with your doctor about whether Vraylar is a good choice for you.
  • Pregnancy. Talk with your doctor about the risks and benefits of taking Vraylar during pregnancy. For more information, please see the “Vraylar and pregnancy” section above.
  • Breastfeeding. It’s not known if Vraylar passes into breast milk. For more information, please see the “Vraylar and breastfeeding” section above.

Note: For more information about the potential negative effects of Vraylar, see the “Vraylar side effects” section above.

When you get Vraylar from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Vraylar capsules at room temperature (68°F to 77°F/20°C to 25°C) in a tightly sealed container away from light. Avoid keeping this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Vraylar and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Vraylar is approved by the Food and Drug Administration (FDA) to treat the following conditions in adults:

Administration

Vraylar is taken by mouth once a day.

Mechanism of action

The pharmacological classification of Vraylar is an atypical antipsychotic. It contains the active drug cariprazine. The exact mechanism of action of Vraylar in schizophrenia and bipolar disorder is not fully understood. However, it is known to have the following receptor interactions (with highest affinity for the first four receptor subtypes in this list):

  • partial agonist at dopamine D3
  • partial agonist at dopamine D2
  • partial agonist at serotonin 5-HT1A
  • antagonist at serotonin 5-HT2A
  • antagonist at serotonin 5-HT2B
  • antagonist at histamine H1
  • antagonist at serotonin 5-HT2C
  • antagonist at adrenergic alpha 1a

Pharmacokinetics and metabolism

Cariprazine is rapidly absorbed after oral administration of the Vraylar capsule, with Cmax reached in 3 to 6 hours.

Cariprazine is primarily metabolized by CYP3A4 to two active metabolites, desmethyl cariprazine (DCAR) and didesmethyl cariprazine (DDCAR). These three molecules have equipotent activity. DCAR is further metabolized to DDCAR. CYP2D6 also plays a minor role in metabolizing cariprazine and DCAR.

With regular once-a-day dosing, cariprazine and DCAR reach steady state in 1 to 2 weeks, while steady state of DDCAR is reached in 4 to 8 weeks.

Plasma protein binding of cariprazine, DCAR, and DDCAR is between 91% and 97%.

The elimination half-life of cariprazine and DCAR is approximately 1 day, while that of DDCAR is approximately 1 week.

Contraindications

Vraylar is contraindicated in people with known hypersensitivity to cariprazine.

Misuse, withdrawal, and dependence

The potential for misuse and dependence of Vraylar has not been studied; however, Vraylar is not a controlled substance. Stopping treatment is not known to cause withdrawal symptoms.

Storage

Store Vraylar at room temperature from 68°F to 77°F (20°C to 25°C). Deviations are allowed from 59°F to 86°F (15°C to 30°C).

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.