Vraylar is a brand-name capsule prescribed for certain mental health conditions. Vraylar contains the active drug cariprazine and belongs to the atypical (second-generation) antipsychotic drug class.

Vraylar is FDA approved to treat the following in adults:

  • Manic or mixed episodes of bipolar I disorder: With bipolar I disorder, you may have episodes of mania (high mood) that last at least 7 days or are severe enough to need treatment in a hospital. These are called manic episodes. A mixed episode is when you have symptoms of mania and depression (low mood) at the same time. Vraylar is used for acute treatment of manic or mixed episodes. “Acute” means short term.
  • Depressive episodes of bipolar I disorder: Vraylar can also be used to treat episodes of depression in bipolar I disorder. These episodes may be referred to as bipolar depression.
  • Schizophrenia: With schizophrenia, you may have symptoms of psychosis such as hallucinations (seeing or hearing things that aren’t really there). You may also have delusions (beliefs that aren’t true).
  • Major depressive disorder (MDD): Also known as depression), MDD may cause a low mood that persists, loss of motivation, trouble sleeping, and other symptoms. For treating depression, Vraylar is taken in combination with an antidepressant. In this situation, Vraylar is referred to as an adjunctive treatment, meaning it is not taken alone.

Drug details

Key information about Vraylar follows:

  • Drug form: oral capsule
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2015

Vraylar has boxed warnings. A boxed warning is the most serious warning from the FDA. For details, see the “Vraylar precautions” section.

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Vraylar is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Vraylar contains the active drug cariprazine.

The Food and Drug Administration (FDA) approves prescription drugs such as Vraylar to treat certain conditions. Vraylar may also be prescribed off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Vraylar for manic or mixed episodes in bipolar I disorder

Vraylar is FDA approved to treat manic or mixed episodes of bipolar I disorder in adults. The drug is used for acute (short-term) treatment of these episodes.

Bipolar disorder is a mental health condition in which you have episodes of mania (high mood) and episodes of depression (low mood). Episodes of mania are also called manic episodes, and episodes of depression are also called depressive episodes. With bipolar I disorder, your manic episodes last at least 7 days or are severe enough to need treatment in a hospital.

During manic episodes of bipolar I disorder, your mood becomes very high. Mixed episodes of bipolar I disorder involve having symptoms of mania and depression at the same time.

Symptoms of manic episodes can include:

  • feeling euphoric and exhilarated
  • feeling restless, wired, and jittery
  • having racing thoughts
  • talking excessively
  • having excessive self-confidence
  • having impaired judgment
  • having a reduced sense of risk
  • engaging in behavior that may have harmful effects

People experiencing a manic episode may not recognize that their behavior is unusual.

With severe manic episodes, you may also have symptoms of psychosis. These include hallucinations (seeing or hearing things that aren’t really there) and delusions (beliefs that aren’t true).

To learn about symptoms of depression that can occur during mixed episodes alongside the symptoms of mania described previously, see the “Vraylar for depressive episodes in bipolar I disorder” section.

Vraylar works to help improve your mood, thinking, and behavior.

Effectiveness for manic or mixed episodes

In clinical trials, Vraylar was found to be effective for treating acute manic or mixed episodes of bipolar I disorder. For details of these trials, see Vraylar’s prescribing information.

Vraylar for depressive episodes in bipolar I disorder

Vraylar is FDA approved to treat depressive episodes of bipolar I disorder in adults.

Bipolar disorder is a mental health condition in which you have manic episodes and depressive episodes. With bipolar I disorder, manic episodes last at least 7 days or are severe enough to need treatment in a hospital. To read more about manic episodes, see the “Vraylar for manic or mixed episodes in bipolar I disorder” section.

With depressive episodes of bipolar I disorder, your mood becomes very low. Symptoms can include:

  • extreme sadness or gloom
  • hopelessness
  • guilt
  • anxiety
  • trouble sleeping or extreme tiredness
  • lack of energy
  • memory problems
  • difficulty concentrating
  • feeling easily irritated

You may also have symptoms of psychosis with severe episodes of depression. These symptoms include hallucinations and delusions.

Vraylar works to help improve your mood, thinking, and behavior.

Effectiveness for depressive episodes

In clinical trials, Vraylar was found to be effective for treating depressive episodes of bipolar I disorder. For details of these trials, see Vraylar’s prescribing information.

Vraylar for schizophrenia

Vraylar is FDA approved to treat schizophrenia in adults.

Schizophrenia is a chronic (long-term) mental health condition. Typically, schizophrenia has positive symptoms and negative symptoms. Positive symptoms may also be called symptoms of psychosis.

Positive symptoms are thoughts and behaviors that you didn’t have before you became ill. These may include hallucinations and delusions. Also, you may have paranoia (an irrational fear of a threat toward yourself).

Negative symptoms are thoughts and behaviors that you have less of since you became ill. So you may have less energy or less interest in things you used to enjoy. And you may be less able to concentrate, remember, plan, express emotion, or communicate with others.

Vraylar is an antipsychotic medication that works to help restore your mood, thinking, and behavior.

Effectiveness for schizophrenia

Vraylar was found to be effective for treating schizophrenia in several clinical trials. For details of these trials, see Vraylar’s prescribing information.

Vraylar for depression

Vraylar is FDA approved to treat major depressive disorder (MDD) (also known as depression) in adults. The condition is thought to be caused by an imbalance of chemicals in the brain.

