Vraylar (cariprazine)

Medically Reviewed By Alex Brewer, PharmD, MBA

This drug has boxed warnings, the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Increased risk of suicidal thoughts or behaviors in certain people. While you’re taking Vraylar, your doctor will watch for new or worsening suicidal thoughts or behaviors. This is because medications used to treat depression can increase the risk of suicidal thoughts or behaviors in some people. (Keep in mind that Vraylar is used for depression in certain people.)

Specifically, the risk affects children and adults ages 24 years or younger. (Although Vraylar is used to treat certain depressive episodes in adults, it’s not approved for this use in children.)

Your doctor may monitor you more closely if you’ve recently had your Vraylar dosage changed or recently started taking Vraylar.

Increased risk of death in older people who have psychosis related to dementia. Typically, doctors won’t prescribe Vraylar for older adults who have psychosis related to dementia. (Psychosis is a mental health condition that causes hallucinations, delusions, and other disorganized thoughts or behaviors.) This is because, in some cases, antipsychotic drugs can increase the risk of death in adults ages 65 years and older with this condition. And Vraylar is an antipsychotic drug.

To learn more about these risks, see “Vraylar’s side effects explained” in the “ Vraylar: Side effects” section below.

About Vraylar

Vraylar is a brand-name prescription drug. It’s approved by the Food and Drug Administration (FDA) to treat the following conditions.

  • Mixed or manic episodes of bipolar I disorder. Bipolar I disorder is a mood disorder that typically involves depressive episodes and manic episodes. Mixed episodes happen when symptoms of both depression and mania occur at the same time. Doctors can prescribe Vraylar for short-term use during mixed or manic episodes in adults with bipolar I disorder.
  • Depressive episodes of bipolar I disorder. Doctors can prescribe Vraylar for depressive episodes in adults with bipolar I disorder. Vraylar may be prescribed for short-term or long-term use during depressive episodes.
  • Schizophrenia. Doctors can prescribe Vraylar for schizophrenia in adults. For schizophrenia, Vraylar is typically prescribed for long-term use.

For details about these conditions and how the drug treats them, see the “Vraylar: Uses” section below.

Key points

The following table provides key facts about Vraylar.

Active drug cariprazine
Drug class atypical antipsychotic, which is a newer type of antipsychotic drug
Form oral capsule

Finding a healthcare professional

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Vraylar: Generic

Vraylar contains the active drug cariprazine. It only comes as a brand-name medication. And it isn’t currently available as a generic drug.

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

Vraylar: Side effects

As with most drugs, it’s possible to have side effects with Vraylar. These can include some mild side effects, but also some serious ones.

To learn more about Vraylar’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

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

Mild and serious side effects

Mild and serious side effects of Vraylar are listed in the table below. This table does not include all of Vraylar’s possible side effects.

Mild side effects* Serious side effects
nausea and vomiting tardive dyskinesia (involuntary body movements)
indigestion seizures
• sleepiness • trouble with body temperature regulation
akathisia (an uncontrollable urge to move), leading to restlessness • low level of white blood cells
dizziness • neuroleptic malignant syndrome (a condition that can cause confusion and muscle rigidity)
fatigue orthostatic hypotension (sudden decrease in blood pressure upon standing), which can lead to falls or fainting
headache • trouble making decisions or thinking clearly
insomnia • trouble swallowing
• movement disorders, such as involuntary muscle movements, tremor, muscle stiffness • changes in metabolism, which may lead to high blood sugar level, weight gain,† or high triglyceride and high cholesterol levels 
constipation allergic reaction
  • increased risk of suicidal thoughts or behaviors in certain people‡
  • increased risk of death in older people who have psychosis related to dementia

* This is not a complete list of Vraylar’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For more information about this side effect, see “Vraylar’s side effects explained” below.
Vraylar has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see “Vraylar’s side effects explained” below.

