| Schizophrenia

Aristada & Aristada Initio vs Vraylar

Side-by-side clinical, coverage, and cost comparison for schizophrenia.

Deep comparison between: Aristada vs Vraylar with Prescriber.AI

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Safety signalsVraylar has a higher rate of injection site reactions vs Aristada based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Vraylar but not Aristada, including UnitedHealthcare

Category

Aristada

Vraylar

At A Glance

RouteIM injection

FrequencyMonthly to every 2 months

ClassDopamine D2 partial agonist

RouteOral

FrequencyDaily

ClassAtypical antipsychotic

Indications

Schizophrenia

Schizophrenia
Manic Disorder
Depression, Bipolar
Major Depressive Disorder

Dosing

Schizophrenia 441 mg, 662 mg, or 882 mg monthly, 882 mg every 6 weeks, or 1064 mg every 2 months via IM injection into the deltoid (441 mg only) or gluteal muscle; initiate with ARISTADA INITIO 675 mg plus a single 30 mg oral aripiprazole dose, or supplement with 21 consecutive days of oral aripiprazole concomitant with the first injection.

Schizophrenia Adults: start 1.5 mg once daily; recommended 1.5-6 mg once daily (max 6 mg). Pediatric patients (13-17 years): start 0.5 mg once daily; recommended 1.5-4.5 mg once daily (max 4.5 mg).

Manic Disorder Adults: start 1.5 mg once daily, increase to 3 mg on Day 2; recommended 3-6 mg once daily (max 6 mg). Pediatric patients (10-17 years): start 0.5 mg once daily; recommended 3 mg or 4.5 mg once daily (max 4.5 mg).

Depression, Bipolar Adults: start 1.5 mg once daily; may increase to 3 mg on Day 15 (max 3 mg once daily).

Major Depressive Disorder Adults (adjunctive to antidepressants): start 1.5 mg once daily; may increase to 3 mg on Day 15 (max 3 mg once daily).

Contraindications

Known hypersensitivity reaction to aripiprazole (reactions have ranged from pruritus/urticaria to anaphylaxis)

History of hypersensitivity reaction to cariprazine, including rash, pruritus, urticaria, and reactions suggestive of angioedema (e.g., swollen tongue, lip swelling, face edema, pharyngeal edema, swelling face)

Drug Interactions

1246View drug interactions

1082View drug interactions

Adverse Reactions

Most common (>=5%) Akathisia

Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, seizures, orthostatic hypotension

Postmarketing Anaphylactic reaction, angioedema, pathological gambling, drug reaction with eosinophilia and systemic symptoms (DRESS), oculogyric crisis, fecal incontinence

Most common (>=5%) Extrapyramidal symptoms, akathisia, nausea, restlessness, insomnia, somnolence, dyspepsia, vomiting

Serious Neuroleptic malignant syndrome, tardive dyskinesia, increased mortality in elderly patients with dementia-related psychosis, suicidal thoughts and behaviors, cerebrovascular adverse reactions, metabolic changes, leukopenia/neutropenia/agranulocytosis, orthostatic hypotension, seizures

Postmarketing Stevens-Johnson syndrome

Pharmacology

Aripiprazole lauroxil is a prodrug of aripiprazole that, following IM injection, undergoes enzyme-mediated hydrolysis to yield aripiprazole, which exerts its effects through partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at serotonin 5-HT2A receptors.

Cariprazine is an atypical antipsychotic that acts as a partial agonist at central dopamine D2/D3 and serotonin 5-HT1A receptors and as an antagonist at serotonin 5-HT2A receptors; its two major active metabolites, desmethylcariprazine (DCAR) and didesmethylcariprazine (DDCAR), have in vitro receptor binding profiles similar to the parent drug.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Aristada