Doctors may diagnose a person with depression if they experience certain symptoms most days for at least 2 weeks. Symptoms of depression can include:

  • low mood that persists
  • hopelessness
  • anxiety
  • trouble sleeping or extreme tiredness
  • lack of energy
  • memory problems
  • short attention span
  • loss of motivation

For treating depression, Vraylar is used in combination with an antidepressant, such as fluoxetine (Prozac) or citalopram (Celexa). Your doctor may add Vraylar to your depression treatment plan if you’ve tried taking antidepressants alone but your condition didn’t improve. In this situation, Vraylar is referred to as an adjunctive treatment, meaning it is not taken alone. Together, the medications work to help improve your mood, thinking, and behavior.

Effectiveness for depression

In clinical trials, Vraylar was found to be effective for treating depression. For details of these trials, see Vraylar’s prescribing information.

Vraylar for other conditions

In addition to the uses listed previously, Vraylar may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder whether Vraylar is used for certain other conditions. Information follows about other possible uses for Vraylar.

Vraylar for autism

Vraylar isn’t FDA approved to treat autism, also called autism spectrum disorder (ASD). The drug has been studied for ASD in children, but it’s still not known how effective Vraylar is for this use.

ASD is a group of conditions that are caused by atypical brain development in childhood. People with ASD have differences in how they communicate, interact, and behave with other people. This can affect learning ability, emotions, and impulse management.

Some people who have ASD can develop severe problems with aggressive, impulsive, or self-harming behavior. And certain atypical (second-generation) antipsychotics can help treat these types of behaviors. Those drugs approved for this use include aripiprazole (Abilify) and risperidone (Risperdal).

Further research is needed before it’s known whether Vraylar is effective for ASD. Talk with your doctor if you’re interested in using Vraylar for ASD.

Vraylar for bipolar II disorder (not an approved use)

Vraylar isn’t FDA approved for treating bipolar II disorder, which is also known as bipolar 2 disorder. The drug isn’t included in current U.S. treatment guidelines for bipolar disorder. However, these guidelines haven’t been updated since 2005, and Vraylar was approved in 2015.

Bipolar disorder is a mental health condition in which a person has episodes of mania and episodes of depression. (For details on manic and depressive episodes, see “Vraylar for manic or mixed episodes in bipolar I disorder” and “Vraylar for depressive episodes in bipolar I disorder.”) With bipolar II disorder, you have episodes of hypomania, rather than “full” manic episodes. Hypomania is a milder version of mania.

Very little research has been done into the treatment of bipolar II disorder. Further study is needed before it’s known whether Vraylar is effective for people with this condition.

If you have bipolar II disorder, talk with your doctor about which treatments are right for you.

Vraylar and children

Vraylar isn’t FDA approved for treating schizophrenia, bipolar I disorder, or depression in children. The safety and effectiveness of Vraylar haven’t been fully studied in this age group.

Ongoing studies are looking at the use of Vraylar to treat schizophrenia and depressive episodes related to bipolar I disorder in children. However, it’s not yet known whether Vraylar is safe and effective for children with these conditions.

It’s important to note that Vraylar and similar drugs have a boxed warning regarding the risk of suicidal thoughts and behaviors. This risk affects children and adults younger than age 25 years.

If your child has schizophrenia, bipolar I disorder, or depression, and you’d like to learn more about Vraylar or other treatments, talk with your child’s doctor.

Vraylar can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Vraylar. These lists don’t include all possible side effects.

Some side effects may not occur for several weeks after you start taking Vraylar or for several weeks after any dose increases.

For more information on the possible side effects of Vraylar, refer to this article. Or talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Vraylar, you can do so through MedWatch.

Mild side effects

Mild side effects of Vraylar can include:

  • involuntary muscle movements, such as twitching, jerking, or twisting movements of your head, neck, tongue, arms, or legs
  • trouble moving or slow movements
  • muscle stiffness
  • headache
  • dizziness
  • dry mouth
  • indigestion
  • constipation
  • weight gain
  • feeling sleepy
  • akathisia (feeling uncomfortably restless and unable to sit or stand still)
  • nausea and vomiting

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

For more information about some of these side effects, see the “Side effect details” section.

Serious side effects

Serious side effects from Vraylar aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include:

* Vraylar has boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Allergic reaction

For some people, Vraylar can cause an allergic reaction.

But it’s not clear how often this side effect occurred in the drug’s studies.

In general, symptoms of allergic reaction can be mild or serious.

Ways to manage

For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.

For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Vraylar, your doctor may recommend taking a different medication instead.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on several of the side effects this drug may or may not cause.

Boxed warning: Risk of suicidal thoughts and behaviors

People with a mental health condition, such as schizophrenia, bipolar disorder, or depression, have an increased risk of suicidal thoughts and behaviors. In some cases, children and young adults have a higher risk of suicidal thoughts and actions while taking an antidepressant medication. Vraylar is an antipsychotic medication, but it also has an antidepressant effect.

Clinical trials of various antidepressants have found the risk of suicidal thoughts and behaviors is higher in children and adults younger than age 25 years. This risk is highest during the first few months after starting an antidepressant treatment and after any dose changes.

Your doctor will monitor you closely for any signs of suicidal thoughts and behaviors during your Vraylar treatment.

While taking Vraylar, call your doctor right away if you:

  • feel that your depression is getting worse
  • have sudden changes in your mood, thoughts, or behaviors
  • have thoughts about dying or harming yourself
  • try to harm yourself or attempt suicide

Vraylar is not approved for use in children ages 17 years and younger.