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

Serious side effects from Vraylar aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Vraylar’s side effects explained

Below, you can find detailed information about some of Vraylar’s side effects. To learn more about other side effects of this medication, talk with your doctor. 

Increased risk of suicidal thoughts or behaviors in certain people

Medications used to treat depression can increase the risk of suicidal thoughts and behaviors in some people. And Vraylar is used to treat depressive episodes related to bipolar I disorder in adults.

In fact, Vraylar has a boxed warning for this risk. 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.

This risk affects children and adults ages 24 years or younger. (However, Vraylar is only approved to treat depressive episodes in adults. The drug is not approved for this use in children.)

While you’re taking Vraylar, your doctor will watch for new or worsening suicidal thoughts or behaviors. They may also monitor for mood changes, such as agitation, anger, irritability, and hostility. If you have any of these symptoms during treatment with Vraylar, tell your doctor right away.

Your doctor may monitor you more closely if you’ve recently had your Vraylar dosage changed or recently started taking Vraylar.

If you have thoughts of self-harm while taking Vraylar, call 911 or your local emergency number immediately.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Increased risk of death in older people who have psychosis related to dementia

Antipsychotic drugs can increase the risk of death in adults ages 65 years and older who have psychosis related to dementia. (Psychosis is a mental health condition that causes hallucinations, delusions, and other disorganized thoughts or behaviors.) Keep in mind that Vraylar is an antipsychotic drug.

In fact, Vraylar has a boxed warning for this risk. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Below were the most common causes of death in clinical studies of older people who took antipsychotic drugs:

In older people, antipsychotics can also increase the risk of stroke, which may lead to death in some cases. Possible stroke symptoms can include:

  • weakness on one side of your body, usually in your arm, leg, or face
  • trouble walking, seeing, or speaking
  • headache
  • confusion

If you have symptoms of stroke while taking Vraylar, call 911 or your local emergency number right away.


Because of this risk, doctors typically won’t prescribe Vraylar for older adults who have psychosis related to dementia. Your doctor can recommend other treatments instead.

Weight gain

Weight gain is a common side effect of antipsychotic drugs, including Vraylar. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

Keep in mind that Vraylar may cause changes in your body’s metabolism. (“Metabolism” refers to the chemical processes that keep your body functioning.) Vraylar can cause your metabolism to slow down, possibly leading to weight gain.

If you’re concerned about weight gain with Vraylar, talk with your doctor. They can suggest ways to help you maintain a weight that’s healthy for you while you’re taking Vraylar.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Vraylar. A more severe allergic reaction is rare but possible. Although there were no reports of allergic reaction in clinical studies of Vraylar, it can still happen.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids
rash • swelling in your throat or mouth
• itching trouble breathing

If you have an allergic reaction to Vraylar, call your doctor right away. This is important to do because  the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Vraylar: Dosage

Below, you’ll find dosages that are commonly recommended for Vraylar. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Most often, doctors start by prescribing a low dosage of Vraylar. Then, they’ll change the dosage over time to an amount that’s right for the condition being treated. Doctors typically prescribe the smallest dosage that gives the desired outcome.

The dosage of Vraylar that your doctor prescribes will depend on factors such as:

  • your age
  • other medications you take
  • the condition you’re using Vraylar to treat and the severity of the condition

Vraylar’s forms and strengths

Vraylar is available as follows:

  • Form: oral capsule
  • Strengths: 1.5 milligrams (mg), 3 mg, 4.5 mg, and 6 mg

Vraylar’s recommended dosages

Recommended dosages for Vraylar are described below.

Bipolar disorder dosage

Vraylar is approved to treat depressive, manic, or mixed episodes of bipolar I disorder in adults.

Vraylar’s recommended dosing for bipolar I disorder mania or mixed episodes is as follows:

  • Starting dose: 1.5 mg once daily
  • Maintenance dose: 3 mg to 6 mg once daily
  • Maximum dose: 6 mg once daily

Vraylar’s recommended dosing for depressive episodes of bipolar I disorder is as follows:

  • Starting dose: 1.5 mg once daily
  • Maintenance dose: 3 mg once daily
  • Maximum dose: 3 mg once daily

Schizophrenia dosage

Vraylar is approved to treat schizophrenia in adults.

