Vraylar vs. Rexulti

Vraylar (cariprazine) and Rexulti (brexpiprazole) are atypical antipsychotics used to treat schizophrenia.

Vraylar is also used for the acute treatment of manic or mixed episodes associated with bipolar I disorder.

Rexulti is also used as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD).

Side effects of Vraylar and Rexulti that are similar include extrapyramidal symptoms (muscle spasms, muscle rigidity, tremor, jerking movements), agitation, restlessness, weight gain, headache, constipation, anxiety, and dizziness.

Side effects of Vraylar that are different from Rexulti include indigestion, nausea, vomiting, sleepiness, insomnia, abdominal pain, toothache, diarrhea, pain in extremities, dry mouth, loss of appetite, back pain, and cough.

Side effects of Rexulti that are different from Vraylar include distress, fatigue, runny or stuffy nose, increased appetite, and drowsiness. Children, teenagers, and young adults may have suicidal thoughts while taking Rexulti. Tell your doctor if this occurs.

Both Vraylar and Rexulti may interact with CYP3A4 inducers (such as rifampin carbamazepine) and inhibitors (such as itraconazole and ketoconazole).

Rexulti may also interact with CYP2D6 inhibitors (such as paroxetine, fluoxetine, and quinidine).

Side effects of Vraylar include:

• extrapyramidal symptoms (muscle spasms, muscle rigidity, tremor, jerking movements),
• agitation,
• indigestion,
• nausea,
• vomiting,
• sleepiness,
• restlessness,
• weight gain,
• headache,
• insomnia,
• abdominal pain,
• constipation,
• toothache,
• anxiety,
• diarrhea,
• pain in the extremities,
• dry mouth,
• loss of appetite,
• back pain,
• dizziness, and
• cough.

Common side effects of Rexulti include:

• weight gain,
• agitation,
• distress,
• restlessness,
• constipation,
• fatigue,
• runny or stuffy nose,
• increased appetite,
• headache,
• drowsiness,
• tremor,
• dizziness, and
• anxiety.
• Children, teenagers, and young adults may have suicidal thoughts while taking Rexulti. Tell your doctor if this occurs.

This is not a complete list of side effects, and others may occur.

Vraylar (cariprazine) is an atypical antipsychotic indicated for the treatment of schizophrenia, and the acute treatment of manic or mixed episodes associated with bipolar I disorder.

Rexulti (brexpiprazole) is an atypical antipsychotic indicated for use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder (MDD) and for treatment of schizophrenia.

Vraylar may interact with CYP3A4 inducers and inhibitors. Tell your doctor all medications and supplements you use.

Rexulti may interact with strong/moderate CYP2D6 or CYP3A4 inhibitors or strong CYP3A4 inducers. Tell your doctor all medications and supplements you use. The effects of Rexulti on a fetus are unknown. Neonates whose mothers are exposed to antipsychotic drugs, like Rexulti, during the third trimester of pregnancy are at risk for extrapyramidal and/or withdrawal symptoms. There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to Rexulti during pregnancy. It is unknown if Rexulti passes into breast milk or if it would affect a nursing infant. Consult your doctor before breastfeeding.

The starting dose of Vraylar is 1.5 mg once daily.

The recommended starting dosage for Rexulti as adjunctive treatment for MDD is 0.5 mg or 1 mg once daily, taken orally. The recommended target Rexulti dosage to treat schizophrenia is 2 mg to 4 mg once daily.