Boxed warning: Increased risk of death in older adults with dementia-related psychosis

Adults ages 65 and older with dementia-related psychosis (loss of contact with reality) have a higher risk of death if they take antipsychotic medications such as Vraylar. Dementia refers to problems with thinking, memory, and communication.

Vraylar is not FDA approved to treat psychosis that’s related to dementia in older adults.

Weight gain

Some people may gain weight while taking Vraylar. This side effect was reported in clinical trials of the drug.

Your doctor will regularly check your weight while you take Vraylar. If you’re concerned about weight gain, talk with them about ways to manage your weight during your treatment.

Weight loss

Vraylar isn’t likely to cause weight loss. People didn’t report losing weight in clinical trials of the drug.

Feeling sleepy

Vraylar use can cause people to feel sleepy. In clinical trials, sleepiness was a reported side effect.

If you find that Vraylar does make you sleepy, you should not drive or take part in other activities that could be dangerous. And if the sleepiness is bothersome to you, talk with your doctor. They may be able to suggest a different medication.

Akathisia and tardive dyskinesia

Conditions known as akathisia and tardive dyskinesia are possible side effects of Vraylar use.

Akathisia

Akathisia is one of the most common side effects of Vraylar reported in clinical trials.

Akathisia is an uncomfortable feeling of restlessness and the urge to move around. It can cause you to make repetitive movements, especially with your legs, to ease these feelings.

Symptoms of akathisia can include:

  • feeling very restless or tense
  • fidgeting
  • tapping your feet
  • rocking back and forth while standing or sitting
  • shifting weight from one leg to the other
  • walking in place
  • pacing
  • crossing and uncrossing your legs or swinging one leg while sitting

If you develop symptoms of akathisia while taking Vraylar, tell your doctor. Sometimes these symptoms can be eased by lowering the dose of Vraylar. Or your doctor may prescribe a different medication to help relieve this side effect.

Tardive dyskinesia

It’s not known exactly how often tardive dyskinesia occurs with Vraylar. However, the condition tends to be more common in females* and older adults. And it’s more likely to occur when you take a higher dose or use the medication for a long time.

Tardive dyskinesia describes involuntary, repetitive body movements that you can’t control. The movements usually occur in your face, tongue, or jaw, but can also develop in other parts of your body, such as your arms or legs. This side effect typically develops after you’ve been taking Vraylar for a long time. It can also develop after you’ve stopped using it. Tardive dyskinesia can sometimes be permanent.

Symptoms of tardive dyskinesia can include:

  • lip smacking
  • tongue twisting
  • chewing motions
  • puffing out your cheeks
  • grimacing
  • jerky movements of your arms, legs, or torso

If you develop symptoms of tardive dyskinesia while using Vraylar, tell your doctor right away. Sometimes the symptoms can be relieved by lowering the dose of the medication. Or your doctor may prescribe a different drug to help ease tardive dyskinesia. If these options don’t help, your doctor may suggest switching to a medication other than Vraylar.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to the sex assigned at birth.

Nausea

Some people may experience nausea while taking Vraylar. Nausea was a reported side effect in clinical trials of the drug.

If you have nausea while taking Vraylar, talk with your doctor about ways to manage it.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

The Vraylar dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Vraylar to treat
  • your age
  • other medical conditions you may have
  • other medications you may be taking

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

For additional details, refer to this article about Vraylar’s dosage.

Drug forms and strengths (1.5 mg, 3 mg, 4.5 mg, and 6 mg)

Vraylar comes as an oral capsule. It’s available in four different strengths: 1.5 milligrams (mg), 3 mg, 4.5 mg, and 6 mg.

Dosage for manic or mixed episodes in bipolar I disorder

To treat manic or mixed episodes of bipolar I disorder, the typical dosage of Vraylar is between 3 mg and 6 mg once per day.

You’ll usually start your treatment with a dose of 1.5 mg on day 1. This is followed by a dose of 3 mg on day 2. After this, your doctor may gradually increase your daily dose as needed, up to a maximum of 6 mg once per day.

Dosage for depressive episodes in bipolar I disorder

To treat episodes of depression in bipolar I disorder, the typical starting dose of Vraylar is 1.5 mg. You’d take this once per day. If needed, on day 15 of treatment, your doctor may increase your dosage to 3 mg once per day.

Dosage for schizophrenia

To treat schizophrenia, the typical dosage of Vraylar is between 1.5 mg and 6 mg once per day.

You’ll likely start your treatment with a dose of 1.5 mg on day 1. On day 2, your doctor may increase the dose to 3 mg. After this, your doctor may gradually increase your daily dose as needed, up to a maximum of 6 mg once per day.

Dosage for depression

To treat depression, the typical starting dosage of Vraylar is 1.5 mg once per day. If needed, on day 15 of treatment, your doctor may increase your dosage to 3 mg once per day.

For treating depression, you’ll take Vraylar in combination with an antidepressant. In this situation, Vraylar is referred to as an adjunctive treatment, meaning it is not taken alone. For more information, see the “Vraylar uses” section.

Dosage adjustments based on side effects

Higher doses of Vraylar are associated with more side effects. Side effects can also become more severe with higher doses. (For details on side effects, see the “Vraylar side effects” section.)

However, it takes a long time for Vraylar to build up in your body. This means that you may not have some side effects until several weeks after you start taking Vraylar or after your doctor increases your dose. They’ll monitor you closely for side effects after you start treatment and after any dose increases.

