Can Vraylar (cariprazine) be split?

Vraylar (Cariprazine) Should Not Be Split

Vraylar capsules should be swallowed whole and must not be split, crushed, or opened. This is a critical administration requirement for this medication.

Pharmaceutical Formulation Considerations

• Cariprazine is formulated as capsules, not tablets, which are designed to be swallowed intact 1, 2
• The medication has complex pharmacokinetic properties with a very long half-life (2-5 days for the parent compound and 2-3 weeks for its active metabolite didesmethyl-cariprazine), making precise dosing essential 3
• Splitting or opening capsules would compromise the intended drug delivery system and could result in unpredictable absorption and dosing 2

Clinical Implications of the Long Half-Life

• The active metabolite didesmethyl-cariprazine (DDCAR) reaches exposure levels several times higher than the parent compound and takes weeks to reach steady state 3
• This extended pharmacokinetic profile means that any alteration in dosing (such as splitting capsules) could have prolonged and unpredictable effects on drug levels 2
• Steady-state concentrations are achieved only after prolonged administration, making consistent, intact dosing critical for therapeutic efficacy 3

Dosing Flexibility

• Cariprazine is available in multiple capsule strengths to allow for appropriate dose titration without the need to split capsules 1
• The approved dose range for schizophrenia and bipolar disorder is 1.5-12 mg/day, with specific capsule strengths manufactured to accommodate this range 4, 5
• If dose adjustment is needed, prescribers should change to a different capsule strength rather than attempting to split existing capsules 2

Safety Considerations

• Altering the capsule formulation could lead to dose dumping, increasing the risk of adverse effects including akathisia and extrapyramidal symptoms, which are already dose-dependent with cariprazine 4, 5
• The medication undergoes extensive hepatic metabolism via CYP3A4, and maintaining consistent dosing is important for predictable drug exposure 3