Caripran
Generic Name
Cariprazine
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| caripran 3 mg capsule | ৳ 22.00 | ৳ 132.00 |
Description
Overview of the medicine
Cariprazine is an atypical antipsychotic indicated for the treatment of schizophrenia, bipolar I disorder (manic, mixed, and depressive episodes), and as adjunctive therapy to antidepressants for major depressive disorder.
Uses & Indications
Dosage
Adults
Schizophrenia: Initial dose 1.5 mg once daily, target dose 1.5-6 mg/day. Bipolar I Mania: Initial 1.5 mg once daily, target 3-6 mg/day. Bipolar I Depression: Initial 1.5 mg once daily, target 1.5-3 mg/day. Major Depressive Disorder (adjunctive): Initial 1.5 mg once daily, target 1.5-3 mg/day.
Elderly
Use with caution; consider lower starting doses and slower titration, particularly in patients with dementia-related psychosis where it is contraindicated.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. Not recommended for severe renal impairment (CrCl <30 mL/min).
How to Take
Take orally once daily, with or without food. Swallow the capsule whole.
Mechanism of Action
Cariprazine acts primarily as a partial agonist at dopamine D2 and D3 receptors, and serotonin 5-HT1A receptors. It also acts as an antagonist at serotonin 5-HT2B and 5-HT2A receptors.
Pharmacokinetics
Onset
Therapeutic effects may take several weeks to become apparent due to its long half-life and that of its active metabolites.
Excretion
Primarily excreted in feces (approximately 59%) and urine (approximately 33%) as metabolites.
Half life
Cariprazine: approximately 2-4 days. Active metabolites (desmethylcariprazine and didesmethylcariprazine): 1-3 weeks.
Absorption
Well absorbed after oral administration, peak plasma concentrations of cariprazine are reached within 3-7 hours. Food does not significantly affect absorption.
Metabolism
Extensively metabolized by CYP3A4 and to a lesser extent by CYP2D6 to its active metabolites, desmethylcariprazine and didesmethylcariprazine.
Side Effects
Contraindications
- Known hypersensitivity to cariprazine or any component of the formulation.
- Dementia-related psychosis in elderly patients (due to increased risk of death).
Drug Interactions
CYP2D6 Inhibitors (e.g., paroxetine)
No dosage adjustment necessary, but monitor for adverse reactions.
Strong CYP3A4 Inducers (e.g., rifampin)
Avoid concomitant use as it significantly decreases cariprazine and active metabolite levels, reducing efficacy.
Strong CYP3A4 Inhibitors (e.g., ketoconazole)
Avoid concomitant use as it significantly increases cariprazine and active metabolite levels, leading to increased side effects.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and light. Keep out of reach of children.
Overdose
There is no specific antidote for cariprazine overdose. Management should consist of supportive care, including establishing and maintaining a clear airway, ensuring adequate oxygenation and ventilation, and monitoring cardiac function and vital signs. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Limited data available. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as it may be excreted in breast milk.
Side Effects
Contraindications
- Known hypersensitivity to cariprazine or any component of the formulation.
- Dementia-related psychosis in elderly patients (due to increased risk of death).
Drug Interactions
CYP2D6 Inhibitors (e.g., paroxetine)
No dosage adjustment necessary, but monitor for adverse reactions.
Strong CYP3A4 Inducers (e.g., rifampin)
Avoid concomitant use as it significantly decreases cariprazine and active metabolite levels, reducing efficacy.
Strong CYP3A4 Inhibitors (e.g., ketoconazole)
Avoid concomitant use as it significantly increases cariprazine and active metabolite levels, leading to increased side effects.
Storage
Store at controlled room temperature (20°C to 25°C), away from moisture and light. Keep out of reach of children.
Overdose
There is no specific antidote for cariprazine overdose. Management should consist of supportive care, including establishing and maintaining a clear airway, ensuring adequate oxygenation and ventilation, and monitoring cardiac function and vital signs. Gastric lavage and activated charcoal may be considered.
Pregnancy & Lactation
Pregnancy Category C. Limited data available. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Not recommended during breastfeeding as it may be excreted in breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
FDA Approved (2015, for original formulation)
Patent Status
Patented (original formulation)
Clinical Trials
Cariprazine has undergone extensive clinical trials for its approved indications, demonstrating efficacy and an acceptable safety profile in treated populations. Studies show significant improvement in PANSS scores for schizophrenia and MADRS/YMRS scores for bipolar depression/mania.
Lab Monitoring
- Monitor for changes in weight, glucose (fasting plasma glucose), and lipid profile (fasting total cholesterol, LDL, HDL, and triglycerides) periodically. Monitor for extrapyramidal symptoms.
Doctor Notes
- Emphasize the importance of patient adherence due to the long half-life of active metabolites.
- Monitor for emergent suicidal ideation, especially in young adults.
- Assess for metabolic side effects regularly.
Patient Guidelines
- Take Caripran exactly as prescribed by your doctor.
- Do not stop taking Caripran suddenly, even if you feel better, without consulting your doctor.
- Report any unusual changes in mood or behavior, or any new or worsening side effects to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Cariprazine may cause drowsiness, dizziness, or visual disturbances, which could impair your ability to drive or operate machinery. Patients should be advised to exercise caution until they are reasonably certain that cariprazine does not adversely affect them.
Lifestyle Advice
- Avoid alcohol consumption while taking Caripran as it may increase sedation.
- Be cautious when driving or operating machinery until you know how Caripran affects you, as it may cause drowsiness or dizziness.
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