Caplyta vs. Vraylar: Differences, similarities & side effects

In this article:

• Caplyta vs. Vraylar: Key differences
• Caplyta vs. Vraylar: Conditions treated
• Is Vraylar better than Caplyta?
• Caplyta vs. Vraylar: Insurance coverage and cost comparison
• Caplyta vs. Vraylar side effects
• Caplyta and Vraylar drug interactions
• Caplyta and Vraylar drug warnings
• Can you take Caplyta and Vraylar together?

In this article

• Caplyta vs. Vraylar: Key differences
• Caplyta vs. Vraylar: Conditions treated
• Is Vraylar better than Caplyta?
• Caplyta vs. Vraylar: Insurance coverage and cost comparison
• Caplyta vs. Vraylar side effects
• Caplyta and Vraylar drug interactions
• Caplyta and Vraylar drug warnings
• Can you take Caplyta and Vraylar together?

Caplyta (lumateperone) and Vraylar (cariprazine) are brand-name medications approved by the Food and Drug Administration (FDA) for treating schizophrenia and bipolar depression. As members of the same class of medications, these drugs work by blocking specific dopamine and serotonin receptors while activating others. Despite their similar classification as second-generation antipsychotics, Caplyta and Vraylar are different in several ways and have different active ingredients. 

Caplyta vs. Vraylar: Key differences

Antipsychotic medications are prescribed to manage conditions associated with psychosis, a group of symptoms that involve a disconnection from reality. These conditions include schizophrenia, bipolar disorder, delirium, and other mental health disorders. There are two categories of antipsychotics: first-generation and second-generation. 

First-generation antipsychotics, also called typical antipsychotics, were the initial medications developed for treating psychosis. While effective, they have significant side effects. Second-generation antipsychotics, also called atypical antipsychotics, are newer medications that are more commonly prescribed than typical antipsychotics because they have a favorable side effect profile. Both Caplyta and Vraylar are second-generation antipsychotics. Each medication is FDA approved for use in adults and can be taken with or without food. Neither drug is recommended for use in children.

Compare Caplyta vs. Vraylar key differences
	Caplyta	Vraylar
Drug class	Second-generation antipsychotic; atypical antipsychotic	Second-generation antipsychotic; atypical antipsychotic
Brand/generic status	Brand	Brand
What is the generic name?	The active ingredient is lumateperone, but there is no generic available.	The active ingredient is cariprazine, but there is no generic available.
What form(s) does the drug come in?	Oral capsules: 10.5 mg, 21 mg, and 42 mg	Oral capsules: 1.5 mg, 3 mg, 4.5 mg, and 6 mg
What is the standard dosage?	42 mg by mouth once daily	Varies by indication; generally, the dose ranges from 1.5 to 6 mg by mouth once daily
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults	Adults

 

Caplyta vs. Vraylar: Conditions treated

Caplyta and Vraylar are both used to treat schizophrenia in adults. Caplyta is also approved for managing depressive episodes associated with bipolar I or bipolar II disorder, while Vraylar is specifically indicated for bipolar I disorder. Vraylar can also be used for acute manic or mixed episodes related to bipolar I disorder. Additionally, Vraylar can be used as an add-on medication to antidepressants for treating depression in adults.

Compare Caplyta vs. Vraylar conditions treated
Condition	Caplyta	Vraylar
Schizophrenia	Yes	Yes
Depressive episodes associated with bipolar  disorder (bipolar depression)	Yes, for bipolar I or bipolar II disorder; can be used alone or as an adjunctive (add-on) treatment along with lithium or valproate	Yes, for bipolar I disorder
Acute treatment of manic episodes or mixed episodes associated with bipolar I disorder	No	Yes
Add-on medication to antidepressants such as Prozac (fluoxetine) to treat depression (major depressive disorder)	No	Yes

 

Is Vraylar better than Caplyta?

There is no data directly comparing Vraylar vs Caplyta. However, a review of clinical studies involving several atypical antipsychotics, including both Vraylar and Caplyta, found that all five medications studied were more effective than placebo (inactive medicine). Additional findings include:

• In terms of efficacy, Caplyta was ranked third, while Vraylar was ranked fifth. 
• Caplyta was associated with higher rates of sleepiness compared to Vraylar.
• Caplyta had lower rates of weight gain compared to both the placebo and other antipsychotics. 
• Caplyta was rated second for overall tolerability, whereas Vraylar was rated the least tolerable among the medications reviewed.

Only a healthcare provider can determine the best treatment option for your condition, considering individual factors such as symptoms, medical conditions, medical and family history, potential side effects, and drug interactions. 

Caplyta vs. Vraylar: Insurance coverage and cost comparison

Most commercial health insurance plans and Medicare prescription plans provide coverage for Caplyta and Vraylar. However, copays and out-of-pocket expenses will vary depending on the specific plan. You may contact your health insurance provider for the latest pricing estimates for Caplyta or Vraylar.

Without insurance, the average retail price of a one-month supply of Caplyta is approximately $2,161 for 30, 42 mg capsules However, using a free SingleCare coupon can reduce the cost to around $1,609 per month.

A one-month supply of Vraylar costs approximately $2,000 for 30, 1.5 mg capsules without insurance. SingleCare coupons can reduce the cost to about $1,298 per month.

Compare Caplyta vs. Vraylar cost & coverage
	Caplyta	Vraylar
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare Part D?	Yes	Yes
Quantity	30, 42 mg capsules	30, 1.5 mg capsules
SingleCare cost*	$1,608	$1,298

*Cost at the time of publication. Cost varies by pharmacy.

Caplyta vs. Vraylar side effects

Antipsychotic medications like Caplyta and Vraylar are commonly associated with extrapyramidal symptoms (EPS), which are types of movement disorders. There are various forms:

• Dystonia: This involves involuntary muscle contractions that lead to abnormal postures and repetitive movements. Dystonia can affect areas such as the back, pelvis, stomach, neck, jaw, eyes, face, and tongue.
• Akathisia: Characterized by a sense of restlessness and an overwhelming urge to move, akathisia may cause people to frequently fidget or shift their weight.
• Parkinsonism: Symptoms of Parkinsonism include tremors, muscle stiffness, a slow and shuffling gait, stooped posture, imbalance, and difficulty standing up from a seated position.
• Tardive dyskinesia: This condition involves involuntary movements of the face and tongue, such as grimacing, lip-smacking, and blinking.

In addition to these EPS, common side effects of Caplyta include drowsiness, dizziness, dry mouth, and nausea. Caplyta may also impact fertility in both males and females. If you have concerns about these effects, it is important to consult with your healthcare provider.

Common side effects of Vraylar include headache, insomnia (difficulty sleeping), and EPS.

In rare cases, a serious allergic reaction may occur. If you have symptoms of hives, trouble breathing, or swelling of the face, lips, tongue, or throat, seek emergency medical help. 

The table below provides more information about the side effects of Caplyta and Vraylar. This is not a full list of adverse effects, and others may occur. Consult your healthcare professional or pharmacist for more information about side effects.

Compare Caplyta vs. Vraylar side effects
	Caplyta		Vraylar
Side effect	Applicable?	Frequency	Applicable?	Frequency
EPS	Yes	1.3–6.7%	Yes	15–20%
Nausea	Yes	9%	Yes	5–8%
Vomiting	Yes	4%	Yes	4–5%
Drowsiness or sedation	Yes	24%	Yes	5–10%
Dizziness	Yes	5%	Yes	3–5%
Dry mouth	Yes	6%	Yes	1–3%
Headache	Yes	14%	Yes	9–18%
Insomnia	No	N/A	Yes	11–13%
Increased appetite	No	N/A	Yes	3–5%
Constipation	No	N/A	Yes	6–10%

Source: Caplyta (DailyMed), Vraylar (DailyMed)

Caplyta and Vraylar drug interactions

Before taking Caplyta or Vraylar, tell your healthcare provider about all the medications you take, including prescription drugs, over-the-counter medications, vitamins, and supplements. The table below outlines some of the interactions between other drugs and Caplyta or Vraylar. As you can see, Caplyta and Vraylar share many of the same interactions. This is not a full list of drug interactions, and others may occur. Consult your prescribing healthcare provider for more information about drug interactions and how they may affect you.

Compare Caplyta vs. Vraylar drug interactions
Drug	Drug class	Interacts with Caplyta?	Interacts with Vraylar?
Clarithromycin  Ketoconazole Ritonavir Voriconazole	Strong CYP3A4 inhibitors	Yes	Yes
Diltiazem  Erythromycin  Verapamil	Moderate CYP3A4 inhibitors	Yes	Yes
Carbamazepine Phenytoin  Rifampin  St. John’s wort	Strong CYP3A4 inducers	Yes	Yes
Bosentan  Modafinil  Nafcillin	Moderate CYP3A4 inducers	Yes	Yes
Benztropine Diphenhydramine	Anticholinergic drugs	Yes	Yes
Atenolol  Lisinopril  Valsartan	Medications that lower blood pressure	Yes	Yes
Alcohol Anxiety medicines Muscle relaxants Opioid pain medicines  Seizure medicines Sleeping medicines	Drugs that cause central nervous system (CNS) depression	Yes	Yes

 

Caplyta and Vraylar drug warnings

Before starting Caplyta or Vraylar, tell your healthcare provider about any medical conditions you have, including if you are pregnant, planning to become pregnant, or breastfeeding.

Both Caplyta and Vraylar carry a boxed warning, the most serious warning required by the FDA. These warnings state that:

• Older adults with dementia-related psychosis are at an increased risk of death when taking antipsychotic medications. Neither Caplyta nor Vraylar should be used in these patients.
• Antidepressants may increase the risk of suicidal thoughts and behaviors, especially in children and young adults. Patients of any age taking Caplyta or Vraylar should be closely monitored for any changes in mood or behavior, including suicidal thoughts.

Additional warnings shared by Caplyta and Vralyar include:

• Neuroleptic malignant syndrome (NMS) is a potentially fatal condition that may occur with antipsychotic medications. Watch for symptoms such as rigid muscles, high fever, delirium, and kidney failure, and get emergency medical attention if any of these symptoms occur.
• Both Caplyta and Vraylar may lead to metabolic changes such as high blood sugar or diabetes, high cholesterol, and weight gain. Regular monitoring of these changes is essential.
• Both medications can affect white blood cell counts. If a significant decrease occurs, your healthcare provider may advise you to discontinue the medication.
• Caplyta and Vraylar can cause a drop in blood pressure when standing, potentially leading to fainting, falls, and fractures. Your healthcare provider will monitor your blood pressure and heart rate while on either medication, especially if you have heart disease or certain medical conditions.
• Avoid alcohol while taking these medications, and do not drive or operate machinery until you know how the medication affects you.
• Tell your healthcare provider if you have ever had a seizure.
• Both medications may increase sensitivity to hot temperatures. Stay hydrated, especially during exercise or in hot weather, to prevent dehydration.

Can you take Caplyta and Vraylar together?

Combining Caplyta and Vraylar is generally not recommended due to their similar mechanisms of action and potential for increased side effects. Both medications work on dopamine and serotonin receptors, and using them together may worsen side effects. Clinical guidelines typically recommend using a single antipsychotic at a time, and any decision to combine these drugs would require close supervision by a healthcare provider.