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Vraylar Side Effects

Generic Name: cariprazine

Note: This page contains side effects data for the generic drug cariprazine. It is possible that some of the dosage forms included below may not apply to the brand name Vraylar.

In Summary

Common side effects of Vraylar include: oculogyric crisis, trismus, akathisia, basal ganglia disease, bradykinesia, cogwheel rigidity, constipation, drowsiness, dyskinesia, dystonia, extrapyramidal reaction, hypersomnia, hypertonia, hypokinesia, muscle rigidity, nausea, sedation, tardive dyskinesia, torticollis, tremor, vomiting, weight gain, and drooling. Other side effects include: asthenia, blurred vision, dizziness, dyspepsia, fatigue, hypertension, increased blood pressure, increased creatine phosphokinase, and restlessness. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to cariprazine: oral capsule

As well as its needed effects, cariprazine (the active ingredient contained in Vraylar) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking cariprazine, check with your doctor immediately:

More common:
  • Blurred vision
  • chills
  • dizziness
  • drooling
  • fever
  • headache
  • inability to move the eyes
  • inability to sit still
  • increased blinking or spasms of the eyelid
  • loss of balance control
  • muscle trembling, jerking, or stiffness
  • need to keep moving
  • nervousness
  • pounding in the ears
  • restlessness
  • shuffling walk
  • slow or fast heartbeat
  • sticking out of the tongue
  • stiffness of the limbs
  • trouble with breathing, speaking, or swallowing
  • twisting movements of the body
  • uncontrolled movements, especially of the face, neck, arms, or legs
  • unusual facial expressions
Less common:
  • Bladder pain
  • bloody or cloudy urine
  • difficult, burning, or painful urination
  • fast, pounding, or irregular heartbeat or pulse
  • frequent urge to urinate
  • lower back or side pain
  • muscle aches
  • sore throat
  • stuffy or runny nose
  • unusual tiredness or weakness
Incidence not known:
  • Confusion
  • convulsions
  • double vision
  • drooling
  • high fever
  • increased sweating
  • lip smacking or puckering
  • muscle trembling, jerking, or stiffness
  • puffing of the cheeks
  • rapid or worm-like movements of the tongue
  • severe muscle stiffness
  • uncontrolled chewing movements
  • unusually pale skin

Minor Side Effects

Some cariprazine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Abdominal or stomach pain
  • diarrhea
  • difficulty having a bowel movement (stool)
  • nausea
  • sleepiness or unusual drowsiness
  • trouble sleeping
Less common:
  • Acid or sour stomach
  • anxiety
  • back pain
  • belching
  • cough
  • decreased appetite
  • difficulty with moving
  • dry mouth
  • heartburn
  • indigestion
  • irritability
  • muscle pain or stiffness
  • pain in the arms, joints, or legs
  • rash
  • shaking
  • stomach discomfort or upset
  • weight gain

For Healthcare Professionals

Applies to cariprazine: oral capsule, oral kit


The most frequently reported adverse effects were extrapyramidal symptoms, akathisia, dyspepsia, vomiting, somnolence, and restlessness.[Ref]

Nervous system

Very common (10% or more): Extrapyramidal symptoms (29%), akathisia (21%), headache (18%)
Common (1% to 10%): Dizziness, somnolence, dystonia, Parkinsonism
Rare (less than 0.1%): Ischemic stroke[Ref]

During 6 week schizophrenia placebo controlled trials, 17% of patients reported extrapyramidal symptoms, excluding akathisia and restlessness in the cariprazine group. This led to study discontinuation in 0.3% of patients. Akathisia occurred in 11% of patients, leading to study discontinuation of 0.5%.

