Drug Interaction Report

Cariprazine and Tazemetostat: 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

Tazemetostat

Tazverik
+

Cariprazine

Vraylar Vraylar®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 16, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 157 documented Cariprazine interactions, 148 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
At a glance + Effects may be weaker
The Bottom Line
Tazemetostat can speed up how your body clears cariprazine, which may make the cariprazine work less well; keep taking both as prescribed and tell your care team so they can monitor you and adjust the dose if needed.

These two medicines can affect each other. Tazemetostat (Tazverik) speeds up an enzyme in your body called CYP3A. That same enzyme breaks down cariprazine (Vraylar). So when you take them together, your body may clear the cariprazine faster, leaving less of it in your system.

The concern here is not extra side effects. It is that your cariprazine may not work as well, which could mean your mood or psychiatric symptoms are less well controlled. The good news is your care team can watch for this and adjust things as needed. Do not stop or change either medicine on your own, just let your doctor or pharmacist know you are on both.

Effect: Tazemetostat is a CYP3A inducer; cariprazine is a CYP3A4 substrate. Coadministration is expected to increase cariprazine (and its active metabolites) clearance, lowering exposure and potentially reducing antipsychotic efficacy.

  • Direction: reduced cariprazine effect (induction, not a prodrug situation).
  • Magnitude: not established for cariprazine; tazemetostat 800 mg BID reduced midazolam AUC by 40% and Cmax by 21%.
  • Evidence: probable. Onset: unspecified (induction typically develops over days).
  • Management: monitor for loss of symptom control; dose may need individualization by the prescriber. Note cariprazine's long-acting active metabolites.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Reduced CYP3A substrate exposure and reduced efficacy of CYP3A substrate

Interaction Deep Dive

When tazemetostat is taken alongside CYP3A substrates, the exposure to those substrates can decline, which may diminish their effectiveness. A drug interaction study found that giving tazemetostat 800 mg twice daily together with oral midazolam (a sensitive CYP3A substrate) to patients lowered the AUC of midazolam by 40% and its Cmax by 21%1.

Why it happens (mechanism)

Induction of CYP3A-substrate metabolism by tazemetostat

How to manage this interaction

The main risk is that cariprazine may become less effective while you are also taking tazemetostat.

  • Keep taking both exactly as prescribed unless your care team tells you otherwise.
  • Your team may monitor you more closely for the return or worsening of psychiatric symptoms.
  • Your cariprazine dose may need to be adjusted and individualized by your prescriber.
  • Tell your pharmacist and prescriber that you take both drugs, and report any drop in how well your symptoms feel controlled.

Management is individual — confirm any change with your pharmacist or prescriber.

Literature reports

1 report — tap to read

a) In a study assessing drug interactions, giving tazemetostat 800 mg twice daily together with oral midazolam (a sensitive CYP3A substrate) to patients reduced the AUC of midazolam by 40% and its Cmax by 21% 1.

Common questions

Can I take Cariprazine and Tazemetostat together?

Tazemetostat can speed up how your body clears cariprazine, which may make the cariprazine work less well; keep taking both as prescribed and tell your care team so they can monitor you and adjust the dose if needed. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Cariprazine and Tazemetostat 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 Tazemetostat interaction managed?

The main risk is that cariprazine may become less effective while you are also taking tazemetostat. Keep taking both exactly as prescribed unless your care team tells you otherwise. Your team may monitor you more closely for the return or worsening of psychiatric symptoms. Your cariprazine dose may need to be adjusted and individualized by your prescriber. Tell your pharmacist and prescriber that… Management is individual — always follow your own care team's guidance.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Cariprazine or Tazemetostat 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)

  1. Product Information: TAZVERIK(R) oral tablets, tazemetostat oral tablets. Epizyme Inc (per FDA), Cambridge, MA, 2024. DailyMed
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.