Can Vraylar (cariprazine) cause a false positive urine drug screen?

From the Guidelines

Vraylar (cariprazine) is unlikely to cause a false positive urine drug screen, as it is not structurally similar to commonly tested substances like amphetamines, benzodiazepines, opioids, or THC. The medication works on dopamine and serotonin receptors in the brain, and standard urine drug screens are designed to detect specific classes of drugs of abuse rather than prescription antipsychotics 1. However, it's essential to inform the testing facility or medical professional about all prescription medications being taken, including Vraylar, to properly interpret any results and avoid false conclusions. Some key points to consider when interpreting urine drug test results include:

• The possibility of false positives and false negatives, as well as what can cause uninterpretable test outcomes, such as cross-reaction with unrelated substances in urine, like fluoroquinolone antibiotics with opiate screens 1.
• The importance of verifying which substances are included in the testing panel before administration of the screening, as only a few substances are routinely included in panels 1.
• The need to be aware that a negative screen does not mean that an individual is not engaged in substance use, and that building ongoing rapport with patients can help increase the likelihood of disclosure of substance use 1. In rare cases, very sensitive or comprehensive drug panels might detect atypical antipsychotics, but this is not common with standard drug screens. If concerns arise about how Vraylar might affect drug testing in a specific situation, it is recommended to consult with a healthcare provider or the testing facility for guidance.

From the FDA Drug Label

Cariprazine and its major active metabolites are minimally excreted in urine. The FDA drug label does not answer the question.

From the Research

False Positive Urine Drug Screen Results

• False-positive results in urine drug screens can occur due to cross-reactivity with other medications or metabolites 2, 3, 4.
• Various medications, including antihistamines, antidepressants, antibiotics, analgesics, antipsychotics, and nonprescription agents, have been associated with false-positive urine drug screen results 4.
• Antipsychotic medications, such as quetiapine and chlorpromazine, have been reported to cause false-positive results for amphetamine and methamphetamine 4.

Cariprazine (Vraylar) and Urine Drug Screens

• Cariprazine (Vraylar) is an atypical antipsychotic that preferentially binds to the dopamine D3 receptor and has partial agonist activity at serotonin 5-HT1A receptors 5.
• There is no direct evidence in the provided studies to suggest that cariprazine (Vraylar) causes false-positive urine drug screen results.
• However, other antipsychotic medications have been associated with false-positive results, highlighting the importance of confirming urine drug screen results with additional analytical methods 4.

Importance of Confirming Urine Drug Screen Results

• Immunoassay results should be considered presumptive until confirmed by a second independent chemical technique, such as gas chromatography-mass spectrometry 2, 4.
• Verification of urine drug screen results is crucial to avoid adverse consequences for patients, particularly in clinical, employment, educational, and legal settings 3.