What is Vraylar used for?
Vraylar (cariprazine) is an atypical antipsychotic that is manufactured by AbbVie Inc to treat certain mental health conditions. It is approved by the U.S. Food and Drug Administration (FDA) 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
How does Vraylar work?
Vraylar is the only dopamine and serotonin partial agonist approved for depressive, manic, or mixed episodes of bipolar I disorder. While the exact mechanism of Vraylar is not known, it is thought to be due to its partial agonist activity at central dopamine (D2, D3) and serotonin 5-HT1A receptors as well as antagonist activity at serotonin 5-HT2A receptors. Clinical studies have suggested that blocking the D3 receptors in your brain leads to antidepressant effects and a decrease in schizophrenia symptoms.
What are the most commonly prescribed doses of Vraylar?
- 1.5 mg capsules
- 3 mg capsules
- 4.5 mg capsules
- 6 mg capsules
How to take Vraylar
- Read the Prescribing Information, Boxed Warnings, and the Medication Guide that comes with Vraylar.
- Take Vraylar exactly as your doctor tells you to take it. Do not change the dose or stop taking Vraylar without first talking to your doctor.
- Vraylar is usually taken by mouth once a day with or without food.
- If you miss a dose of Vraylar, take it immediately. Skip the missed dose if it’s almost time for your next dose, then go back to your regular schedule. Do not take extra doses of Vraylar to make up for missed doses.
- If you think you have taken too much Vraylar, contact your doctor or Poison Control Center for medical advice or go to the nearest emergency room, immediately.
- Do not drive, operate machinery, or do other activities that require cognitive or motor skills until you see how Vraylar affects you.
- Drink plenty of fluids while taking Vraylar. Do not become too hot or dehydrated during treatment.
- Store Vraylar at room temperature between 68°F to 77°F (20°C to 25°C) away from moisture.
Vraylar contraindications
Vraylar is contraindicated in:
- Patients with a history of allergic reactions to Vraylar or any of its inactive ingredients.
- The safety and effectiveness of Vraylar in patients under the age of 18 have not been established. Medications such as Vraylar are known to increase the risk of suicidal thoughts and behaviors in pediatric patients.
Vraylar warnings
- Vraylar use causes an increased risk of death in elderly patients with dementia-related psychosis.
- Use of Vraylar increases the risk of neuroleptic malignant syndrome (NMS). Contact your healthcare professional if you notice high fever, muscle stiffness, confusion, increased sweating, or changes in your breathing, heart rate, and blood pressure.
- Vraylar can cause random, uncontrolled body movements (tardive dyskinesia), typically your tongue, face, or head. Vraylar should be stopped immediately if you develop signs or symptoms of tardive dyskinesia.
- Due to Vraylar’s long half-life, you may experience adverse effects that may last several weeks after starting Vraylar or after a dosage change.
- Vraylar can cause metabolic changes. You and your doctor should monitor for high blood sugar (hyperglycemia), increased cholesterol and triglyceride levels, and weight gain.
- Your doctor should perform complete blood counts if you have a history of low white blood cell counts, leukopenia, or neutropenia.
- You are at an increased risk of orthostatic hypotension if you have established heart or cerebrovascular disease. You should regularly check your heart rate and blood pressure while taking Vraylar.
- Vraylar may lower the seizure threshold.
- Use caution while operating machinery as Vraylar may cause drowsiness.
- Taking Vraylar during the 3rd trimester of pregnancy can cause your fetus to develop uncontrolled muscle movement or withdrawal symptoms at birth. There is a pregnancy registry that monitors the outcomes of mothers and babies who have been exposed to Vraylar. Contact the National Pregnancy Registry for Atypical Antipsychotics at 1-866-961-2388 or visit http://womensmentalhealth.org/clinical-and-researchprograms/pregnancyregistry/ for more information.
- Lactation studies have not been done with Vraylar so it is not known if it is found in human breast milk. Animal studies showed the presence of Vraylar in rat milk. You should discuss with your doctor the clinical need, benefits, and risks of taking Vraylar while breastfeeding.
Vraylar drug interactions
When Vraylar is taken with other medicines, they may interact and change how those work. It may also increase the severity of certain side effects or make them more likely to occur. Make sure your healthcare professional knows all your medications, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Some possible drug interactions of Vraylar include:
- Reduce Vraylar dosage by half if given with strong CYP3A4 inhibitors such as itraconazole and ketoconazole.
- Vraylar use is not recommended along with CYP3A4 inducers such as rifampin and carbamazepine.
Side effects of Vraylar
Some common side effects of Vraylar may include:
- Extrapyramidal symptoms (EPS)
- Headache
- Unable to sit or stand still (akathisia)
- Trouble sleeping (insomnia)
- Nausea
- Constipation
- Sleepiness
- Indigestion
- Lightheadedness
Vraylar can cause some serious side effects including:
- Stroke
- Neuroleptic malignant syndrome (NMS)
- Tardive dyskinesia (uncontrolled muscle movements)
- Suicidal thoughts and behaviors
- Increased risk of seizures
- Increased body temperature
- Serious allergic reactions
You can report any side effects you experience to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Vraylar alternatives
There are other antipsychotic drugs that your healthcare provider can prescribe if Vraylar is not the right medication for you. Some alternative FDA-approved treatment options include:
- Abilify (aripiprazole)
- Seroquel (quetiapine)
- Risperdal (risperidone)
- Zyprexa (olanzapine)
Is Vraylar better than Risperdal (risperidone)?
Vraylar and risperidone are both atypical antipsychotics used to treat schizophrenia and bipolar mania. Risperidone also treats irritability associated with autism, PTSD, and Tourette’s syndrome. Vraylar is also used to treat mixed episodes of bipolar disorder. They both share a lot of the same side effects and drug interactions.
A study published in Lancet showed Vraylar to be more effective in treating negative symptoms in schizophrenic patients.
There is a huge price between these two medications. Risperidone is relatively inexpensive and costs less than $5 for #30, 1mg tablets. Vraylar is much more expensive, costing over $1500 for a month’s supply of #30, 1.5mg capsules.
Vraylar FAQs
Will I gain weight taking Vraylar?
Some people gain weight while taking Vraylar. Clinical studies showed that people who took Vraylar gained between 1 to 2 pounds over 3 to 8 weeks. How much weight you might gain will depend on your treatment’s medical condition and your dose of Vraylar.
How long does Vraylar stay in the system?
Vraylar and its metabolites have a half-life of up to 3 weeks. This means it can remain in your circulation for up to 15 weeks after your last dose.
Does Vraylar cause withdrawal?
While stopping Vraylar should not cause withdrawal symptoms, it may cause the symptoms of your condition to return or worsen. Do not stop taking Vraylar without talking to your doctor.
How do I store Vraylar?
Vraylar should be stored at room temperature between 68°F to 77°F (20°C to 25°C) away from light and moisture.
How long does it take for Vraylar to start working?
While you may see some benefits from taking Vraylar within the first 2 weeks, it may take up to 12 weeks before you see the full benefit of Vraylar treatment.
Is there a generic for Vraylar?
Currently, there is not a generic Vraylar available on the market. However, you can still save on brand-name drugs like Vraylar with the help of NiceRx.
