Repotrectinib 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
Repotrectinib
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.
Cariprazine (Vraylar) is broken down in your body by an enzyme called CYP3A4. This same enzyme also creates the long-lasting active forms of cariprazine that do much of the work. Repotrectinib (Augtyro) can speed up that enzyme, which may shift how much cariprazine and its active pieces are in your system. Because of the way this drug works, the net result is hard to predict, so the two are generally not recommended together.
The good news is your care team can manage this. Don't stop or change either medicine on your own. Just let your pharmacist or doctor know you take both so they can watch how you're doing and adjust the plan if needed.
Mechanism: Repotrectinib can induce CYP3A4, the enzyme responsible for both the formation and elimination of cariprazine's active metabolites (didesmethyl-cariprazine and others). Because CYP3A4 governs both activation and clearance, the net effect on total active moiety exposure is unpredictable.
- Direction: Unclear net effect (not a simple loss or gain of efficacy).
- Evidence: Theoretical; not formally studied.
- Severity/onset: Major; onset unspecified.
- Management: Coadministration is not recommended. If unavoidable, monitor closely for altered antipsychotic response and adverse effects (EPS, akathisia, sedation); consider an alternative TRK inhibitor or antipsychotic.
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 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 outcome remains uncertain1.
Why it happens (mechanism)
Induction of CYP3A4-mediated metabolism of cariprazine
How to manage this interaction
The labeling advises that this combination generally isn't recommended, because repotrectinib can change how cariprazine is processed and the overall effect is not fully predictable.
- Keep taking both as prescribed unless your prescriber tells you otherwise. Do not stop or change doses on your own.
- Tell your pharmacist and prescriber that you take both, so they can decide the safest plan.
- Your team may monitor you more closely, adjust and individualize your dose, or consider an alternative medication.
- Report any new or worsening symptoms, such as restlessness, muscle stiffness, tremor, unusual drowsiness, or a return of the symptoms cariprazine treats.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Repotrectinib and Cariprazine together?
Cariprazine and repotrectinib together can unpredictably alter cariprazine levels and generally aren't recommended, so don't change anything on your own; ask your pharmacist or doctor to review it and monitor you. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Repotrectinib 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 Repotrectinib and Cariprazine interaction managed?
The labeling advises that this combination generally isn't recommended, because repotrectinib can change how cariprazine is processed and the overall effect is not fully predictable. Keep taking both as prescribed unless your prescriber tells you otherwise. Do not stop or change doses on your own. Tell your pharmacist and prescriber that you take both, so they can decide the safest plan. Your team… 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 Repotrectinib 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 Cariprazine
Keep reading about Repotrectinib
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist