Rifampin
Severe
Textbook
Potential loss of efficacy.
Not recommended.
Source: G&G 14e · p367
Drug reference
Cariprazine
Atypical Antipsychotic · Antipsychotic
Also known as Cariprazine hydrochloride, Reagila
Atypical AntipsychoticAntipsychotic
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Avoid; toxicity observed in animal studies.
FDA category + note
Top interactionssee all 12 →
- RifampinSevereTextbookG&G 14e · p367
- AlfentanilSevereDatabaseDDInter
- AmprenavirSevereDatabaseDDInter
- AtazanavirSevereDatabaseDDInter
Mechanism
Cariprazine is a second-generation antipsychotic drug that acts as an inverse agonist of the 5-HT2A receptor, blocking its constitutive activity. These receptors modulate the release of neurotransmitters such as dopamine, norepinephrine, glutamate, GABA, and acetylcholine in the cortex, limbic region, and striatum. This modulation contributes to its antipsychotic effects.
Indications
SchizophreniaBipolar disorderacute mania/bipolar mixedbipolar depression (monotherapy)
Dosing
- Adult
- 3–6 mg/day (oral)
- Renal adjustment
- Avoid in severe impairment
- Hepatic adjustment
- Avoid in severe impairment
Pharmacokinetics
Peak effect
3–6 h
Half-life
31.6–68.4 h (cariprazine), 29.7–39.5 h (DCAR), 314–446 h (DDCAR)
Bioavailability
65%
Metabolism
CYP3A4 converts cariprazine to active metabolites DCAR and DDCAR. CYP2D6 is a minor pathway. Parent drug and DDCAR show good brain penetration.
Contraindications
- Severe hepatic impairment
- Severe renal impairment
- Use in elderly dementia patients (increased mortality risk)
Side effects
Common
Anxietyappetite abnormalbradyphreniadroolingdyslipidaemiaeye disordersfatiguegait abnormalhypertensionjoint stiffnessmuscle complaintsmusculoskeletal stiffnessnauseaoral disorderspainreflexes abnormalsleep disordersspeech impairmentteeth grindingvision disordersLow risk of metabolic adverse effectslowers serum prolactinakathisia
Serious
- Anaemia
- cardiac conduction disorder
- delirium
- depression
- diabetes mellitus
- dysaesthesia
- eosinophilia
- eye irritation
- gastrooesophageal reflux disease
- grimacing
- hiccups
- pruritus
- sexual dysfunction
- suicidal behaviour
- thirst
- urinary disorders
- vertigo
- Cataract
- dysphagia
- hypothyroidism
- memory loss
- rhabdomyolysis
- Hepatitis toxic
- Neuroleptic malignant syndrome
- increased mortality in elderly dementia patients
Pregnancy & lactation
Pregnancy
Avoid; toxicity observed in animal studies.
Lactation
Avoid; present in milk in animal studies.
Drug interactions
Alfentanil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Atazanavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Benzhydrocodone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Boceprevir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Buprenorphine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bupropion
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Butorphanol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ceritinib
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Clarithromycin
Severe
Database
Increased cariprazine exposure.
Reduce cariprazine dose by 50%.
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Other Atypical Antipsychotic drugs
Ask House about Cariprazine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team