A second-generation antipsychotic

Cariprazine

A second-generation antipsychotic for schizophrenia with a long-lasting effect in the body.

What is Cariprazine?

Cariprazine is a second-generation (atypical) antipsychotic taken by mouth for schizophrenia. It and its active breakdown products stay in the body for a long time, so its effects, and any side effects, can build up gradually and persist for some time after stopping. Restlessness (akathisia) is a common side effect.

Class: Antipsychotics · Brands: Reagila

Education and reference only. This is a plain-language guide to Cariprazine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review
Class: Antipsychotics → Brands: Reagila
Cariprazine (Antipsychotics) — Meds Global Health reference card with 2D molecular structure
Cariprazine — Antipsychotics. The image shows the active ingredient's 2D molecular structure.

What it is

Cariprazine is a newer, second-generation antipsychotic used to treat schizophrenia. A notable feature is its long half-life: the medicine and its active breakdown products remain in the body for a long time. This means changes in effect happen gradually, and the medicine keeps working for a while even after a dose is missed or it is stopped.

How it works

Cariprazine acts mainly on dopamine and serotonin receptors in the brain, helping to rebalance the signalling thought to be disturbed in schizophrenia. This can reduce symptoms such as hallucinations, delusions and disordered thinking. Because it is broken down into long-lasting active substances, its effect is steady and slow to change.

Company & origin

Originated / developed by: Branded in the UK as Reagila..

Cariprazine is a second-generation (atypical) antipsychotic with a long-acting effect in the body.

What it treats

Conditions Cariprazine is used for

Schizophrenia & psychosisA serious mental illness where a person loses some contact with reality — treated with ant…

Practical use

How to take Cariprazine

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it by mouth once a day, at about the same time each day, with or without food.
  • Because it acts slowly, give it time to work and do not expect rapid changes when the dose is altered.
  • If you miss a dose, take it when you remember unless it is nearly time for the next; do not double up.
  • Do not stop it suddenly; remember its effect lingers for some time after the last dose.
  • Tell your team if you feel restless or unable to keep still, as this is a recognised side effect.

Weighing it up

Advantages & disadvantages of Cariprazine

Advantages

  • Effective for symptoms of schizophrenia, including reduced motivation and social withdrawal.
  • Taken once daily, which is convenient.
  • The long-lasting effect means a missed single dose is less likely to cause a sudden drop in cover.

Disadvantages

  • Because it stays in the body a long time, side effects can take a while to settle after stopping.
  • Commonly causes restlessness (akathisia), which can be distressing.
  • Can cause weight gain and changes in blood sugar and cholesterol (metabolic effects).

Practical use

Good to know

Cariprazine has a long half-life, so effects and side effects build up slowly and persist after stopping; do not expect quick changes when the dose alters. Restlessness (akathisia) is common, particularly early on. Do not stop it suddenly, and tell your team about any restlessness, agitation or movement problems. Seek urgent help (999 or A&E) if you develop a high temperature with severe muscle stiffness, confusion and a fast heartbeat — this can signal a rare but serious reaction called neuroleptic malignant syndrome.

Who should not take it / use with caution

  • People with a known allergy to cariprazine.
  • Used with caution in heart disease, diabetes, epilepsy and in older people, particularly those with dementia.
  • Care is needed in pregnancy and breastfeeding; discuss this with your team.

Monitoring

  • Regular review of symptoms and side effects, especially restlessness.
  • Weight, blood sugar and cholesterol (metabolic monitoring).
  • Blood pressure and, where appropriate, an ECG.

Side effects

  • Restlessness and an inability to keep still (akathisia).
  • Movement effects such as tremor and stiffness.
  • Difficulty sleeping or, in some people, drowsiness.
  • Weight gain and changes in blood sugar and cholesterol (metabolic effects).
  • Nausea and constipation.
  • Rarely, effects on heart rhythm.

Key interactions

  • Certain medicines that affect how the liver processes drugs can change cariprazine levels; tell your team about all your medicines.
  • Alcohol and other sedating medicines can add to drowsiness.
  • Medicines that affect heart rhythm may add to that risk.
  • Check with a pharmacist before taking new over-the-counter medicines.

Available as: Capsules.

Answers

Cariprazine: frequently asked questions

Why do the effects of cariprazine last so long?

Cariprazine is broken down into active substances that stay in the body for a long time. This means it keeps working steadily, but it also means side effects can take a while to settle after stopping.

I feel restless and can't sit still. Is that the medicine?

