Clobazam and Cariprazine: 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
Clobazam
Cariprazine
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.
You've been prescribed clobazam (Onfi) along with cariprazine (Vraylar). Here's what to know. Cariprazine is broken down by a liver enzyme called CYP3A4, and this same enzyme also forms cariprazine's long-lasting active pieces. Clobazam can mildly speed up that enzyme, which could shift how much active drug is in your body. Because this exact combination hasn't been studied, the true effect isn't certain, and that's why using them together isn't generally recommended.
The good news is your care team can manage this. Don't stop or change either medicine on your own. Just check in with your doctor or pharmacist so they can decide the safest plan for you.
Mechanism: Cariprazine is a CYP3A4 substrate, and CYP3A4 also forms and eliminates its active metabolites (didesmethyl-cariprazine). Clobazam is a weak CYP3A4 inducer. Neither is a prodrug in a way that reverses direction here.
- Direction/magnitude: Induction could alter parent and active-metabolite exposure; net effect on total active moiety is unpredictable and not evaluated.
- Evidence: Theoretical only.
- Onset: Unspecified (enzyme induction is typically delayed, days to weeks).
- Management: Concomitant use with a CYP3A4 inducer is not recommended. If used, monitor clinical response (psychiatric symptom control, tolerability); dose may need individualization by the care team.
What happens
Effects on the cariprazine exposure has not been evaluated and the net effect is unclear
Interaction Deep Dive
Using cariprazine (which is metabolized by CYP3A4) together with a CYP3A4 inducer is advised against. The generation and clearance of cariprazine's active metabolites depend on CYP3A4. How CYP3A4 inducers alter cariprazine exposure has not been studied, so the overall outcome remains uncertain1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of cariprazine
How to manage this interaction
Because the effect of a CYP3A4 inducer on cariprazine hasn't been formally studied, this combination is generally not recommended. That doesn't mean panic, it means your care team will look closely at whether it's right for you.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your team may watch your response more closely and, if needed, adjust and individualize your dose.
- Ask your pharmacist or doctor whether an alternative to one of these might suit you better.
- Report any change in your symptom control or new side effects.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clobazam and Cariprazine together?
Combining clobazam with cariprazine isn't generally recommended because clobazam may speed up cariprazine's metabolism and the net effect is unknown; keep taking both as prescribed and ask your doctor or pharmacist to review the combination. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clobazam and Cariprazine 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 Clobazam and Cariprazine interaction managed?
Because the effect of a CYP3A4 inducer on cariprazine hasn't been formally studied, this combination is generally not recommended. That doesn't mean panic, it means your care team will look closely at whether it's right for you. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may watch your response more closely and, if needed, adjust and individualize your dos… 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 Clobazam or Cariprazine 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 Clobazam
Keep reading about Cariprazine
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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