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Cariprazine Dosage

Applies to the following strength(s): 1.5 mg ; 3 mg ; 4.5 mg ; 6 mg ; 1.5 mg-3 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Schizophrenia

Initial dose: 1.5 mg orally once a day
Titration: As soon as day 2, may increase to 3 mg once a day; further dose adjustments should be made in 1.5 or 3 mg increments based on efficacy and tolerability.
Dose range: 1.5 to 6 mg orally once a day
Maximum dose: 6 mg orally once a 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.
-Dosages 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: On day 2, increase to 3 mg once a day; further dose adjustments should be made in 1.5 or 3 mg increments based on efficacy and tolerability.
Dose range: 3 to 6 mg orally once a day
Maximum dose: 6 mg orally once a 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.
-Dosages 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 (CrCl 30 mL/min or greater): No adjustment recommended
Severe renal impairment (CrCl less than 30 mL/min): Not recommended

Liver Dose Adjustments

Mild to moderate hepatic impairment (Child-Pugh score 5 to 9): No adjustment recommended
Severe hepatic impairment (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 Cariprazine:
-Reduce the current cariprazine dosage 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 Cariprazine While Receiving a Strong CYP450 3A4 Inhibitor:
-Initial dose: Cariprazine 1.5 mg orally once a day on day 1 and day 3, with no dose given on day 2; starting on day 4, take cariprazine 1.5 mg orally once a day.
-Dose may be titrated to a maximum dose of cariprazine 3 mg orally once a day.

Withdrawing a Strong CYP450 3A4 Inhibitor While on cariprazine:
-A dose increase of cariprazine may be necessary.

CYP450 3A4 INDUCERS: Concomitant use of cariprazine 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.

Precautions

US BOXED WARNING: INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS
-Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death.
-Cariprazine is not approved for the treatment of patients with dementia-related psychosis.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

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.

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