Vraylar’s recommended dosing for schizophrenia is as follows:

  • Starting dose: 1.5 mg once daily
  • Maintenance dose: 3 mg to 6 mg once daily
  • Maximum dose: 6 mg once daily

Dosage considerations

Below are some things to consider about Vraylar’s dosage.

  • Missing a dose. If you miss a dose of Vraylar, take it as soon as you remember. If it’s almost time for your next dose, you can skip your missed dose. You’ll take your next dose at its usual time. Don’t take extra doses to make up for a missed dose. Doing this can increase your risk of side effects. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Length of treatment. Doctors may prescribe Vraylar as a short-term or long-term treatment. For schizophrenia and depressive episodes of bipolar disorder, you may take Vraylar long term. However, for manic or mixed episodes of bipolar disorder, you’ll likely take Vraylar short term. After this short-term use, once the symptoms of your condition have eased, your doctor may prescribe a different treatment for long-term use.

Vraylar: Cost

Like other medications, prices for Vraylar may vary. The drug’s price will depend on factors such as:

If you have questions about Vraylar’s cost, including its cost with Medicare, talk with your doctor or pharmacist. Or view this page on the drug manufacturer’s site.

Cost considerations for Vraylar

Here’s a list of things to consider when looking into the cost of Vraylar.

  • Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
  • Need for prior authorization. Before insurance coverage for Vraylar is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Vraylar. Then, the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Vraylar, contact your insurance company.
  • Possible cost assistance options. Financial assistance to help lower the cost of Vraylar is available. AbbVie, Inc., the manufacturer of the drug, offers a savings card on this drug. To learn more and see if you’re eligible for support, visit the manufacturer’s website. Also, read this article to learn about ways to save on prescription drugs.
  • Use of a mail-order pharmacy. Vraylar may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
  • Availability of a generic form. Vraylar doesn’t come in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Typically, generics cost less than brand-name drugs.

Vraylar: Uses

Prescription drugs, such as Vraylar, are approved by the Food and Drug Administration (FDA) to treat certain conditions. Doctors sometimes prescribe drugs off-label for other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

Using Vraylar for mixed or manic episodes of bipolar I disorder

Vraylar is approved to treat manic or mixed episodes of bipolar I disorder in adults.

Bipolar I disorder is a type of bipolar disorder. This mood disorder typically involves depressive episodes and manic episodes.

Possible phases of bipolar I disorder are as follows:

  • Depressive episodes, which are sometimes called bipolar depression. (For symptoms of this condition, see “Using Vraylar for depressive episodes of bipolar I disorder” just below.)
  • Manic episodes, which are sometimes called bipolar mania. They typically involves moments of extremely high energy, excitement, and happiness.
  • Mixed episodes, which happen when symptoms of both depression and mania occur at the same time.

Doctors can prescribe Vraylar for short-term use during mixed or manic episodes. Once the symptoms of your condition have eased, your doctor may prescribe a different treatment for long-term use.

Using Vraylar for depressive episodes of bipolar I disorder

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

Bipolar I disorder is a type of bipolar disorder. It typically involves depressive episodes and manic episodes. (See the section directly above for information about manic episodes.)

Depressive episodes of bipolar I disorder are sometimes called bipolar depression. Symptoms can include:

  • fatigue
  • feeling hopeless, sad, or helpless
  • restlessness
  • changes in weight or appetite
  • changes in sleep, such as sleeping more or less than usual
  • loss of interest in activities you once enjoyed

Doctors can prescribe Vraylar for short-term or long-term use during depressive episodes. Your doctor will advise on the length of time you’ll take Vraylar to treat this condition.

Using Vraylar for schizophrenia

Vraylar is approved to treat schizophrenia in adults.

Schizophrenia is a mental health condition that affects a person’s thoughts, feelings, and behaviors. Symptoms of schizophrenia can include:

  • hallucinations (hearing or seeing things that aren’t real)
  • delusions (believing things that aren’t real)
  • loss of interest in work, school, or other activities
  • disorganized behaviors, such as agitation or lack of muscle coordination

For schizophrenia, doctors typically prescribe Vraylar for long-term use.

Taking Vraylar with other drugs

Doctors may prescribe Vraylar in combination with other drugs. This can vary depending on the specific condition you have.

For example, Vraylar may sometimes be taken in combination with:

Your doctor will advise if you should take Vraylar with other drugs. If so, they’ll recommend the drug combination that’s best for treating your condition.

Using Vraylar in children

Doctors typically won’t prescribe Vraylar for use in children. The drug is only approved for use in adults.

Finding a healthcare professional for Vraylar

If you’re interested in taking Vraylar, you can find a doctor who might prescribe it by searching here. You can prepare for your appointment by visiting Healthgrades’ appointment guide for bipolar disorder or schizophrenia.

Vraylar: Alternatives

Doctors may prescribe drugs other than Vraylar for your condition. Certain drugs may work better for you than others.

In addition to other conditions, Vraylar is used for depressive episodes related to bipolar I disorder. Here’s a summary of other drugs that doctors sometimes prescribe for depression. (These drugs may not all be used for depressive episodes related to bipolar I disorder.)

To learn about some alternatives of Vraylar, view the following articles:

Your doctor can tell you about other similar drugs, such as brexpiprazole (Rexulti) and quetiapine (Seroquel).

To learn more about alternatives to Vraylar, ask your doctor. They can tell you about other medications they could prescribe for your condition.

Vraylar: Questions you may have

Here are some common questions and brief answers about Vraylar. If you’d like to know more about these topics, ask your doctor.

Are there interactions with Vraylar and Adderall or Vraylar and caffeine?

Vraylar isn’t known to interact with either Adderall, Adderall XR, or caffeine.

However, to be safe, you should check with your doctor or pharmacist before taking any medications or supplements with Vraylar. (Keep in mind that some over-the-counter medications and supplements contain caffeine.)

It’s important to check with a healthcare professional because caffeine may interact with other drugs prescribed in combination with Vraylar. This includes lithium, for example.

Is Vraylar used for anxiety, depression, PTSD, or borderline personality disorder?

Vraylar isn’t currently approved to treat anxiety, depression, post-traumatic stress disorder (PTSD), or borderline personality disorder (BPD).

Doctors may prescribe Vraylar off-label for these conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

Vraylar is approved to treat depressive episodes of bipolar I disorder. However, this condition is different from major depressive disorder, which is commonly known as “depression.”

If you’re interested in using Vraylar for anxiety, depression, PTSD, or BPD, talk with your doctor.

They can advise on the best treatment options for each condition.

Do Vraylar’s side effects go away?

Many of Vraylar’s side effects are expected to go away within a few days or weeks after starting or stopping the drug.

However, some of Vraylar’s side effects may last longer. For example, tardive dyskinesia (involuntary body movements) can happen after you’ve taken Vraylar for a long time. And this side effect doesn’t always go away, even after you’ve stopped taking the drug.

If you have bothersome or long lasting side effects with Vraylar, talk with your doctor. They may suggest treatments for your symptoms or prescribe a medication other than Vraylar.

Will I have weight loss, hallucinations, or paranoia with Vraylar?

No, Vraylar isn’t likely to cause weight losshallucinations, or paranoia. These weren’t reported as side effects in clinical studies of the drug.

In fact, Vraylar is more likely to cause weight gain than weight loss. For more information about this side effect, see “Vraylar’s side effects explained” in the “Vraylar: Side effects” section above.

Hallucinations involve seeing or hearing things that aren’t really there. Paranoia refers to a feeling of suspicion or distrust, even though there isn’t proof of an actual threat. These side effects aren’t known to happen with Vraylar. That said, these symptoms can happen with schizophrenia, which Vraylar is used to treat.

