Drugs Q & A

How Long Does It Take For Cariprazine (Vraylar) To Work?

Cariprazine (Vraylar) is an antipsychotic prescription medication that is used to treat the following mental health conditions in adults:

•          schizophrenia

•          short-term episodes of bipolar mania in people with bipolar I disorder

•          episodes of bipolar depression in people with bipolar I disorder

Vraylar comes as a capsule that you swallow, usually once a day. It can be used as a short-term or long-term treatment.

Typical dosing for Cariprazine (Vraylar)

Schizophrenia: The typical starting dose is 1.5 mg by mouth once a day. The usual dosing range is 1.5 mg to 6 mg once a day.

Bipolar Mania: The typical starting dose is 1.5 mg by mouth once a day. The usual dosing range is 3 mg to 6 mg once a day.

Bipolar Depression: The typical starting dose is 1.5 mg by mouth once a day. The usual dosing range is 1.5 mg to 3 mg once a day.

Is cariprazine available in the US?

Yes, on May 28th, 2019, the U.S. Food and Drug Administration (FDA) approved cariprazine for the treatment of depressive episodes in adults with bipolar I disorder under the brand name Vraylar.

How does Cariprazine (Vraylar) work?

The active substance in Cariprazine (Vraylar), cariprazine, attaches to receptors (targets) in the brain for two neurotransmitters called dopamine and serotonin, which nerve cells use to communicate with neighboring cells. Since dopamine and serotonin play a role in schizophrenia, by attaching to their receptors, cariprazine helps normalize the activity of the brain. This reduces symptoms of schizophrenia and prevents them from returning.

How Long Does It Take For Cariprazine (Vraylar) To Work?

It is very important to tell your doctor how you feel things are going during the first few weeks after you start taking cariprazine. It will probably take several weeks to see big enough changes in your symptoms to decide if cariprazine is the right medication for you.

Antipsychotic treatment is generally needed lifelong for persons with schizophrenia. Your doctor can best discuss the duration of treatment you need based on your symptoms and illness.

•          Hallucinations, disorganized thinking, and delusions may improve in the first 1-2 weeks

•          Sometimes these symptoms do not completely go away

•          Motivation and desire to be around other people can take at least 1-2 weeks to improve

•          Symptoms continue to get better the longer you take cariprazine.

•          It may take 2-3 months before you get the full benefit of cariprazine.

How long does Cariprazine stay in your body?

Studies have shown that Cariprazine (Vraylar) is metabolized to two major active metabolites with a half-life of 2 to 4 days. Desmethylcariprazine has a half-life of 1 to 2 days, and didesmethylcariprazine has a half-life of 1 to 3 weeks. The half-life is the amount of time it takes to reduce blood levels of a drug by one-half.

Both metabolites are considered to be equipotent to cariprazine. The drug and metabolites are all >90% bound to plasma proteins. This implies that Cariprazine (Vraylar) stays in your body for a long time.

It normally takes at least 5 half-lives to get most of a drug out of your system, so this could be as long as 15 weeks (over 100 days) for Vraylar. However, the half-life and elimination of a drug can vary from person to person based on age, weight, genetics, other medicines they take, or even medical conditions.

Why does Cariprazine (Vraylar) affect my blood sugar, cholesterol, and weight?

Cariprazine (Vraylar) treats bipolar disorder and schizophrenia by changing the level of chemicals in your body. This not only affects your mood and behavior, but also your body’s ability to control appetite, blood sugar, and cholesterol levels. But it’s also known that Cariprazine (Vraylar) causes less of these side effects compared to other similar medications. Your provider might check your weight and order blood tests regularly to make sure your blood sugar, cholesterol, and weight aren’t too high.

Will Cariprazine (Vraylar) make me sleepy?

Yes, Cariprazine (Vraylar) can make you feel drowsy or sleepy. Be careful and avoid activities that require you to be alert, such as driving a car, until you know how this medication affects you.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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