Cariprazine and Sulfinpyrazone: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 16, 2026 · Source data updated Jul 16, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Sulfinpyrazone
No brand names on recordCariprazine
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's the short version. Sulfinpyrazone can speed up an enzyme in your liver (called CYP3A4) that handles cariprazine (Vraylar). Cariprazine is a bit unusual because that same enzyme both builds up and breaks down its active forms, so speeding things up could shift how much active medicine is in your body. Because of this, the net effect is hard to predict, which is why the two are generally not recommended together.
The good news is that your care team can handle this. Please don't stop or change either medicine on your own. Just check in with your pharmacist or doctor so they can decide the safest plan and watch how you're doing.
Mechanism: Sulfinpyrazone can act as a CYP3A4 inducer; cariprazine is a CYP3A4 substrate. CYP3A4 mediates both formation and elimination of cariprazine's active metabolites (desmethyl- and didesmethyl-cariprazine), so the net change in active-moiety exposure is not predictable.
- Direction: Unclear; could alter parent and active metabolite AUC/Cmax in either direction.
- Onset: Unspecified (enzyme induction is typically delayed, days to weeks).
- Evidence: Theoretical; formal PK studies with inducers not conducted.
- Management: Combination not recommended. If used, individualize dosing and monitor clinical response and tolerability closely.
What happens
Effects on the cariprazine exposure has not been evaluated and the net effect is unclear
Interaction Deep Dive
Giving cariprazine, which is metabolized by CYP3A4, together with a CYP3A4 inducer is not advised. The generation as well as the clearance of cariprazine's active metabolites depend on CYP3A4. How CYP3A4 inducers alter cariprazine exposure has not been studied, so the overall effect remains uncertain1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of cariprazine
How to manage this interaction
What your care team may do:
- Consider whether the combination is appropriate; guidance says pairing cariprazine with a CYP3A4 inducer is generally not recommended.
- Possibly choose an alternative medication, or individualize your cariprazine dose and monitor you more closely for changes in symptom control or side effects.
What you should do:
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Tell your pharmacist and doctor you take both drugs, and report any worsening symptoms or new side effects so they can adjust the plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Cariprazine and Sulfinpyrazone together?
Sulfinpyrazone may change how your body handles cariprazine in an unpredictable way, so the combination is generally not recommended. Keep taking both as prescribed and ask your pharmacist or doctor about the safest plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Cariprazine and Sulfinpyrazone interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Cariprazine and Sulfinpyrazone interaction managed?
What your care team may do: Consider whether the combination is appropriate; guidance says pairing cariprazine with a CYP3A4 inducer is generally not recommended. Possibly choose an alternative medication, or individualize your cariprazine dose and monitor you more closely for changes in symptom control or side effects. What you should do: Keep taking both exactly as prescribed unless your prescri… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Cariprazine or Sulfinpyrazone need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: VRAYLAR(R) oral capsules, cariprazine oral capsules. AbbVie Inc. (per FDA), North Chicago, IL, 2024. DailyMed
Keep reading about Sulfinpyrazone
Keep reading about Cariprazine
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