If you’re concerned about weight loss, hallucinations, or paranoia with Vraylar, talk with your doctor.

Does Vraylar treat bipolar II disorder?

Vraylar is approved to treat a type of bipolar disorder called bipolar I disorder. Vraylar isn’t currently approved to treat bipolar II disorder.

Bipolar disorder is a mood disorder that typically involves depressive episodes and manic episodes. Both bipolar I and bipolar II disorder can cause symptoms of depression and mania. (To learn more about symptoms of bipolar depression and bipolar mania, see the “Vraylar: Uses” section above.)

However, symptoms of mania are typically more severe with bipolar I disorder than with bipolar II disorder.

Doctors may prescribe Vraylar off-label for bipolar II disorder. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.

If you’re interested in using Vraylar for bipolar II disorder, talk with your doctor. They can recommend the best treatment options for your condition.

Is Vraylar a controlled substance?

No, Vraylar isn’t a controlled substance.

Controlled substances carry a high risk of misuse (also called abuse) and dependence. (Misuse refers to taking a medication in a way that’s different from how your doctor prescribed it. With dependence, your body needs the drug to feel as you usually do.) However, Vraylar doesn’t carry these risks.

Does Vraylar cause sexual side effects, such as erectile dysfunction or increased libido?

Sexual side effects weren’t reported in clinical studies of Vraylar.

Certain sexual side effects are known to happen with other antipsychotic drugs. (Keep in mind that Vraylar is an antipsychotic.) For example, brexpiprazole (Rexulti) may cause changes in sex drive. However, Vraylar isn’t known to cause sexual side effects.

If you’re concerned about sexual side effects while taking Vraylar, talk with your doctor. To learn more about side effects from Vraylar, see the “Vraylar: Side effects” section above.

Vraylar: Consuming alcohol during treatment

There aren’t any known interactions between Vraylar and alcohol.

However, drinking alcohol with Vraylar can worsen certain side effects of the drug. These include:

If you drink alcohol, ask your doctor about the amount, if any, that’s safe to drink while taking Vraylar.

Vraylar: Interactions

Vraylar may interact with other medications. However, it’s not known to interact with supplements or foods.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

  • Vraylar and other medications. Because Vraylar may interact with the following drugs, your doctor may recommend that you don’t take it with these drugs. Examples include:
  • Vraylar and herbs and supplements. No herbs or supplements are known to interact with Vraylar. Before using any of these products while taking Vraylar, talk with your doctor or pharmacist.
  • Vraylar and foods. No foods are known to interact with Vraylar. If you have questions about eating certain foods with Vraylar, talk with your doctor or pharmacist.

Vraylar: How it works

Vraylar is approved to treat the following mental health conditions:

To learn more about how Vraylar is used for these conditions, see the “Vraylar: Uses” section above.

Vraylar belongs to a drug class called atypical antipsychotics. (This is a newer type of antipsychotic drug.)

Vraylar’s mechanism of action (how it works) isn’t fully understood. The drug is thought to increase levels of brain chemicals called serotonin and dopamine. Having higher levels of these chemicals in the brain may help ease symptoms of bipolar disorder and schizophrenia.

How long does Vraylar take to start working?

It may take several weeks for symptoms of your condition to ease after you’ve started taking Vraylar.

How long does Vraylar stay in your system?

Vraylar is likely to stay in your system for about 5 weeks.

This is based on Vraylar’s half-life of about 1 week. (A drug’s half-life is the time it takes for half of a drug’s dose to leave your body.) It generally takes about five half-lives for a drug to leave your body completely. So, Vraylar is expected to stay in your system for about 5 weeks.

Vraylar: Withdrawal and dependence

There haven’t been studies to know whether Vraylar can cause drug dependence. (With dependence, your body needs the drug to feel as you usually do.)

