Vraylar vs. Latuda: Differences, similarities & side effects

In this article:

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

In this article

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

Antipsychotic medications treat conditions related to psychosis (a group of symptoms that involve a disconnection from reality). They can be used for the treatment of schizophrenia, bipolar disorder, delirium, and other mental health conditions. There are two main types of antipsychotics:

• First-generation antipsychotics, or typical antipsychotics, were the first types of antipsychotic medicines developed. These drugs, which include Haldol (haloperidol), fluphenazine, and others, are not commonly used to treat psychosis due to their side effects. 
• Second-generation antipsychotics are also known as atypical antipsychotics and include Abilify (aripiprazole), Geodon (ziprasidone), Risperdal (risperidone), Zyprexa (olanzapine), Rexulti (brexpiprazole), and Seroquel (quetiapine). Atypical antipsychotics are now the preferred drugs to treat psychosis because they have fewer side effects than first-generation antipsychotics. 

Vraylar (cariprazine) and Latuda (lurasidone) are two brand-name second-generation (atypical) antipsychotics that treat schizophrenia and bipolar depression. As members of the same drug class, they work the same way—by blocking certain dopamine and serotonin receptors and activating other receptors. Although both medications are classified as second-generation antipsychotics, they are not exactly the same. They have some similarities and some differences as well. Read on to learn more about Vraylar and Latuda.

Vraylar vs. Latuda: Key differences

Vraylar and Latuda are both classified as second-generation antipsychotics, or atypical antipsychotics. Vraylar and Latuda are brand-name drugs, but Latuda is also available as generic lurasidone. Vraylar is approved by the Food and Drug Administration (FDA) for use in adults only. Latuda can be used in adults as well as older children and adolescents, depending on the use. While Vraylar can be taken with or without food, Latuda should always be taken with at least 350 calories of food for optimal absorption.

Vraylar vs. Latuda: Comparing key differences
	Vraylar	Latuda
Drug class	Second-generation antipsychotic; atypical antipsychotic	Second-generation antipsychotic; atypical antipsychotic
Brand/generic status	Brand	Brand and generic
What is the generic name?	The active ingredient is cariprazine, but there is no generic available	Lurasidone
What form(s) does the drug come in?	Oral capsules: 1.5 mg, 3 mg, 4.5 mg, and 6 mg	Oral tablets: 20 mg, 40 mg, 60 mg, 80 mg, and 120 mg
What is the standard dosage?	Varies by indication; generally, the dose ranges from 1.5 to 3 mg or 6 mg by mouth once daily Can be taken with or without food	Varies by indication Schizophrenia: 40 to 160 mg by mouth once daily Bipolar depression: 20 to 120 mg by mouth once daily Should always be taken with at least 350 calories of food for optimal absorption
How long is the typical treatment?	Long-term	Long-term
Who typically uses the medication?	Adults	Adults and adolescents 13–17 years old for schizophrenia Adults and pediatric patients 10–17 years old for bipolar depression

Vraylar vs. Latuda: Conditions treated

Both medications are FDA approved to treat schizophrenia as well as bipolar depression (see ages in the table below). Additionally, Vraylar can be used for acute treatment of mixed or manic episodes associated with bipolar I disorder and as an add-on medicine to treat depression in adults.

Vraylar vs. Latuda: Comparing conditions treated
Condition	Vraylar	Latuda
Schizophrenia	Yes (adults)	Yes (adults and adolescents 13–17 years old)
Acute treatment of manic or mixed episodes associated with bipolar I disorder	Yes (adults)	No
Depressive episodes associated with bipolar I disorder (bipolar depression)	Yes (adults)	Yes (for use in adults and pediatric patients 10–17 years when used as the only treatment; for use in adults only when used along with a mood stabilizer such as  lithium or divalproex)
Add-on medication to antidepressants such as Prozac (fluoxetine) to treat major depressive disorder (depression)	Yes (adults)	No

Latuda vs. Vraylar: Which is better?

A literature review and meta-analysis (review of many clinical trials) compared Vraylar, Latuda, and another atypical antipsychotic, Rexulti, in the treatment of schizophrenia. The researchers found that all three drugs were similar in safety and efficacy at the six-week mark, although Latuda was more effective when taken at the maximum dose of 160 mg daily.

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. 

Can you take Vraylar and Latuda together?

While some healthcare providers may prescribe two or more antipsychotic medications together, there is limited evidence that doing so is effective and safe. What’s more, prescribing more than one antipsychotic medication can increase the risk of complications such as drug interactions and medication errors. Experts generally recommend avoiding combining two or more antipsychotic medications except in certain rare and very specific cases. 

Vraylar vs. Latuda: Insurance coverage and cost comparison

Most commercial insurance plans and Medicare prescription plans offer coverage for Vraylar and Latuda. However, copays will vary. Since Latuda is available as generic lurasidone, insurance plans generally charge less for lurasidone. The brand-name drug may cost more or may not be covered. You can contact your insurance plan for the most recent pricing estimates.

For individuals without insurance, the out-of-pocket cost for a one-month supply of Vraylar is about $1,916. However, you can use a free SingleCare coupon to pay $1,328 monthly. 

RELATED: How to save on Vraylar

For people without insurance, the out-of-pocket cost of a one-month supply of brand-name Latuda is about $1,859. However, using a free SingleCare coupon can decrease the price to $1,373. Choosing generic lurasidone can decrease the price to as low as $19.