If you do develop side effects that are very bothersome, your doctor may lower your dose. This may not make the Vraylar side effects go away, but it might make them less severe. However, because Vraylar can stay in your body for a long time, it can take at least a week for side effects to begin to ease.

You should not change your dose of Vraylar unless your doctor recommends it.

What if I miss a dose?

If you miss a dose of Vraylar, take it as soon as possible, unless it’s nearly time for your next dose. In this case, just skip the missed dose. Then take your next dose as usual. Don’t take two doses together to make up for a missed dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A medication timer may be useful, too.

Will I need to use this drug long term?

For manic or mixed episodes of bipolar I disorder, you’ll likely take Vraylar for a few weeks. Keep taking it for as long as your doctor recommends.

For its other uses, Vraylar is meant to be taken as a long-term treatment. If you and your doctor determine that Vraylar is safe and effective for you, you’ll likely take it long term. Unless your doctor tells you otherwise, it’s important to keep taking Vraylar, even if you feel better. Vraylar doesn’t cure these conditions. The drug only manages your symptoms. Stopping Vraylar use could make your symptoms come back.

As with all medications, the cost of Vraylar can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Vraylar, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Vraylar, contact your insurance company.

For more details, refer to this article about Vraylar and cost.

Drug coupons

To save money on your Vraylar prescription, explore the Optum Perks* coupons that follow.

You can also visit Optum Perks for price estimates of Vraylar. These estimates are based on the use of Optum Perks coupons.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

* Optum Perks is a sister site of Medical News Today.

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Financial and insurance assistance

If you need financial support to pay for Vraylar, or if you need help understanding your insurance coverage, help is available.

A savings program and payment assistance program for Vraylar are available. For more information and to find out if you’re eligible for support, call 800-761-0436 or visit the program website.

Generic version

Vraylar isn’t available in a generic form. Generics usually cost less than brand-name drugs.

Vraylar is an atypical (second-generation) antipsychotic that’s used for schizophrenia, bipolar I disorder, and major depressive disorder.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Vraylar, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is prescribed to treat a different condition.

Alternatives for manic or mixed episodes in bipolar I disorder

Examples of other drugs that may be used to treat manic or mixed episodes in bipolar I disorder include:

Alternatives for depressive episodes in bipolar I disorder

Examples of other drugs that may be used to treat depressive episodes in bipolar I disorder include:

Alternatives for schizophrenia

Examples of other drugs that may be used to treat schizophrenia include:

  • other atypical antipsychotics, such as:
    • aripiprazole (Abilify, Abilify MyCite, Abilify Asimtufii, Abilify Maintena, Aristada)
    • asenapine (Saphris)
    • brexpiprazole (Rexulti)
    • lurasidone (Latuda)
    • olanzapine (Zyprexa, Zyprexa Zydis, Zyprexa Relprevv)
    • paliperidone (Invega, Invega Sustenna, Invega Trinza, Invega Hafyera)
    • quetiapine (Seroquel, Seroquel XR)
    • risperidone (Risperdal, Risperdal Consta, Perseris, Rykindo, Uzedy)
    • ziprasidone (Geodon)
  • typical (first-generation) antipsychotics, such as:
    • chlorpromazine
    • fluphenazine, fluphenazine decanoate
    • haloperidol, haloperidol decanoate
    • perphenazine

Alternatives for adjunctive treatment of depression

For treating depression in adults, Vraylar is taken in combination with an antidepressant. In this situation, Vraylar is referred to as an adjunctive treatment, meaning it is not taken alone.

Examples of other drugs used as adjunctive treatment with an antidepressant for depression include:

  • aripiprazole (Abilify, Abilify MyCite)
  • brexpiprazole (Rexulti)

Drinking alcohol with Vraylar can raise your risk of certain side effects, such as feeling sleepy, dizziness, and nausea.

Drinking alcohol can also make your depression symptoms worse.

If you drink alcohol, talk with your doctor about whether it’s safe for you to consume it while you’re taking Vraylar.

Vraylar can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

For more information about Vraylar interactions, refer to this article.

Vraylar and other medications

The following lists of medications can interact with Vraylar. These lists do not contain all drugs that may interact with Vraylar.

Before taking Vraylar, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Vraylar and certain drugs to treat infections

Taking Vraylar with certain drugs to treat infections may affect how well your liver can process Vraylar. Some drugs can cause the level of Vraylar to build up in your body. In turn, this can increase your risk of side effects from Vraylar.

Examples of antimicrobial drugs that can raise the risk of side effects with Vraylar include:

If you need to take one of these drugs with Vraylar, your doctor may have you take a dose of Vraylar that’s lower than usual.

Using Vraylar with certain other drugs to treat infections can lower the level of Vraylar in your body. This could make Vraylar less effective, so you should not take these drugs with Vraylar.

Examples of these drugs include:

  • rifabutin (Mycobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

If you’re taking any medication to treat an infection, talk with your doctor before taking Vraylar. They can adjust your treatment plan as needed.

Vraylar and certain seizure medications

Taking Vraylar with certain seizure medications could make Vraylar less effective. So you shouldn’t take these drugs with Vraylar.

Examples of seizure medications that could make Vraylar less effective include:

If you’re using any of these medications, talk with your doctor before taking Vraylar. They can adjust your treatment plan as needed.

Vraylar and stimulants

Stimulants are drugs that are mainly used to treat attention deficit hyperactivity disorder (ADHD), but they’re sometimes misused. (Misuse means to take a drug in a way other than how a doctor prescribes it.) Examples of these drugs include amphetamine/dextroamphetamine (Adderall, Adderall XR, Mydayis) and lisdexamfetamine (Vyvanse).

