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Kaletra Oral Solution and Vraylar

Determining the interaction of Kaletra Oral Solution and Vraylar and the possibility of their joint administration.

Check result:
Kaletra Oral Solution <> Vraylar
Relevance: 05.01.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ritonavir can significantly increase the blood levels of cariprazine. This may increase the risk of side effects such as drowsiness, Parkinson-like symptoms, abnormal muscle movements, seizures, high blood sugar, diabetes, high cholesterol, weight gain, low white blood cell count, difficulty swallowing, and heat-related disorders such as heat intolerance or heat stroke. You may also be more likely to experience side effects associated with low blood pressure such as dizziness, lightheadedness, headache, flushing, fainting, and heart palpitations. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the interaction, but has determined that this is the best course of treatment for you and has taken appropriate precautions or made dose adjustments and is monitoring you closely for any potential complications. Your doctor may also be able to prescribe alternatives that do not interact. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of cariprazine and its major active metabolite, didesmethyl cariprazine (DDCAR), both of which are primarily metabolized by the isoenzyme. When cariprazine (0.5 mg/day) was coadministered with the potent CYP450 3A4 inhibitor, ketoconazole (400 mg/day), cariprazine peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 3.5- and 4-fold, respectively, while Cmax and AUC of DDCAR increased by approximately 1.5-fold each. The Cmax and AUC of another active metabolite, desmethyl cariprazine (DCAR), decreased by approximately one-third.

MANAGEMENT: The dosage of cariprazine should be reduced in the presence of a potent CYP450 3A4 inhibitor. When initiating a potent CYP450 3A4 inhibitor during stable treatment with cariprazine, the manufacturer recommends reducing the current dosage of cariprazine by one-half. For patients taking 4.5 mg daily, the dosage should be reduced to 1.5 mg or 3 mg daily. For patients taking 1.5 mg daily, the dosing interval should be adjusted to every other day. Conversely, if cariprazine therapy is initiated during treatment with a potent CYP450 3A4 inhibitor, the recommended starting dosage of cariprazine is 1.5 mg on day 1 and day 3, with no dose administered on day 2. From day 4 onward, the dosage should be 1.5 mg daily, then increased to a maximum dosage of 3 mg daily. Following withdrawal of the CYP450 3A4 inhibitor, the dosage of cariprazine may need to be increased.

References
  • "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc., Parsippany, NJ.
Kaletra Oral Solution

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Kaletra

Vraylar

Generic Name: cariprazine

Brand name: Vraylar

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction