Drug Interaction Report

Insulin Icodec-Abae 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

Cariprazine

Vraylar Vraylar®
+

Insulin Icodec-Abae

Awiqli
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jul 16, 2026
LinkedIn
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 113 documented Insulin Icodec-Abae interactions, 113 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 + Theoretical Effects may be weaker
The Bottom Line
Cariprazine may reduce how well your insulin icodec controls blood sugar, so expect closer glucose monitoring and possible insulin dose adjustments. Keep taking both as prescribed and stay in touch with your care team.

Here's what's going on. Cariprazine (Vraylar) belongs to a group of medicines called atypical antipsychotics. These medicines can sometimes raise blood sugar and make your body a little less responsive to insulin. Because of that, your insulin icodec (Awiqli) may not lower your blood sugar as well as it usually does.

This is a theoretical concern, meaning it's based on how these drugs work rather than lots of hard proof. The good news is your care team can manage it easily by checking your blood sugar more often and adjusting your insulin dose if needed. Please keep taking both medicines as prescribed and talk with your pharmacist or doctor.

Effect: Reduced glucose-lowering efficacy of insulin icodec (Awiqli) when combined with cariprazine.

Mechanism: Atypical antipsychotics can impair glucose homeostasis (reduced insulin sensitivity, altered glucose regulation), a pharmacodynamic antagonism of insulin's effect. Neither agent's metabolism drives this interaction.

  • Direction: Decreased insulin effect (potential hyperglycemia).
  • Onset: Unspecified.
  • Evidence: Theoretical; severity rated major.
  • Management: Increase frequency of blood glucose monitoring. Insulin dose may need to be adjusted and individualized by the care team. Monitor for hyperglycemia, especially when initiating or titrating cariprazine.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced efficacy of insulin icodec-abae

Interaction Deep Dive

When insulin icodec-abae is taken together with atypical antipsychotics, the glucose lowering action of insulin icodec-abae may be diminished. Coadministration may call for higher doses along with more frequent monitoring of glucose1.

Why it happens (mechanism)

Reduced blood glucose lowering effects of insulin icodec-abae

How to manage this interaction

The takeaway: This combination may make your insulin work a bit less well, so your blood sugar could run higher.

What your care team typically does:

  • Checks your blood sugar more often, especially when you start or change the dose of cariprazine.
  • Adjusts your insulin dose as needed. The dose may need to be increased and individualized by your team.

What you can do:

  • Keep taking both medicines exactly as prescribed.
  • Tell your pharmacist or doctor if you notice more frequent high blood sugar readings, increased thirst, or frequent urination.

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

Common questions

Can I take Insulin Icodec-Abae and Cariprazine together?

Cariprazine may reduce how well your insulin icodec controls blood sugar, so expect closer glucose monitoring and possible insulin dose adjustments. Keep taking both as prescribed and stay in touch with your care team. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Insulin Icodec-Abae 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 Insulin Icodec-Abae and Cariprazine interaction managed?

The takeaway: This combination may make your insulin work a bit less well, so your blood sugar could run higher. What your care team typically does: Checks your blood sugar more often, especially when you start or change the dose of cariprazine. Adjusts your insulin dose as needed. The dose may need to be increased and individualized by your team. What you can do: Keep taking both medicines exactl… 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 Insulin Icodec-Abae 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)

  1. Product Information: AWIQLI subcutaneous injection, insulin icodec-abae subcutaneous injection. Novo Nordisk Inc. (Per FDA), Plainsboro, NJ, 2026. DailyMed
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