Vraylar
Vraylar Uses, Dosage, Side Effects, Food Interaction and all others data.
Vraylar is an antipsychotic drug developed by Gedeon Richter and marketed by Actavis under the trade name Vraylar. Vraylar acts as a D2 and D3 receptor partial agonist, with high selectivity towards the D3 receptor. This mechanism is relatively unique, since many other antipsychotics are D2 and 5-HT2A agonists. Vraylar was approved by the FDA in September 2015 and is indicated in the treatment of schizophrenia and bipolar disorder. Action on the dopaminergic systems makes it also potentially useful as an add-on therapy in major depressive disorder.
Vraylar acts as a partial agonist at the dopamine D3 and D2 receptors with high binding affinity. Vraylar acts as an antagonist at 5-HT2B and 5-HT2A receptors with high and moderate binding affinity as well as it binds to the histamine H1 receptors. Vraylar shows lower binding affinity to the serotonin 5 HT2C and α1A- adrenergic receptors and has no appreciable affinity for cholinergic muscarinic receptors.
| Trade Name | Vraylar |
| Availability | Prescription only |
| Generic | Cariprazine |
| Cariprazine Other Names | Cariprazine |
| Related Drugs | Vraylar, quetiapine, lamotrigine, Abilify, Seroquel, aripiprazole, olanzapine, risperidone, lithium |
| Weight | 1.5mg, 1.5mg + 3mg, 3mg, 4.5mg, 6mg, |
| Type | Oral capsule |
| Formula | C21H32Cl2N4O |
| Weight | Average: 427.41 Monoisotopic: 426.1953171 |
| Protein binding | Cariprazine and its metabolites are highly protein bound (91-97%). |
| Groups | Approved, Investigational |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States, |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Vraylar is an atypical antipsychotic used to treat schizophrenia and acute manic or mixed episodes due to bipolar I disorder.
Vraylar is an atypical antipsychotic indicated for the treatment of schizophrenia and for the acute treatment of manic or mixed episodes associated with bipolar I disorder.
Vraylar is also used to associated treatment for these conditions: Mixed manic depressive episode, Schizophrenia, Acute Manic episode
How Vraylar works
The mechanism of action of cariprazine in schizophrenia and bipolar I disorder is unknown. However, the efficacy of cariprazine could be mediated through a combination of partial agonist activity at central dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at serotonin 5-HT2A receptors. Vraylar forms two major metabolites, desmethyl cariprazine (DCAR) and didesmethyl cariprazine (DDCAR), that have in vitro receptor binding profiles similar to the parent drug.
Toxicity
Accidental acute overdosage (48 mg/day) was reported in one patient. This patient experienced orthostasis and sedation. The patient fully recovered the same day. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Vraylar is not approved for the treatment of patients with dementia-related psychosis.
Food Interaction
No interactions found.[Moderate] GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cariprazine.
The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of cariprazine by certain compounds present in grapefruit.
When cariprazine (0.5 mg The Cmax and AUC of another active metabolite, desmethyl cariprazine (DCAR), decreased by approximately one-third. The interaction has not been studied with grapefruit juice. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Increased exposure to cariprazine may increase the risk of adverse effects such as extrapyramidal symptoms, cognitive and motor impairment, hyperglycemia, dyslipidemia, weight gain, orthostatic hypotension, leucopenia, neutropenia, seizures, and dysphagia.
MANAGEMENT: Patients should avoid the consumption of grapefruit and grapefruit juice during treatment with cariprazine.
Vraylar Alcohol interaction
[Moderate] GENERALLY AVOID:
Alcohol may potentiate some of the pharmacologic effects of central nervous system (CNS)-active agents.
Use in combination may result in additive CNS depression and/or impairment of judgment, thinking, and psychomotor skills.
Patients receiving CNS-active agents should be advised to avoid or limit consumption of alcohol.
Ambulatory patients should be counseled against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
Vraylar Cholesterol interaction
[Moderate] Atypical antipsychotic drugs have been associated with undesirable alterations in lipid levels.
While all agents in the class have been shown to produce some changes, each drug has its own specific risk profile.
Before or soon after initiation of antipsychotic medication, obtain a fasting lipid profile at baseline and monitor periodically during treatment.
Vraylar Drug Interaction
Moderate: aripiprazole, lorazepam, diphenhydramine, duloxetine, divalproex sodium, cyclobenzaprine, lamotrigine, quetiapine, sertraline, cetirizineUnknown: amphetamine / dextroamphetamine, sulfamethoxazole / trimethoprim, ubiquinone, copper gluconate, fluticasone, glycerin, bioflavonoids, cyanocobalamin, cholecalciferol, lisdexamfetamine
Vraylar Disease Interaction
Major: dementia, NMS, tardive dyskinesiaModerate: depression, aspiration, seizure, hematologic abnormalities, hyperglycemia/diabetes, hypotension, lipid alterations, renal impairment, weight gain, hyperprolactinemia
Half Life
~1 week for the combined drug.
Elimination Route
Urine (21% of dose)
Innovators Monograph
You find simplified version here Vraylar