Typically, medications that cause dependence will also cause withdrawal symptoms after you stop taking the medication. However, there were no reports of withdrawal symptoms in clinical studies of Vraylar.

Still, stopping Vraylar “cold turkey” (suddenly) isn’t recommended. If you’d like to stop taking the drug, talk with your doctor. They can advise if it’s best for you to keep taking it. If you and your doctor decide to end treatment, they’ll show you how to stop Vraylar safely.

If you’re concerned about the side effects of stopping Vraylar, talk with your doctor or pharmacist.

Vraylar: Overdose

Serious effects can occur if you use more than the recommended dosage of Vraylar. Do not use more Vraylar than your doctor recommends. 

Symptoms of overdose

Symptoms that an overdose could cause include:

What to do in case of overdose

Call your doctor if you think you’ve taken too much of this drug. Also, you can call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. However, if your symptoms are severe, call 911 or your local emergency number. Or go to the nearest emergency room right away.

Vraylar: Taking while pregnant

It isn’t known if Vraylar is safe to take during pregnancy.

Human studies haven’t looked at the use of Vraylar during pregnancy. Animal studies have shown harm to offspring born to pregnant animals that were given Vraylar. However, animal studies may not predict what happens in humans.

There have been reports of certain side effects in infants born to people who took antipsychotics during their last 3 months of pregnancy. (Keep in mind that Vraylar is an antipsychotic drug.)

Examples of these side effects include withdrawal symptoms and movement disorders, such as:

  • tremors
  • sleepiness
  • refusing to eat
  • restlessness
  • trouble breathing

The National Pregnancy Registry for Atypical Antipsychotics is collecting information on the safety of Vraylar and similar drugs when used during pregnancy. If you’d like to learn more, call 866-961-2388 or visit the registry website. You can also talk with your doctor.

If you’re pregnant or planning a pregnancy, talk with your doctor about the benefits and risks of taking Vraylar.

Vraylar and birth control needs

Doctors aren’t sure whether it’s safe to take Vraylar during pregnancy. Talk with your doctor about your birth control needs with Vraylar if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

Vraylar: Taking while breastfeeding

It isn’t known if Vraylar is safe to take while breastfeeding. Whether the drug passes into breast milk or causes side effects in a breastfed child isn’t known either.

If you’re breastfeeding or are planning to do so, talk with your doctor before starting Vraylar treatment. They’ll talk with you about the risks and benefits of breastfeeding while taking the drug.

Vraylar: How to take

Your doctor will recommend how you should take Vraylar. It’s important that you take the drug exactly as your doctor instructs.

Vraylar comes as an oral capsule.

Questions about taking Vraylar

Here’s a list of common questions related to taking Vraylar.

  • When should I take Vraylar? You’ll likely take Vraylar once daily. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Do I need to take Vraylar with food? You can take Vraylar with food or without it.
  • Can Vraylar be chewed, split, or crushed? The manufacturer of Vraylar hasn’t stated whether you can chew, split, or crush the capsules. If you have trouble swallowing Vraylar capsules, talk with your doctor or pharmacist.
  • Is there a best time of day to take Vraylar? No, there isn’t a best time of day to take Vraylar. You can take Vraylar any time of day. However, to help keep a steady level of the drug in your body, try to take your doses around the same time each day. This allows the drug to work well for your condition.

Vraylar: Precautions

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings, the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Increased risk of suicidal thoughts or behaviors in certain people. While you’re taking Vraylar, your doctor will watch for new or worsening suicidal thoughts or behaviors. This is because medications used to treat depression can increase the risk of suicidal thoughts and behaviors in some people. (Keep in mind that Vraylar is used for depression in certain people.)

Specifically, the risk affects children and adults ages 24 years or younger. (Although Vraylar is used to treat certain depressive episodes in adults, it’s not approved for this use in children.)

Your doctor may monitor you more closely if you’ve recently had your Vraylar dosage changed or recently started taking Vraylar.