In 3 week bipolar mania placebo controlled trials, 28% of cariprazine treated patients experienced extrapyramidal symptoms, excluding akathisia and restlessness. This led to study discontinuation in 1% of patients. Akathisia occurred in 20% of patients, leading to study discontinuation of 2%.[Ref]


Hyperglycemia/Diabetes Mellitus: In long-term, open label studies in patients with schizophrenia or bipolar disorder, 4% of patients with normal baseline hemoglobin A1c developed elevated levels (HbA1c 6.5% or higher). In short-term trials, the number of patients with shifts from normal fasting glucose (less than 100 mg/dL) to high (greater than 126 mg/dL) and borderline (100 to less than 126 mg/dL) levels were similar to placebo-treated patients.

Dyslipidemia: In the 3 week placebo controlled bipolar mania and 6 week placebo controlled schizophrenia trials, the shifts in fasting total cholesterol, LDL, HDL, and triglycerides were similar in treatment and placebo groups.

Weight gain: In the 6 week placebo controlled trial of patients with schizophrenia, a 7% weight increase or greater was observed in 8% of the patients receiving 1.5 mg to 3 mg of drug daily (n=512), 8% of patients receiving 4.5 mg to 6 mg daily (n=570), and 17% in the 9 mg to 12 mg once daily group (n=203). During a long term, uncontrolled trial in patients with schizophrenia, the mean change from baseline weight at 48 weeks was 2.5 kg.[Ref]

Common (1% to 10%): Decreased appetite, weight gain, increase in blood creatine phosphokinase, hyperglycemia
Infrequent: Hyponatremia, diabetes mellitus
Frequency not reported: Dyslipidemia[Ref]


In 3 placebo controlled trials, during a three week period of treating bipolar mania (n=1065), there was no clinically significant difference between cariprazine (the active ingredient contained in Vraylar) and placebo treated patients regarding changes from baseline to endpoint supine blood pressure parameters. There was however, an increase in supine diastolic blood pressure in the 9 to 12 mg orally once a day cariprazine treated patients.[Ref]

Common (1% to 10%): Tachycardia, hypertension
Uncommon (0.1% to 1%): Orthostatic hypotension[Ref]


Common (1% to 10%): Rash
Infrequent: Hyperhidrosis[Ref]


Very Common (10% or more): Nausea (11%)
Common (1% to 10%): Constipation, vomiting, dyspepsia, abdominal pain, diarrhea, dry mouth, toothache
Infrequent: Gastroesophageal reflux disease, gastritis
Frequency not reported: Dysphagia[Ref]


Very common (10% or more): Insomnia (13%)
Common (1% to 10%): Restlessness, agitation, anxiety
Rare (less than 0.1%): Completed suicide
Infrequent: Suicide attempts, suicidal ideation[Ref]


Frequency not reported: Leukopenia, neutropenia, agranulocytosis[Ref]


Transaminase elevations 3 times the upper limit of normal or greater occurred in 1% to 2% of patients in the cariprazine (the active ingredient contained in Vraylar) group during 6 week schizophrenia trials; the incidence increased with dose. Elevations occurred in 2% to 4% of patients during 3 week bipolar mania trials.[Ref]

Uncommon (0.1% to 1%): Increase in hepatic enzymes
Rare (less than 0.1%): Hepatitis[Ref]


Common (1% to 10%): Urinary tract infection
Infrequent: Pollakiuria[Ref]


Frequency not reported: Rash, pruritus, urticaria, swollen lips/tongue, face and pharyngeal edema, swelling of the face[Ref]


Common (1% to 10%): Back pain, arthralgia, pain in extremities, stiffness
Rare (less than 0.1%): Rhabdomyolysis[Ref]


Common (1% to 10%): Cough, oropharyngeal pain
Uncommon (0.1% to 1%): Nasopharyngitis[Ref]


Common (1% to 10%): Blurred vision
Uncommon (0.1% to 1%): Cataracts[Ref]

In long term uncontrolled schizophrenia (48 week) and bipolar mania (16 week) trials, cataracts occurred in 0.1% and 0.2% of participants respectively.[Ref]


Common (1% to 10%): Fatigue, pyrexia[Ref]


1. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc., Parsippany, NJ.

It is possible that some side effects of Vraylar may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.