People with mental health conditions such as bipolar disorder or schizophrenia should typically avoid taking stimulants. This is because stimulants can cause new symptoms of psychosis or mania, and make these conditions worse. (For information on these symptoms, see the “Vraylar uses” section.)

Taking stimulants with Vraylar could also raise your risk of having certain side effects, especially involuntary muscle movements, such as tremors, twitches, or tics. (To learn more about these side effects, see the “Vraylar side effects” section.)

If you’re taking a stimulant, talk with your doctor before you start using Vraylar. They can recommend the best treatment options for you.

Vraylar and antidepressants

Antidepressants are sometimes used to treat depression in people with schizophrenia or bipolar disorder. And they may sometimes be used in combination with Vraylar.

Taking an antidepressant with Vraylar is typically fine, but the combination may raise your risk of side effects. These include feeling sleepy, dizziness when getting up, and seizures. In addition, many antidepressants have a boxed warning for an increased risk of suicidal thoughts and behaviors in children and adults younger than age 25 years. Vraylar also comes with this boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Using both an antidepressant and Vraylar can also affect your ability to make decisions, think clearly, or react quickly. So it’s important that you know how your medications affect you before driving.

Examples of antidepressants that might be used with Vraylar include:

If your doctor has prescribed you an antidepressant to take with Vraylar, they’ll closely monitor you for possible side effects. Talk with them if you’re concerned about any side effects you may have from taking these medications together.

Vraylar and mood stabilizers

Mood stabilizers are medications that are used in bipolar disorder to help prevent future episodes of mania and depression. Your doctor may recommend that you start taking a mood stabilizer while you’re using Vraylar to treat an episode of mania or depression.

Taking a mood stabilizer with Vraylar is typically fine. However, the combination may raise your risk of certain side effects. These include feeling sleepy, dizziness when getting up, and confusion.

Using both a mood stabilizer and Vraylar can also affect your ability to make decisions, think clearly, or react quickly. So it’s important that you know how your medications affect you before driving.

Examples of mood stabilizers that may be used with Vraylar include:

If your doctor has prescribed you a mood stabilizer to take with Vraylar, they’ll closely monitor you for possible side effects. Talk with them if you’re concerned about any side effects you may have from taking these medications together.

Vraylar and anticholinergic drugs

Anticholinergic drugs are sometimes used to treat involuntary body movements that can be a side effect of Vraylar. Anticholinergic drugs are also sometimes used to treat chronic obstructive pulmonary disease (COPD), asthma, and an overactive bladder.

If you take anticholinergic drugs with Vraylar, you may be more likely to have other side effects. These can include constipation, dry mouth, blurred vision, and problems managing your body temperature.

Examples of anticholinergic drugs that may increase the risk of side effects if taken with Vraylar include:

If you need to take one of these medications with Vraylar, your doctor will monitor you closely. Tell them if you notice any side effects, such as blurred vision or a dry mouth. And take care to avoid getting too hot.

Vraylar and herbs and supplements

Taking St. John’s wort with Vraylar may lower the level of Vraylar in your body. You should not use St. John’s wort with Vraylar, as it could make Vraylar less effective.

Vraylar and caffeine and foods

There aren’t any foods that have been specifically reported to interact with Vraylar. If you have any questions about eating certain foods with Vraylar, talk with your doctor.

Vraylar and caffeine

Caffeine isn’t known to interact with Vraylar. Caffeine is a type of stimulant found in foods as well as beverages such as coffee, tea, and energy drinks. (For more information on how stimulants can affect Vraylar, see the “Vraylar and stimulants” section.)

However, caffeine can affect your ability to fall asleep, which may lead to mood changes if you have bipolar I disorder.

If you have questions about consuming caffeine while taking Vraylar, talk with your doctor.

Vraylar and grapefruit juice

Consuming grapefruit or grapefruit juice can raise the levels of some medications in your blood. This can increase the risk of side effects from the medication. In theory, eating grapefruit or drinking grapefruit juice with Vraylar could increase the level of Vraylar in your body. However, there haven’t been any studies on this.

If you want to eat grapefruit or drink grapefruit juice with Vraylar, talk with your doctor about whether this is safe for you. If you have increased side effects with the combination, avoid consuming grapefruit products with Vraylar in the future.

Here are answers to some frequently asked questions about Vraylar.

Can Vraylar be used for anxiety?

It’s unlikely. Vraylar, a type of antipsychotic drug, isn’t specifically used for treating anxiety disorders. Anxiety disorders are typically treated with medications such as benzodiazepines, certain antidepressants, or beta-blockers.

If treatments like these don’t work, antipsychotics other than Vraylar might be used on occasion. For instance, a review of studies found quetiapine (Seroquel, Seroquel XR) to be effective for treating generalized anxiety disorder. However, because antipsychotics can cause some serious side effects, other anxiety treatments are usually a better option.

Keep in mind that if anxiety is one of the symptoms of your schizophrenia, bipolar I disorder, or depression, it may ease as your condition improves with Vraylar treatment.

If you have anxiety, talk with your doctor about what treatments are right for you.

Is Vraylar an SSRI?

No, Vraylar isn’t an SSRI, which stands for selective serotonin reuptake inhibitor. SSRIs are a particular type of antidepressant medication.

Vraylar is an atypical (second-generation) antipsychotic medication.

Does Vraylar cause sexual side effects?

