Vraylar side effects and how to avoid them

Vraylar is the brand name of an antipsychotic drug also known as an atypical antipsychotic drug. It is used to treat bipolar depression for short-term or long-term treatment. Vraylar can cause adverse effects. The most common tend to be drowsiness to more serious movement disorders and worsening mental health. Learn more about the most common Vraylar side effects and how to avoid them.

What is Vraylar?

Vraylar is the brand name of an FDA-approved antipsychotic medication. It is prescribed to adults to treat manic and depressive episodes caused by bipolar I disorder, as well as manic episodes caused by schizophrenia.

Bipolar disorder, previously called manic depression, is a mental disorder. It causes periods of both depressed mood and elevated mood, called mania. During depressed moods, you can feel down and sad, numb, get no pleasure from pastimes you usually enjoy, feel irritable and guilty, and have trouble sleeping. During periods of mania, you can feel high, elated, invigorated, wired, and jumpy, thoughts and feelings can come in quick bursts, and you may feel more impulsive and engage in risky behaviors. You can also have mixed episodes where you get symptoms of both depression and mania at the same time.

Schizophrenia is a mental disorder that also causes episodes of mania. These episodes may also involve psychosis – periods where you lose your connection to reality, you can see and hear things that aren’t really there and have delusional thoughts. Both bipolar disorder and schizophrenia are thought to be caused by a mix of genetics and life events that can disrupt your natural brain chemistry. Imbalances in naturally occurring chemicals, like dopamine, may lead to the highs and lows that can cause periods of depression or mania.

There are no known cures for bipolar disorder or schizophrenia, but medications like Vraylar can help you manage your disorder. Vraylar can balance your levels of dopamine and can reduce your depressive and manic symptoms.

Vraylar active ingredients

The active ingredient in Vraylar is called cariprazine. It helps with schizophrenia and bipolar disorder by regulating how your brain responds to dopamine.

Dopamine is a chemical you produce naturally. It helps your brain cells send and receive signals, and it assists with regulating aspects of your brain function. When you take Vraylar, the active ingredient cariprazine binds with areas on the outside of the cells in your brain called dopamine receptors. This stimulates the effect of dopamine on your brain cells, but to a lesser degree than actual dopamine. If you have low dopamine levels, cariprazine acts as if it’s boosting your dopamine. If you have high dopamine levels, cariprazine acts as if it’s reducing them. This can balance your response to dopamine, and has been shown to reduce both depressive and manic symptoms, even when they occur at the same time.

How do you take Vraylar?

Vraylar comes as a capsule that is swallowed with or without food or water. If you miss a dose of Vraylar, take it as soon as you remember. If it’s almost time for your next dose, you can skip your missed dose. Store this medicine in its original packaging at room temperature, away from moisture, heat, and light

Vraylar possible side effects

All medications can have side effects. It’s important to note that not everyone will experience side effects, or get the same ones if they do. The most common side effects of Vraylar include:

  • Headaches
  • Feeling lightheaded
  • Sleepiness
  • Indigestion
  • Abdominal pain
  • Constipation
  • Nausea and vomiting
  • Weight gain
  • Feeling restless and that you need to move around (akathisia)
  • Tremors
  • Difficulty moving and/or slow movements

In rare instances, Vraylar can cause more serious side effects, including:

  • Allergic reactions to the medication
  • An increased risk of suicidal thoughts and behaviors in children and young adults (see the boxed warning)
  • Increased risk of death and strokes in elderly or older adults with dementia-related psychosis. Vraylar should not be given to patients with dementia-related psychosis (see boxed warning)
  • Worsening mental health symptoms
  • Neuroleptic malignant syndrome (NMS) – rare but sometimes fatal reaction that can cause fever, muscle stiffness, sweating, confusion, and changes in breathing, blood pressure, and heart rate
  • Uncontrolled body movements (known as extrapyramidal disease or tardive dyskinesia)
  • High blood sugar and diabetes
  • Increased levels of fat in your blood, like cholesterol and triglycerides
  • Low blood pressure when rising from sitting or lying down (orthostatic hypotension)
  • Low white blood cell count (leukopenia)
  • Seizures
  • Increased body temperature
  • Difficulty swallowing

How to avoid Vraylar side effects

1. Discuss medical history and medications

Discussing your medical history with your prescribing healthcare provider is important to help them understand how well Vraylar will work for you. Give a complete list of all the prescription drugs, including over-the-counter meds, supplements, and medical conditions you may have. Talking with your doctor will also allow them to pick up any drug interactions with Vraylar that may increase possible side effects.

2. Stick to the recommended dosage

Take your prescribed dose that has been recommended by your healthcare professional. Stick to the same timing for taking your medication and taking it consistently will make a big difference in how well Vraylar works for you. Consider setting an alarm on your phone as a reminder or putting it in your diary as a daily task.

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Refer to the medication guide for more drug information.

Do not abruptly stop taking your medication or reduce your recommended dose before talking to your doctor as this may result in withdrawal symptoms.

3. Keep cool

Your body temperature may fluctuate when taking Vraylar, particularly when exercising or in hot weather. To avoid this keep cool and stay hydrated. Keep a water bottle with you and refill it on a regular basis.

4. Avoid alcohol

Alcohol may worsen any side effects you may experience. Read our blog on mixing bipolar and alcohol for more information.

5. Pay attention to your body

Paying attention to how your body feels when taking Vraylar is important, taking particular attention to worsening symptoms or new symptoms. Talk to your doctor straight away for medical advice if you start to experience any side effects of Vraylar when taking it.

Vraylar drug interactions

Vraylar can interact with other medications, specifically:

  • Strong CYP3A4 inhibitors, such as itraconazole or ketoconazole
  • CYP3A4 inducers, such as rifampin or carbamazepine

This can change how Vraylar and the other medications work and can make some side effects more likely.

Vraylar warnings & precautions

Vraylar is not suitable for everyone. Do not take Vraylar if you:

  • Are allergic to the active ingredient cariprazine
  • Are allergic to any of the other ingredients in Vraylar
  • Are under 18 years of age
  • Have dementia-related psychosis – antipsychotic medications can put you at an increased risk of death and stroke

Talk to your physician before taking Vraylar if you:

  • Are taking any medications that can interact with Vraylar (listed in the section above)
  • Have previously had a stroke
  • Have or have had any heart problems
  • Have or have had any kidney problems
  • Have or have had any liver problems
  • Have or have had seizures
  • Have or have had a low white blood cell count
  • Have high total cholesterol, LDL cholesterol, triglycerides, or low HDL cholesterol
  • Have diabetes, or have a history of diabetes in your family
  • Are pregnant or are planning to get pregnant
  • Are breastfeeding or are planning to breastfeed – It is not known whether Vraylar is present in human breast milk

Vraylar can cause sleepiness, dizziness, and confusion, which can impair your ability to drive, use machinery, or perform other dangerous tasks. You should avoid these activities when taking Vraylar until you’re confident Vraylar doesn’t give you these side effects.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.