Increased risk of death in older people who have psychosis related to dementia. Typically, doctors won’t prescribe Vraylar for older adults who have psychosis related to dementia. (Psychosis is a mental health condition that causes hallucinations, delusions, and other disorganized thoughts or behaviors.) This is because, in some cases, antipsychotic drugs can increase the risk of death in adults ages 65 years and older with this condition. And Vraylar is an antipsychotic drug.

Other precautions

Tell your doctor about your health history before starting treatment with Vraylar. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

  • Seizures. Vraylar may cause seizures. Before taking Vraylar, tell your doctor if you have seizures now or have had them in the past. Your doctor can recommend if it’s safe for you to take Vraylar.
  • Cholesterol problems. Vraylar may cause high cholesterol levels. Before starting Vraylar, tell your doctor if you already have cholesterol problems. Your doctor will likely monitor your cholesterol level more closely than usual while you’re taking the drug.
  • Low level of white blood cells. Vraylar may cause a low level of white blood cells, possibly increasing your risk of infections. Before starting Vraylar treatment, your doctor may check your white blood cell level. If it’s low, they may suggest a different treatment option for you.
  • Diabetes. Before taking Vraylar, tell your doctor if you have diabetes. Vraylar may cause a high blood sugar level, which could worsen your condition. Your doctor can advise if it’s safe for you to take Vraylar.
  • Heart problems or history of stroke. Before starting Vraylar, tell your doctor about any heart problems you have or if you’ve ever had a stroke. Examples of heart problems include heart failure and heart attack. These conditions could increase your risk of orthostatic hypotension (sudden decrease in blood pressure upon standing) as a side effect of Vraylar. Your doctor can recommend if it’s safe for you to take Vraylar.
  • Severe kidney or liver problems. There are no studies of Vraylar in people with severe kidney or liver problems. It’s not known if the drug is safe to use in people with these conditions. Talk with your doctor about all of your conditions to see whether Vraylar is safe for you to take. Your doctor can discuss other treatments that may be safer for you.
  • Allergic reaction. Your doctor will likely not prescribe Vraylar if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
  • Pregnancy. It isn’t known if Vraylar is safe to use during pregnancy. If you’d like to learn more information about taking Vraylar while pregnant, view the “Vraylar: Taking while pregnant” section above.
  • Breastfeeding. It’s not known if Vraylar is safe to take while breastfeeding. If you’d like to learn more information about taking Vraylar while breastfeeding, view the “Vraylar: Taking while breastfeeding” section above.

To learn more about effects of Vraylar that could be harmful, see the “Vraylar: Side effects” section above.

Vraylar: Expiration, storage, and disposal

Here’s some information about Vraylar’s expiration date, as well as how to store and dispose of the drug.

  • Expiration. Your pharmacist will add an expiration date to the label on Vraylar’s bottle. This date is usually 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know whether you might still be able to use the medication.
  • Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Vraylar capsules should be stored at room temperature between 68°F and 77°F (20°C and 25°C). The capsules can temporarily be stored at temperatures between 59°F and 86°F (15°C and 30°C), such as when traveling. Avoid storing the drug in areas where it could get damp or wet, such as bathrooms. Vraylar capsules should be kept away from light in a tightly sealed container.
  • Disposal. It’s important to safely dispose of Vraylar if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment. Ask your pharmacist for information about disposing of Vraylar. Also, check out this page for several tips on safe medication disposal.

Vraylar: Questions for your doctor

If you have questions about Vraylar, talk with your doctor. They can help advise you on whether Vraylar could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

  • Does my age increase my risk for certain side effects with Vraylar?
  • Do I take any medications that could make Vraylar less effective?
  • Should I take Vraylar in combination with other medications to treat my condition?

Your doctor may also tell you about other treatment options for your condition. Also, check out our selection of videos on bipolar disorder.

Disclaimer: Healthgrades 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.

Medical Reviewer: Alex Brewer, PharmD, MBA
Last Review Date: 2022 Mar 9
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.