(Legend)

Generic Name

• Cariprazine
  T½ = Cariprazine: 2–4 days; DDCAR: 1–3 weeks
  Protein binding = 91%–97%
  Pregnancy category B

Trade Name

• Vraylar

Dose Range/Adult Daily Dose

• Schizophrenia: start 1.5 mg/d, may ↑ on 2nd day to 3 mg, may ↑ 1.5 mg or 3 mg based on response/tolerance to dose of 1.5–6 mg/d (maintenance). Bipolar mania: start: 1.5 mg/d, may ↑ on 2nd day to 3 mg, may ↑ 1.5 mg or 3 mg based on response/tolerance to dose of 1.5–6 mg/d (titrated up to 3–6 mg/d).

Use/Common Side Effects (CSE)

• Use: Treatment of schizophrenia; Acute treatment of mania/mixed episodes in Bipolar I disorder.
  CSE: ↓ appetite, ↑ weight, hyperglycemia, diabetes, dyslipidemia, drowsiness, headache, dyspepsia, dysphagia, nausea, EPS, somnolence, akathisia. NEUROLEPTIC MALIGNANT SYNDROME, AGRANULOCYTOSIS

Geriatric & Dose Considerations

• ↑mortality in elderly with dementia-related psychosis.
  Orthostatic hypotension (caution: falls); caution: renal/hepatic impairment; ↓ CV function, dehydration.

Classification

• Atypical antipsychotic agent

Assessment Cautions

• Assess: BP for orthostatic hypotension; CBC for possible agranulocytosis, leukopenia, neutropenia. Monitor weight and BMI; FBS. Monitor for NMS, TD (D/C).
  Cautions: Hx seizures, CV disease, electrolyte imbalance, dehydration. See product insert for dosage adjustments for CYP3A4 inhibitors/inducer interactions. Neonates exposed in the third trimester may experience extrapyramidal symptoms/withdrawal.