No, Vraylar (a type of antipsychotic medication) isn’t known to cause sexual side effects. These problems weren’t reported in clinical trials of the drug. However, sexual problems are known to occur with other antipsychotics. And sexual problems can also be associated with the conditions that Vraylar treats.

Talk with your doctor if you have sexual problems that concern you. They may be able to recommend a suitable treatment.

Why do I have to avoid getting too hot while taking Vraylar?

Vraylar can reduce sweating and cause problems with how your body manages its core temperature. The drug makes it harder for your body to cool down if you get too hot. This is especially a problem in hot weather or when exercising. If you can’t cool down properly, you could develop heatstroke (overheating).

While using Vraylar, you should avoid strenuous exercise and wearing too much warm clothing. Be sure to drink plenty of water to avoid dehydration (losing too much fluid). And in hot weather, stay in a cool place out of the sun.

Talk with your doctor for other tips on how to avoid getting too hot during your Vraylar treatment.

Will I be able to drive during my Vraylar treatment?

Probably. Most people are able to drive while taking Vraylar. However, you need to be aware that Vraylar can make some people feel sleepy. And the drug could affect your ability to make decisions, think clearly, or react quickly.

Make sure you know how Vraylar affects you before driving. And be sure to drive only if you can do so safely.

You may wonder how Vraylar compares with other medications that are prescribed for similar uses. Here we look at how Vraylar and Abilify are alike and different.

Note: Abilify comes in several versions marketed under different brand names: Abilify, Abilify MyCite, Abilify Maintena, and Abilify Asimtufii. The approved uses for this drug vary depending on the version. This section only applies to the version that’s simply called Abilify. For additional information about the other versions of the drug and the conditions they are approved to treat, talk with your doctor.

Ingredients

Vraylar contains the active drug cariprazine, while Abilify contains the active drug aripiprazole.

Uses

Vraylar is approved to treat:

  • manic and mixed episodes of bipolar I disorder in adults
  • depressive episodes of bipolar I disorder in adults
  • schizophrenia in adults
  • depression in adults, when prescribed with an antidepressant

Abilify is approved to treat:

  • manic and mixed episodes of bipolar I disorder in adults as well as children ages 10 years and older
  • depression in adults, when prescribed with an antidepressant
  • schizophrenia in adults and children ages 13 years and older
  • irritability associated with autism spectrum disorder in children ages 6 years and older
  • Tourette syndrome in children ages 6 years and older

Drug forms and administration

Vraylar comes as an oral capsule that is usually taken once per day.

Abilify comes as an oral tablet that is usually taken once per day.

Side effects and risks

Vraylar and Abilify both contain an atypical (second-generation) antipsychotic drug. They can cause some similar side effects, but some different ones as well. Examples include:

Mild side effects

This list contains up to 10 of the most common mild side effects that can occur with both Vraylar and Abilify (when taken individually):

Serious side effects

These lists contain examples of serious side effects that can occur with Vraylar, with Abilify, or with both drugs (when taken individually).

* Both Vraylar and Abilify have boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

Vraylar and Abilify have different FDA approved uses, but they’re both used to treat manic and mixed episodes of bipolar I disorder, schizophrenia, and depression (when used with an antidepressant).

These drugs haven’t been directly compared in clinical trials, but studies have found both Vraylar and Abilify to be effective for treating these conditions.

Both drugs are recommended as treatment options for schizophrenia in guidelines from the American Psychiatric Association.

If you’re interested in taking Vraylar or Abilify, talk with your doctor about which one is right for you.

Costs

The costs of Vraylar and Abilify will vary depending on your treatment plan. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use. You can visit Optum Perks* for price estimates of Vraylar and Abilify.

Vraylar and Abilify are both brand-name drugs. There is currently no generic form of Vraylar. Generic forms of Abilify are available under the name aripiprazole. Brand-name medications usually cost more than generics.

* Optum Perks is a sister site of Medical News Today.

Like Abilify, the drug Latuda has uses similar to those of Vraylar. Here’s a comparison of how Vraylar and Latuda are alike and different.

Ingredients

Vraylar contains the active drug cariprazine, while Latuda contains the active drug lurasidone.

Uses

Vraylar is approved to treat:

  • manic and mixed episodes of bipolar I disorder in adults
  • depressive episodes of bipolar I disorder in adults
  • schizophrenia in adults
  • depression in adults, when prescribe with an antidepressant

Latuda is approved to treat:

  • depressive episodes of bipolar I disorder in adults and children ages 10 years and older
  • schizophrenia in adults and children ages 13 years and older

Drug forms and administration

Vraylar comes as an oral capsule, while Latuda comes as an oral tablet. You’ll likely take Vraylar or Latuda once per day.

Side effects and risks

Vraylar and Latuda both contain an atypical (second-generation) antipsychotic drug. They can cause some similar side effects, but some different ones as well. Examples of these side effects include:

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Vraylar, with Latuda, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Vraylar, with Latuda, or with both drugs (when taken individually).

* Both Vraylar and Latuda have boxed warnings from the FDA regarding these side effects. A boxed warning is the strongest warning the FDA requires. For more information, see “FDA warnings” at the beginning of this article.

Effectiveness

Vraylar and Latuda have different FDA approved uses, but they’re both used to treat depressive episodes of bipolar I disorder and schizophrenia.

These drugs haven’t been directly compared in clinical trials, but studies have found both Vraylar and Latuda to be effective for treating these conditions.

Both drugs are recommended as treatment options for schizophrenia in guidelines from the American Psychiatric Association.

