Cariprazine

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Generic Name: Cariprazine Brand Name(s): Generics only. No brands available. Avability: Rx Pregnancy Category: N

Uses

What is Cariprazine used for?

Cariprazine is used to treat certain mental/mood disorders (such as bipolar disorder, schizophrenia). Cariprazine belongs to a class of drugs known as atypical antipsychotics. It works by helping to restore the balance of certain natural substances in the brain. This medication can decrease hallucinations, help you to think more clearly and positively about yourself, feel less agitated, and take a more active part in everyday life.

How should I take Cariprazine?

Take this medication by mouth with or without food as directed by your doctor, usually once daily.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

Tell your doctor if your condition does not get better or if it gets worse.

How do I store Cariprazine?

Cariprazine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Cariprazine in the bathroom or the freezer. There may be different brands of Cariprazine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Cariprazine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Cariprazine?

Before taking cariprazine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: poor blood flow to the brain (such as cerebrovascular disease, stroke), diabetes (including family history), heart problems (such as heart failure, irregular heartbeat), loss of too much body water (dehydration), high blood pressure, nervous system problems (such as dementia, NMS, seizures), obesity, low white blood cell count (such as history of low white blood cell count caused by medications), swallowing problems.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Cariprazine may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.

Older adults may be more sensitive to the side effects of this drug, especially seizures, drowsiness, dizziness, lightheadedness, confusion, tardive dyskinesia, swallowing problems, and other serious (rarely fatal) side effects. See also Warning section. Drowsiness, dizziness, lightheadedness, and confusion can increase the risk of falling.

Before having surgery, tell your doctor or dentist about all the products you use (such as prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop symptoms including muscle stiffness or shakiness, drowsiness, feeding/breathing difficulties, or constant crying. If you notice any of these symptoms in your newborn especially during their first month, tell the doctor right away.

Since untreated mental/mood problems (such as bipolar disorder, schizophrenia) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, discuss with your doctor right away the benefits and risks of using this medication during pregnancy.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Cariprazine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Cariprazine. Cariprazine is pregnancy risk category N according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Cariprazine?

Dizziness, lightheadedness, drowsiness, nausea, tiredness, excess saliva/drooling, blurred vision, weight gain, or constipation may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Dizziness and lightheadedness can increase the risk of falling. Get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, such as: fainting, trouble swallowing, restlessness (especially in the legs), shaking (tremor), muscle spasm, mask-like expression of the face, seizures, signs of infection (such as sore throat that doesn’t go away, fever, chills, cough).

This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

This medication may rarely cause a condition called tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual uncontrolled movements (especially of the face, mouth, tongue, arms, or legs).

This medication may rarely cause a very serious condition called neuroleptic malignant syndrome (NMS). Get medical help right away if you have any of the following symptoms: fever, muscle stiffness/pain/tenderness/weakness, severe tiredness, severe confusion, sweating, fast/irregular heartbeat, dark urine, signs of kidney problems (such as change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Cariprazine?

A product that may interact with this drug is: metoclopramide.

Cariprazine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Cariprazine?

Cariprazine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Cariprazine?

Cariprazine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Cariprazine.

What is the dose of Cariprazine for an adult?

Usual Adult Dose for Schizophrenia

Initial dose: 1.5 mg orally once a day

Titration regimen: The dose may be increased to 3 mg once a day on Day 2; further dose adjustments should be made in 1.5 to 3 mg increments based on efficacy and tolerability.

Maintenance dose: 1.5 to 6 mg orally once a day

Maximum dose: 6 mg/day

Comments:

-Due to the long half-life, changes in dose will not be fully reflected in plasma for several weeks; monitor for adverse reactions and treatment response several weeks after beginning therapy and after each dose adjustment.

-Doses above 6 mg once a day have not shown increased effectiveness sufficient to outweigh dose related adverse reactions.

Use: For the treatment of schizophrenia

Usual Adult Dose for Bipolar Disorder

Initial dose: 1.5 mg orally once a day

Titration regimen: The dose should be increased to 3 mg once a day on Day 2; further dose adjustments should be made in 1.5 to 3 mg increments based on efficacy and tolerability.

Maintenance dose: 3 to 6 mg orally once a day

Maximum dose: 6 mg/day

Comments:

-Due to the long half-life, changes in dose will not be fully reflected in plasma for several weeks; monitor for adverse reactions and treatment response several weeks after beginning therapy and after each dose adjustment.

-Doses above 6 mg once a day have not shown increased effectiveness sufficient to outweigh dose related adverse reactions.

Use: For the acute treatment of manic or mixed episodes associated with bipolar 1 disorder

Renal Dose Adjustments

Mild to moderate renal dysfunction (CrCl 30 mL/min or greater): No adjustment recommended

Severe renal dysfunction (CrCl less than 30 mL/min): Not recommended

Liver Dose Adjustments

Mild to moderate liver dysfunction (Child-Pugh score 5 to 9): No adjustment recommended

Severe liver dysfunction (Child-Pugh score 10 to 15): Not recommended

Dose Adjustments

Elderly: Cautious dose selection is recommended

DOSE ADJUSTMENTS FOR CYP450 3A4 INHIBITORS:

Initiating a Strong CYP450 3A4 Inhibitor While on a Stable Dose of This Drug:

-Reduce the current dose of this drug by approximately one-half (e.g.,4.5 mg per day may be reduced to 1.5 or 3 mg per day; 1.5 mg per day may be reduced to 1.5 mg every other day).

Initiating This Drug While Receiving a Strong CYP450 3A4 Inhibitor:

-Initial dose:1.5 mg orally once a day on Days 1 and 3, with no dose given on Day 2; starting on Day 4, 1.5 mg orally once a day.

-Maximum dose: 3 mg/day

Withdrawing a Strong CYP450 3A4 Inhibitor While on This Drug:

-A dose increase of this drug may be necessary.

CYP450 3A4 INDUCERS: Concomitant use of this drug with CYP450 3A4 inducers has not been evaluated and is not recommended.

Upon discontinuation: Plasma concentrations of this drug and its active metabolites decline by 50% in approximately 1 week.

Other Comments

Administration advice: Take orally once a day with or without food

Storage requirements: Protect from light

General:

-It may take approximately 1 week after stopping this drug for plasma concentration to decline by 50%.

-Switching from this drug to other antipsychotics, or co-administration with other antipsychotics has not been studied.

Monitoring:

-Cardiovascular: Orthostatic vital signs in at-risk patients

-Hematologic: CBC frequently during the first few months in patients with preexisting low WBC and/or a prior history of drug-induced leukopenia or neutropenia.

-Metabolic: Monitor for increases in blood sugar, weight, and lipids

Patient advice:

– Counsel patients regarding the signs and symptoms of neuroleptic malignant syndrome (NMS), tardive dyskinesia, hyperglycemia, and diabetes mellitus; instruct patients to contact their physician immediately if signs or symptoms occur.

-This drug may impact mental alertness; have patient avoid driving or operating machinery until adverse effects are determined.

-Patients should be aware that there are a number of potential drug interactions with this drug and they should speak with a healthcare professional before starting any new medications including over the counter medications.

-Counsel patients to avoid becoming dehydrated or overheated, as well as the risk for orthostatic hypotension and syncope.

-Patients should be advised to notify their health care professional if they are pregnant or intend to become pregnant.

What is the dose of Cariprazine for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Cariprazine available?

Cariprazine is available in the following dosage forms and strengths:

  • Oral capsule,
  • Oral kit.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Cariprazine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 16, 2018 | Last Modified: August 16, 2018

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