What to Avoid When Taking Vraylar?

Vraylar (cariprazine) is a newer antipsychotic medication primarily used to treat bipolar disorder and schizophrenia. As with any medication, there are certain substances and activities that should be avoided to ensure its effectiveness and minimize potential side effects. Here, we’ll delve into what you should steer clear of when taking Vraylar and why.

Substances to Avoid


  • Impact: Alcohol can exacerbate the sedative effects of Vraylar, leading to increased drowsiness, dizziness, and even impair cognitive function.
  • Advice: It’s generally recommended to avoid or significantly limit alcohol consumption while taking Vraylar.

Illicit Drugs

  • Impact: The use of illicit drugs can interfere with the way Vraylar works, potentially diminishing its efficacy and increasing side effects.
  • Advice: Always disclose any drug use to your healthcare provider for your safety.

Certain Medications

  • Impact: Some medications, including prescription and over-the-counter drugs, can interact with Vraylar and affect its metabolism.
  • Advice: Inform your doctor of all medications you’re taking to avoid harmful interactions.
Common Drug Interactions with Vraylar

CNS Depressants

  • Examples: Benzodiazepines, opioids, sleep medications
  • Impact: These can increase the sedative effects of Vraylar, leading to excessive drowsiness or respiratory depression.

Anticholinergic Medications

  • Examples: Certain antihistamines, tricyclic antidepressants, medications for overactive bladder
  • Impact: Anticholinergic drugs can add to the cognitive and memory-related side effects of Vraylar.

Blood Thinners

  • Examples: Warfarin, heparin
  • Impact: Vraylar may enhance the effects of blood thinners, potentially increasing the risk of bleeding.


  • Examples: Beta-blockers, ACE inhibitors
  • Impact: There may be an additive effect on lowering blood pressure, which can lead to increased side effects like dizziness or fainting.

CYP3A4 Inhibitors and Inducers

  • Examples: Ketoconazole (inhibitor), St. John’s Wort (inducer), certain antibiotics like erythromycin (inhibitor), and antiepileptics like carbamazepine (inducer)
  • Impact: These can alter the metabolism of Vraylar. Inhibitors can increase Vraylar levels, while inducers can decrease them, affecting its efficacy and side effects.


  • Examples: Fluoxetine, sertraline, venlafaxine
  • Impact: These may interact with Vraylar, leading to an increase or decrease in its concentration in the blood.

Dopamine Agonists

  • Examples: Medications used to treat Parkinson’s disease or restless leg syndrome
  • Impact: Dopamine agonists can counteract the effects of Vraylar, which is a dopamine antagonist.

Dietary Considerations

Grapefruit and Grapefruit Juice

  • Impact: Grapefruit can increase blood levels of certain medications, including Vraylar, leading to heightened side effects.
  • Advice: Avoid grapefruit and its derivatives while taking Vraylar.


  • Impact: Caffeine’s stimulating effects might counteract Vraylar’s regulation of dopamine and other neurotransmitters.
  • Advice: Monitor and potentially reduce caffeine intake if you notice increased anxiety or agitation.

Activities to Limit

Driving or Operating Heavy Machinery

  • Impact: Vraylar can cause drowsiness or impair your motor skills and reaction time.
  • Advice: Be cautious and avoid such activities until you know how Vraylar affects you.

Overexposure to Heat

  • Impact: Antipsychotics can affect the body’s ability to regulate temperature.
  • Advice: Stay hydrated and avoid overheating, especially in hot weather or when exercising.

Health and Wellness


  • Impact: Smoking can induce enzymes that metabolize Vraylar, potentially reducing its effectiveness.
  • Advice: Discuss smoking cessation strategies with your healthcare provider.

Poor Sleep Habits

  • Impact: Lack of sleep can worsen the symptoms of mental health conditions.
  • Advice: Prioritize good sleep hygiene to support your treatment.

Psychological Considerations

Stressful Situations

  • Impact: Stress can exacerbate symptoms of bipolar disorder and schizophrenia.
  • Advice: Engage in stress-reducing activities and therapies.


While Vraylar can be an effective medication for managing certain mental health conditions, it’s crucial to be aware of what to avoid to ensure treatment success. This includes steering clear of alcohol, illicit drugs, certain medications, and grapefruit, while also being mindful of activities and lifestyle choices that can impact your overall well-being.

Always consult with your healthcare provider before making any changes to your medication, diet, or lifestyle. They can provide personalized advice based on your specific health needs and treatment plan.

There are various forms of drugs available, such as tablets or liquids, and each may have a separate patient information leaflet (PIL) for different doses. It is important to refer to the PIL for the specific form and dose of the drug that you have been prescribed.

You can search for further information and PILs on websites such as: