Sotorasib 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
Sotorasib
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 a medicine for mood and thinking conditions. Your liver uses an enzyme called CYP3A4 to both create and clear cariprazine's active forms. Sotorasib (Lumakras), a cancer medicine, can speed up that same enzyme.
Because CYP3A4 handles both the making and the removal of cariprazine's active parts, speeding it up makes the overall result hard to predict. This combination hasn't been formally studied, so experts recommend against using them together. The good news is your care team can plan around this. Please don't stop either medicine on your own. Instead, let your doctor or pharmacist know you take both so they can guide you safely.
Mechanism: Sotorasib induces CYP3A4, the enzyme responsible for both formation and elimination of cariprazine's active metabolites (desmethyl- and didesmethyl-cariprazine). Because CYP3A4 governs both activation and clearance, the net effect on cariprazine exposure is unpredictable.
- Direction: Uncertain; not quantified (theoretical).
- Severity/Evidence: Major; theoretical, exposure not formally evaluated.
- Onset: Unspecified.
- Management: Coadministration is not recommended. If unavoidable, monitor closely for loss of efficacy or altered tolerability; consider an alternative agent that avoids CYP3A4 induction, individualized 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 a CYP3A4 substrate) together with a CYP3A4 inducer is not advised. The generation and clearance of cariprazine's active metabolites depend on CYP3A4. How CYP3A4 inducers influence 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
This combination is not recommended, so the most important step is to make sure both prescribers know you take both drugs.
- Keep taking both as prescribed unless your care team tells you otherwise. Do not start or stop either one on your own.
- Your team may watch you more closely for signs that cariprazine is working less well or causing new side effects, since the net effect is hard to predict.
- They may consider an alternative medicine that doesn't affect this liver enzyme, or adjust your plan and individualize it to you.
Raise any changes in mood, thinking, or new symptoms with your pharmacist or doctor.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Sotorasib and Cariprazine together?
Combining cariprazine and sotorasib is not recommended because sotorasib can speed up the enzyme that both makes and clears cariprazine's active forms, making the result unpredictable. Tell your prescribers you take both so they can monitor you or choose an alternative. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sotorasib 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 Sotorasib and Cariprazine interaction managed?
This combination is not recommended, so the most important step is to make sure both prescribers know you take both drugs. Keep taking both as prescribed unless your care team tells you otherwise. Do not start or stop either one on your own. Your team may watch you more closely for signs that cariprazine is working less well or causing new side effects, since the net effect is hard to predict. The… 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 Sotorasib 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 Sotorasib
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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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