| Schizophrenia
Geodon vs Vraylar
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Geodon vs Vraylar with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsVraylar has a higher rate of injection site reactions vs Geodon based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Vraylar but not Geodon, including UnitedHealthcare
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Category
Geodon
Vraylar
At A Glance
Oral / IM injection
Twice daily
D2/5HT2 antagonist
Oral
Daily
Atypical antipsychotic
Indications
- Schizophrenia
- Bipolar I disorder
- Schizophrenia
- Manic Disorder
- Depression, Bipolar
- Major Depressive Disorder
Dosing
Schizophrenia Initiate at 20 mg twice daily with food; may adjust up to 80 mg twice daily at intervals of not less than 2 days.
Schizophrenia (acute agitation, IM) 10-20 mg IM as needed up to 40 mg/day; 10 mg may be given every 2 hours, 20 mg every 4 hours; limit to 3 consecutive days, then transition to oral.
Bipolar I disorder (acute manic/mixed episodes) Initiate at 40 mg twice daily with food; increase to 60 or 80 mg twice daily on day 2; subsequent doses adjusted within 40-80 mg twice daily range based on tolerability and efficacy.
Bipolar I disorder (maintenance, adjunct to lithium or valproate) Continue at the same dose on which the patient was initially stabilized, within the range of 40-80 mg twice daily with food.
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 history of QT prolongation, including congenital long QT syndrome
- Recent acute myocardial infarction
- Uncompensated heart failure
- Concomitant use with drugs that prolong the QT interval (e.g., dofetilide, sotalol, quinidine, Class Ia and III anti-arrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl acetate, dolasetron mesylate, probucol, tacrolimus)
- Known hypersensitivity to ziprasidone or any excipient
- Concomitant use of MAOIs, or use within 14 days of stopping an MAOI
- 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)
Adverse Reactions
Most common (>=5%) Somnolence, extrapyramidal symptoms, akathisia, dizziness, nausea, constipation, respiratory tract infection, headache, asthenia, abnormal vision
Serious QT prolongation, neuroleptic malignant syndrome, serotonin syndrome, tardive dyskinesia, DRESS, leukopenia, neutropenia, agranulocytosis, seizures
Postmarketing Torsade de pointes, facial droop, galactorrhea, priapism, somnambulism, angioedema, urinary incontinence, postural hypotension, syncope
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
Ziprasidone is a dopamine D2/D3 and serotonin 5HT2A/5HT2C antagonist with agonist activity at 5HT1A receptors and inhibition of synaptic reuptake of serotonin and norepinephrine; its antipsychotic and antimanic effects are thought to be mediated through combined D2 and 5HT2 antagonism.
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.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Geodon
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (6/12) · Qty limit (0/12)
Vraylar
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (3/12)
UnitedHealthcare
Geodon
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Vraylar
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (8/8)
Humana
Geodon
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
Vraylar
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Geodon.
$75/fillfill
Vraylar Savings Card - Non-covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.