Cariprazine

Cariprazine
Clinical data
Pronunciation/kəˈrɪprəˌziːn/
Trade namesVraylar, Reagila, Symvenu
Other namesRGH-188
AHFS/Drugs.comMonograph
License data
Pregnancy
category
Routes of
administration		By mouth
Drug classAtypical antipsychotic
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityHigh
Protein binding91–97%
MetabolismLiver via CYP3A4 and to a lesser extent CYP2D6
Metabolitesdesmethylcariprazine, didesmethylcariprazine
Elimination half-life2–4 days for parent drug, and 1–3 weeks for active metabolites
ExcretionUrine (21%), bile
Identifiers
IUPAC name
  • N'-[trans-4-[2-[4-(2,3-Dichlorophenyl)-1-piperazinyl]ethyl]cyclohexyl]-N,N-dimethylurea
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC21H32Cl2N4O
Molar mass427.41 g·mol−1
3D model (JSmol)
SMILES
  • CN(C)C(=O)N[C@H]1CC[C@H](CCN2CCN(CC2)c2cccc(Cl)c2Cl)CC1
InChI
  • InChI=1S/C21H32Cl2N4O/c1-25(2)21(28)24-17-8-6-16(7-9-17)10-11-26-12-14-27(15-13-26)19-5-3-4-18(22)20(19)23/h3-5,16-17H,6-15H2,1-2H3,(H,24,28)/t16-,17- Y
  • Key:KPWSJANDNDDRMB-QAQDUYKDSA-N Y

Cariprazine, sold under the brand name Vraylar among others, is an atypical antipsychotic developed by Gedeon Richter,[7] which is used in the treatment of schizophrenia and bipolar disorder.[8] It is also prescribed as an add-on treatment for bipolar depression[9] and major depressive disorder.[5] Cariprazine acts primarily as a D3 and D2 receptor partial agonist, with a preference for the D3 receptor. It is a partial agonist at the serotonin 5-HT1A receptor and acts as an antagonist at 5-HT2B and 5-HT2A receptors.[10] It is taken by mouth.[5] The most prevalent side effects include nausea, mild sedation, fatigue, and dizziness. At higher dosages, there is an increased risk for restlessness, insomnia, and tremors.[5]

Cariprazine was approved for medical use in the United States in September 2015.[11] It was approved as a generic medication in 2022,[12] but is covered by patents until 2029.[13] Cariprazine was approved by the TGA for use in Australia in 2020. [14] As of 2025, the cost of Cariprazine is generally around $50.00USD,[15] $30.60AUD[16] on the PBS and £80.36 in the UK when on the NHS.[17]

  1. ^ a b "AusPAR: Cariprazine hydrochloride". Therapeutic Goods Administration (TGA). 21 June 2022. Archived from the original on 4 January 2023. Retrieved 18 April 2023.
  2. ^ "Vraylar Product information". Health Canada. 25 April 2012. Archived from the original on 29 June 2022. Retrieved 29 June 2022.
  3. ^ "Summary Basis of Decision - Vraylar". Health Canada. 26 August 2022. Archived from the original on 29 September 2022. Retrieved 29 September 2022.
  4. ^ "Reagila 1.5 mg hard capsules - Summary of Product Characteristics (SmPC)". (emc). 9 August 2018. Archived from the original on 21 October 2020. Retrieved 20 October 2020.
  5. ^ a b c d Cite error: The named reference Vraylar FDA label was invoked but never defined (see the help page).
  6. ^ "Reagila EPAR". European Medicines Agency (EMA). 18 September 2017. Archived from the original on 24 October 2020. Retrieved 20 October 2020.
  7. ^ Laszlovszky I, Barabássy Á, Németh G (July 2021). "Cariprazine, A Broad-Spectrum Antipsychotic for the Treatment of Schizophrenia: Pharmacology, Efficacy, and Safety". Advances in Therapy. 38 (7): 3652–3673. doi:10.1007/s12325-021-01797-5. PMC 8279990. PMID 34091867.
  8. ^ Agai-Csongor E, Domány G, Nógrádi K, Galambos J, Vágó I, Keserű GM, et al. (May 2012). "Discovery of cariprazine (RGH-188): a novel antipsychotic acting on dopamine D3/D2 receptors". Bioorganic & Medicinal Chemistry Letters. 22 (10): 3437–3440. doi:10.1016/j.bmcl.2012.03.104. PMID 22537450.
  9. ^ Earley W, Burgess MV, Rekeda L, Dickinson R, Szatmári B, Németh G, et al. (June 2019). "Cariprazine Treatment of Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Phase 3 Study". The American Journal of Psychiatry. 176 (6): 439–448. doi:10.1176/appi.ajp.2018.18070824. PMID 30845817.
  10. ^ Kiss B, Horváth A, Némethy Z, Schmidt E, Laszlovszky I, Bugovics G, et al. (April 2010). "Cariprazine (RGH-188), a dopamine D(3) receptor-preferring, D(3)/D(2) dopamine receptor antagonist-partial agonist antipsychotic candidate: in vitro and neurochemical profile". The Journal of Pharmacology and Experimental Therapeutics. 333 (1): 328–340. doi:10.1124/jpet.109.160432. PMID 20093397. S2CID 42933132.
  11. ^ "FDA approves new drug to treat schizophrenia and bipolar disorder" (Press release). U.S. Food and Drug Administration. 17 September 2015. Archived from the original on 26 January 2018. Retrieved 16 December 2019.
  12. ^ "2022 First Generic Drug Approvals". U.S. Food and Drug Administration (FDA). 3 March 2023. Archived from the original on 30 June 2023. Retrieved 30 June 2023.
  13. ^ "Generic Vraylar Availability". Drugs.com. 9 March 2023. Archived from the original on 26 March 2023. Retrieved 26 March 2023.
  14. ^ "Reagila". Therapeutic Drug Association Australia. 11 November 2020. Archived from the original on 19 May 2025. Retrieved 20 May 2025.
  15. ^ "Generic Vraylar Prices (Cariprazine) - U.S. & International". PharmacyChecker.com. 2 June 2025. Archived from the original on 2 June 2025. Retrieved 2 June 2025.
  16. ^ "Pharmaceutical Benefits: Fees, Patient Contributions and Safety Net Thresholds". Pharmaceutical Benefits Scheme. 1 January 2025. Archived from the original on 2 June 2025. Retrieved 2 June 2025.
  17. ^ "AMENDMENTS TO THE DRUG TARIFF" (PDF). NHS Business Services Authority. 1 December 2020. Archived (PDF) from the original on 2 June 2025. Retrieved 2 June 2025.
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