If you’re interested in taking Vraylar or Latuda, talk with your doctor about which one is right for you.

Costs

The actual price you’ll pay for Vraylar or Latuda depends on your insurance plan, your location, and the pharmacy you use. You can visit Optum Perks* for price estimates of Vraylar and Latuda.

Vraylar and Latuda are both brand-name drugs. There is currently no generic form of Vraylar. A generic form of Latuda called lurasidone has been approved by the FDA. Brand-name medications usually cost more than generics.

* Optum Perks is a sister site of Medical News Today.

Vraylar and Rexulti are both atypical (second-generation) antipsychotics, which are drugs that work to improve your mood, thinking, and behavior. But these two drugs also have some important differences.

Vraylar comes as an oral capsule that contains the active drug cariprazine. It’s prescribed to treat:

  • manic or mixed episodes of bipolar I disorder in adults
  • depressive episodes of bipolar I disorder in adults
  • schizophrenia in adults
  • depression in adults, when taken with an antidepressant

Rexulti comes as an oral tablet that contains the active drug brexpiprazole. Rexulti can be prescribed for:

  • depression in adults, when taken with an antidepressant
  • schizophrenia in adults and children 13 years and older
  • agitation in adults resulting from dementia due to Alzheimer’s disease

You can talk with a pharmacist or your doctor for details about how Vraylar and Rexulti compare.

Vraylar and Seroquel are similar drugs, but they have some differences. Both are atypical (second-generation) antipsychotic drugs, meaning they work to improve your mood, thinking, and behavior.

Vraylar comes as an oral capsule and contains the active drug cariprazine. It’s prescribed to treat:

  • manic or mixed episodes of bipolar I disorder in adults
  • depressive episodes of bipolar I disorder in adults
  • schizophrenia in adults
  • depression in adults, when taken with an antidepressant

Seroquel comes as an oral tablet that contains the active drug quetiapine. It’s prescribed to treat:

  • manic or mixed episodes of bipolar I disorder in adults and children ages 10 and older
  • depressive episodes of bipolar I disorder in adults
  • schizophrenia in adults and children ages 13 years and older

Seroquel also comes as an extended-release tablet called Seroquel XR. The conditions Seroquel XR is approved to treat vary from those of Seroquel. “Extended release” means the drug is slowly released into your body over a long period of time.

Your doctor or pharmacist can provide more information about the similarities and differences between these drugs.

It’s unlikely that you’ll have withdrawal symptoms or side effects after stopping Vraylar treatment. Withdrawal symptoms are side effects that occur if you stop taking a drug that your body has become dependent on. And when you’re dependent on a drug, your body needs the drug to feel like it usually does.

However, if you stop taking Vraylar, the symptoms of your condition may return. So you should not stop taking Vraylar without talking with your doctor first. If you and your doctor agree that it’s right for you to stop taking Vraylar, then they will explain how to do this.

It’s important to note that newborns of people who take an atypical (second-generation) antipsychotic in the last 3 months of pregnancy can be at risk of withdrawal symptoms. (Vraylar is an atypical antipsychotic.) See the “Vraylar and pregnancy, breastfeeding, and birth control” section to learn more.

Vraylar misuse (also called abuse)

Vraylar hasn’t been studied for the possibility of drug misuse. Misuse refers to taking a drug in a way other than how a doctor prescribes it. However, misuse of Vraylar can lead to serious side effects. (See “Serious side effects” in the “Vraylar side effects” section for details.) Be sure to take the medication only as prescribed by your doctor, and do not give Vraylar to anyone else.

Vraylar is used to treat schizophrenia and manic, mixed, and depressive episodes of bipolar I disorder. It’s also used to treat major depressive disorder (MDD), often called depression.

What happens in schizophrenia, bipolar disorder, and depression

With schizophrenia, bipolar disorder, and depression, there is an imbalance of neurotransmitters in the brain. This imbalance typically affects dopamine and serotonin.

Neurotransmitters are natural body chemicals that are involved in passing messages between nerve cells and other cells in the body. Dopamine and serotonin are involved in passing messages in the brain that help manage mood, thinking, perception, and behavior.

An imbalance of serotonin and dopamine can lead to symptoms of depression, mania, and psychosis. Symptoms of psychosis include hallucinations (seeing or hearing things that aren’t really there) and delusions (beliefs that aren’t true).

What Vraylar does

Vraylar is a type of drug called an atypical (second-generation) antipsychotic. These drugs work by rebalancing the way that dopamine and serotonin work in the brain. But the exact way Vraylar works is not fully understood.

Vraylar helps reduce symptoms of psychosis such as hallucinations, delusions, and paranoia. The drug also works to reduce symptoms of mania, such as extreme agitation, racing thoughts, and feeling wired or jittery.

Vraylar can help ease symptoms of depression. These may include feelings of extreme sadness, gloom, hopelessness, and guilt.

In addition, Vraylar can ease other symptoms associated with the conditions it treats, such as anxiety, trouble sleeping, and a lack of energy. The medication can also help with problems with memory, concentration, and communication.

How long does it take to work?

Vraylar starts working in the first few days of treatment. Symptoms such as hallucinations and agitation tend to ease first. Other symptoms can take longer to decrease, and it can take several weeks for Vraylar to have its full effect.

It’s important to keep taking Vraylar for as long as your doctor recommends, even if it doesn’t seem to make much difference at first.

How long does Vraylar stay in your system?

Vraylar can stay in your body for several weeks after you stop taking it.