Restlessness, known as akathisia, is a common side effect of cariprazine, especially early in treatment. Tell your team, as it can often be helped by adjusting treatment.

What happens if I miss a dose?

Take it when you remember, unless it is nearly time for the next dose, in which case skip it. Because the medicine lasts a long time, a single missed dose is less likely to cause an immediate problem, but try to take it regularly.

What is neuroleptic malignant syndrome?

It is a rare but serious reaction to antipsychotics. Warning signs include high temperature, severe muscle stiffness, confusion, a fast or irregular heartbeat and sweating. This is a medical emergency: seek urgent help (call 999 or go to A&E) straight away.

Can I stop cariprazine if I feel well?

Do not stop suddenly. Even after stopping, the medicine lingers in your body for some time. Any change should be planned with your team to avoid a relapse.

The wider class

About Antipsychotics

Cariprazine belongs to the antipsychotics class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.

AntipsychoticsDrugs for psychosis, bipolar disorder and other conditions — balanced against movement and metabolic side-effects. QuetiapineAn atypical antipsychotic used in schizophrenia and bipolar disorder; can cause sedation, …OlanzapineAn effective atypical antipsychotic for schizophrenia and bipolar disorder, well known for…AripiprazoleAn atypical antipsychotic for schizophrenia and bipolar disorder that tends to be more wei…RisperidoneA widely used atypical antipsychotic for schizophrenia and bipolar disorder, available as …HaloperidolA long-established first-generation antipsychotic used for schizophrenia, agitation and ot…LurasidoneA second-generation antipsychotic used for schizophrenia, often chosen for its relatively …PaliperidoneA second-generation antipsychotic for schizophrenia, available as daily tablets or as a lo…SulpirideAn antipsychotic used to treat schizophrenia; it can raise prolactin and cause movement ef…AmisulprideA second-generation antipsychotic used for schizophrenia that can calm symptoms at higher …ChlorpromazineAn older 'first-generation' antipsychotic used to treat schizophrenia and other conditions…FlupentixolAn antipsychotic for schizophrenia that can be taken as tablets or given as a long-acting …TrifluoperazineA first-generation antipsychotic used in schizophrenia and other psychosis, and at lower a…LevomepromazineA sedating antipsychotic used in psychosis but, in UK practice, most often in palliative c…PericyazineA first-generation (older) antipsychotic used for schizophrenia and severe agitation.…ZuclopenthixolAn older antipsychotic for schizophrenia, available as tablets and as a long-acting depot …AsenapineA second-generation antipsychotic taken as a tablet that dissolves under the tongue, used …DroperidolA butyrophenone medicine used mainly to prevent and treat nausea and vomiting, especially …BenperidolAn antipsychotic occasionally used under specialist care to control deviant antisocial sex…LoxapineAn antipsychotic medicine; its inhaled form is used in hospital settings to calm sudden ag…PericiazineAn older phenothiazine antipsychotic, also used for severe anxiety or agitation, that is m…PimozideAn antipsychotic tablet used for schizophrenia and a specific delusional condition, which …PipotiazineA long-acting antipsychotic given by injection to maintain treatment for schizophrenia.…PromazineAn older antipsychotic used mainly for short-term agitation and restlessness, especially i…FluphenazineAn older antipsychotic used for schizophrenia, often as a long-acting depot injection that…PerphenazineA first-generation antipsychotic used for conditions such as schizophrenia, and also to tr…ZiprasidoneA second-generation antipsychotic used for schizophrenia and bipolar disorder, taken with …BrexpiprazoleA newer antipsychotic used for schizophrenia and as an add-on in depression that has not r…IloperidoneA second-generation antipsychotic used to treat schizophrenia, with the dose built up slow…ThiothixeneA first-generation antipsychotic used to treat schizophrenia, more commonly seen as a Unit…Aripiprazole lauroxilA long-acting depot injection of the antipsychotic aripiprazole, given every few weeks to …LumateperoneA newer once-daily antipsychotic used for schizophrenia and for bipolar depression.…MolindoneAn older first-generation antipsychotic used to treat schizophrenia, mainly available in t…PimavanserinA medicine used to treat the hallucinations and delusions (psychosis) that can occur in Pa…ClozapineThe most effective medicine for schizophrenia that has not responded to other treatments —…

Browse by body system

Mental healthConditions and medicines for mood, anxiety, psychosis, sleep and dependence — used alongsi…

Authoritative sources

  • BNF: Cariprazine.
  • NICE CKS: Antipsychotics.

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