Medications
Cariprazine - Vraylar
Uses
Side Effects
Interactions
Precautions
Uses
VRAYLAR is an atypical antipsychotic indicated for the:
- Treatment of schizophrenia in adults
- Acute treatment of manic or mixed episodes associated with bipolar I disorder in adults
- Treatment of depressive episodes associated with bipolar I disorder (bipolar depression) in adults
Side Effects
Most common adverse reactions (incidence ≥ 5% and at least twice the rate of placebo) were:
- Schizophrenia: extrapyramidal symptoms and akathisia
- Bipolar mania: extrapyramidal symptoms, akathisia, dyspepsia, vomiting, somnolence, and restlessness
- Bipolar depression: nausea, akathisia, restlessness, and extrapyramidal symptoms
Interactions
- Strong CYP3A4 inhibitors: Reduce VRAYLAR dosage by half
- CYP3A4 inducers: Concomitant use is not recommended
Precautions
- Cerebrovascular Adverse Reactions in Elderly Patients with DementiaRelated Psychosis: Increased incidence of cerebrovascular adverse reactions (e.g., stroke, transient ischemic attack)
- Neuroleptic Malignant Syndrome: Manage with immediate discontinuation and close monitoring
- Tardive Dyskinesia: Discontinue if appropriate
- Late-Occurring Adverse Reactions: Because of VRAYLAR’s long halflife, monitor for adverse reactions and patient response for several weeks after starting VRAYLAR and with each dosage change
- Metabolic Changes: Monitor for hyperglycemia/diabetes mellitus, dyslipidemia and weight gain
- Leukopenia, Neutropenia, and Agranulocytosis: Perform complete blood counts (CBC) in patients with pre-existing low white blood cell counts (WBC) or history of leukopenia or neutropenia. Consider discontinuing VRAYLAR if a clinically significant decline in WBC occurs in absence of other causative factors
- Orthostatic Hypotension: Monitor heart rate and blood pressure and warn patients with known cardiovascular or cerebrovascular disease, and risk of dehydration or syncope
- Seizures: Use cautiously in patients with a history of seizures or with conditions that lower the seizure threshold
- Potential for Cognitive and Motor Impairment: Use caution when operating machinery