Vraylar has a half-life of about 1 week. The half-life of a drug is the length of time it takes for the drug level in your body to be reduced by half. So 1 week after stopping Vraylar use, the drug level in your body will be reduced to half. After another week, the level will be reduced to a quarter, in the next week it will be reduced to an eighth, and so on.

It’s generally considered that it takes 5.5 half-lives for the drug level to be so low that it no longer has an effect. So for Vraylar, this would be about 5.5 weeks. However, small amounts of the drug may still be detectable for longer than this in blood tests.

Do not use more Vraylar than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Vraylar

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

If you can become pregnant, are breastfeeding, or using birth control, it’s important to consider whether Vraylar is a safe choice for you.

You can also refer to this pregnancy, breastfeeding, and birth control article for more information. If you have additional questions, talk with your doctor.

You should take Vraylar according to your doctor’s or healthcare professional’s instructions.

When to take

You’ll likely take Vraylar once per day. Try to take the medication at the same time each day. You can take Vraylar at any time of day, so pick the best time for you to take Vraylar. Sticking to a routine will help you remember to take the drug.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app. A medication timer may be useful, too.

Taking Vraylar with food

You can take Vraylar either with or without food.

Can Vraylar be crushed, split, or chewed?

No, you should swallow Vraylar capsules whole. Taking them with a drink can make this easier for you. If you have trouble swallowing Vraylar, ask your doctor or pharmacist for advice.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death in older adults with psychosis due to dementia: Adults ages 65 years and older with dementia can sometimes develop psychosis (loss of contact with reality). In some cases, antipsychotic medications such as Vraylar can raise the risk of death in these older adults. The FDA has not approved Vraylar to treat psychosis that’s related to dementia in older adults.

Suicidal thoughts and behaviors: In some cases, antidepressant medications can increase the risk of suicidal thoughts and behaviors in children and adults younger than age 25 years. Vraylar is an antipsychotic medication, but it also has an antidepressant effect when used for depression in bipolar I disorder or depression. While you take Vraylar, your doctor may monitor you closely for any signs of suicidal thoughts and behaviors. Vraylar is not approved for use in children ages 17 years and younger.

Other precautions

Before taking Vraylar, talk with your doctor about your health history. Vraylar may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction: If you’ve had an allergic reaction to Vraylar or any of its ingredients, you should not take Vraylar. Ask your doctor what other medications are better options for you.
  • Kidney problems: Vraylar hasn’t been studied in people with severe kidney problems. Talk with your doctor about whether Vraylar is right for you if you have kidney problems.
  • Liver problems: Vraylar hasn’t been studied in people who have severe liver problems. If you have liver problems, talk with your doctor about whether Vraylar is a good option for you.
  • Older age: If you’re age 65 years or older, you could have a higher risk of certain side effects of Vraylar. These include dizziness when getting up, falls, tardive dyskinesia, and problems managing your body temperature. Older adults are typically prescribed a lower dose of Vraylar to minimize any risks from the drug. Your doctor will monitor you for side effects.
  • Diabetes: Vraylar can cause high blood sugar levels and diabetes. If you already have diabetes, taking Vraylar can make your blood sugar harder to manage. Talk with your doctor about whether Vraylar is right for you. If you do take Vraylar, your blood sugar may need to be checked more often than usual. If your blood sugar gets too high, your doctor may need to increase the dose of your diabetes medication.
  • High or low blood pressure: Vraylar may cause changes in your blood pressure. If you have problems with blood pressure, Vraylar may worsen them. Tell your doctor if you have a history of blood pressure problems. They can help you decide whether Vraylar is right for you.
  • High cholesterol or triglyceride levels: Vraylar may increase the levels of fats called cholesterol and triglycerides in your blood. If you already have high levels of these fats, Vraylar could raise them further. While you take Vraylar, your doctor will regularly order blood tests to check your cholesterol and triglyceride levels. If the levels get too high, you may need treatment for them.
  • Low white blood cell count: Vraylar can lower your white blood cell count. You could be more at risk of this if a medication has lowered your white blood cell count in the past. And if your white blood cell count is already low, Vraylar could make it worse. In both situations, your doctor will regularly order blood tests to check your white blood cell levels while you take Vraylar. If your white blood cell count drops too low, you may need to stop the medication.
  • Dehydration: If you get dehydrated while taking Vraylar, this can raise your risk of certain side effects. These include dizziness when getting up and problems managing your body temperature. To avoid getting dehydrated, be sure to drink plenty of water while taking Vraylar. This is especially important in hot weather and when exercising.
  • Heart disease or stroke: Vraylar can cause your blood pressure to drop for a time if you get up too quickly. This could be dangerous if you have a history of stroke or heart problems, such as angina, heart attack, or heart failure. Vraylar hasn’t been studied in people with unstable heart disease or in people who have recently had a heart attack. If you have a history of any of these problems, talk with your doctor about whether Vraylar is right for you. If you do take Vraylar, tell your doctor if you feel dizzy or faint while using it.
  • Seizures: Vraylar can sometimes cause seizures. You’re more likely to have seizures with Vraylar if you have epilepsy or you’ve had seizures in the past. Talk with your doctor about whether Vraylar is a good choice for you.
  • Pregnancy and breastfeeding: Talk with your doctor about the risks and benefits of taking Vraylar during pregnancy or while breastfeeding. For more information, see this article on Vraylar and pregnancy, breastfeeding, and more.

Note: For more information about the potential negative effects of Vraylar, see the “Vraylar side effects” section.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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