From the FDA Drug Label
2.3 Recommended Dosage in Manic or Mixed Episodes Associated with Bipolar I Disorder The starting dosage of VRAYLAR is 1.5 mg orally once daily. Increase the dosage to 3 mg orally once daily on Day 2. The recommended dosage range is 3 mg to 6 mg orally once daily. Depending upon clinical response and tolerability, further dose adjustments can be made in 1.5 mg or 3 mg increments. The maximum recommended dosage is 6 mg orally once daily.
The recommended dosing for bipolar is to start with 1.5 mg orally once daily and increase to 3 mg orally once daily on Day 2, with a recommended dosage range of 3 mg to 6 mg orally once daily.
- The starting dose is 1.5 mg orally once daily.
- The maximum dose is 6 mg orally once daily. 1
From the Research
Vraylar (cariprazine) for bipolar disorder is typically started at 1.5 mg once daily, then increased to 3 mg daily after one day, with a recommended dose range of 3-6 mg once daily for bipolar mania and 1.5-3 mg once daily for bipolar depression, as supported by the most recent and highest quality study 2.
Key Considerations
- Dosage adjustments should be made gradually, usually in increments of 1.5 mg, with at least 1 week between adjustments to allow the medication to reach steady state due to its long half-life.
- Patients with severe hepatic or renal impairment should start at a lower dose of 1.5 mg daily with a maximum of 3 mg daily.
- Common side effects include akathisia (restlessness), extrapyramidal symptoms, and weight gain, though weight changes are generally less significant than with other atypical antipsychotics.
Mechanism of Action
- Vraylar works by acting on dopamine and serotonin receptors in the brain, helping to stabilize mood in both manic and depressive episodes.
Administration
- It should be taken at approximately the same time each day with or without food for consistent blood levels.
Efficacy and Safety
- Cariprazine has demonstrated good tolerability and safety profiles in bipolar disorder, with a low incidence of serious adverse events and no significant metabolic concerns 3, 4.
- The medication has shown efficacy in improving both anhedonia and cognitive dysfunction in patients with bipolar depression 5.