RELATED: Latuda copay card: Eligibility, savings & more

Vraylar vs. Latuda: Comparing insurance & cost
	Vraylar	Latuda
Typically covered by insurance?	Yes	Yes
Typically covered by Medicare Part D?	Yes	Yes (generic)
Quantity	30, 1.5 mg capsules	30, 20 mg tablets
SingleCare cost*	$1,328	$1,373 for brand-name Latuda; $19 for generic lurasidone

*Cost at time of publication. Varies by pharmacy.

Vraylar vs. Latuda side effects

Some common side effects of Vraylar include headache, insomnia, and movement problems called extrapyramidal symptoms (EPS). Vraylar has a long half-life (the time it takes for half of a dose of medicine to clear from the body), so some side effects may take longer to appear.

Common Latuda side effects include nausea, vomiting, drowsiness, and movement disorders. Latuda can also increase prolactin levels.

Serious side effects may occur. People with symptoms of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, should seek emergency medical attention. 

The table below provides more information about side effects. Note that the frequency is a range, which can vary by dose. This is not a full list of side effects, and others may occur. Consult your healthcare provider or pharmacist for more information about side effects.

Vraylar vs. Latuda: Comparing side effects
	Vraylar		Latuda
Side effect	Applicable?	Frequency	Applicable?	Frequency
Headache	Yes	9-18%	No	N/a
Insomnia	Yes	11-13%	Yes	7-11%
EPS	Yes	15-20%	Yes	6-22%
Nausea	Yes	5-8%	Yes	7-13%
Vomiting	Yes	4-5%	Yes	6-9%
Drowsiness	Yes	5-10%	Yes	8-26%
Dizziness	Yes	3-5%	Yes	4-6%
Constipation	Yes	6-10%	No	N/a
Agitation	Yes	3-5%	Yes	3-10%
Anxiety	Yes	3-6%	Yes	3-7%

Source: Vraylar (DailyMed), Latuda (DailyMed)

Vraylar and Latuda drug interactions

Before taking Vraylar or Latuda, you should tell your healthcare provider about all the medications you take, including prescription drugs, over-the-counter medicines, vitamins, and supplements. Certain medications can affect how Vraylar and Latuda are processed in the body, and Vraylar or Latuda can affect other medications. Some drugs should be avoided, while others may require a dosage adjustment. Talk to your healthcare provider about drug interactions and how they may affect you. 

Vraylar vs. Latuda: Comparing drug interactions
Drug	Drug class	Interacts with Vraylar?	Interacts with Latuda?
Clarithromycin  Ketoconazole Ritonavir Voriconazole	Strong CYP3A4 inhibitors	Yes	Yes
Diltiazem  Erythromycin  Fluconazole  Verapamil	Moderate CYP3A4 inhibitors	Yes	Yes
Carbamazepine Phenytoin  Rifampin  St. John’s wort	Strong CYP3A4 inducers	Yes	Yes
Bosentan  Efavirenz  Modafinil  Nafcillin	Moderate CYP3A4 inducers	Yes	Yes

Vraylar and Latuda drug warnings

Before taking Vraylar or Latuda, let your healthcare provider know about any medical conditions you have, including if you are pregnant or breastfeeding.

Both Vraylar and Latuda have a black box warning, or boxed warning, which is the most serious warning required by the FDA. The warnings are the same for each drug:

• Older adults with dementia-related psychosis who take antipsychotic medication have an increased risk of death and should not take Vraylar or Latuda.
• Antidepressants can increase the risk of suicidal thoughts and behaviors in children and young adults. People of any age who take Vraylar or Latuda should be closely monitored for changes in mood and behavior or suicidal thoughts and behaviors.

Other warnings for both drugs include:

• Neuroleptic malignant syndrome (NMS) is potentially fatal and has been reported with antipsychotic medications. Signs and symptoms may include rigid muscles, very high fever, delirium, and kidney failure. Emergency medical help is required.
• Tardive dyskinesia is a type of EPS that can cause repetitive and involuntary movements like grimacing, lip-smacking, and blinking. To minimize the risk of tardive dyskinesia, healthcare providers prescribe the lowest effective dose of medication. Patients who take Vraylar or Latuda will be monitored for various movement disorders.
• Patients who take Vraylar or Latuda will also be monitored for metabolic changes, as high blood sugar/diabetes, high cholesterol, and weight gain may occur. 
• Vraylar and Latuda can cause low white blood cell counts, and patients taking either drug will need to have their blood cell counts monitored. 
• Vraylar and Latuda can cause orthostatic hypotension (a drop in blood pressure when standing up) and fainting. Take your time when standing up. Heart rate and blood pressure may be monitored, especially in people with heart disease or certain other conditions. Because Vraylar and Latuda can cause these effects, as well as extreme drowsiness and instability, people who take these medications may be at risk for falls and fractures. People who take Vraylar or Latuda should avoid alcohol and should not drive or operate machinery until they know how the medication affects them.  
• Vraylar and Latuda should be used cautiously in people with a history of seizures.
• Vraylar and Latuda may make you more sensitive to very hot temperatures. To avoid becoming too hot or dehydrated, be sure to drink enough fluids, especially when exercising and in the heat.

Only a licensed healthcare provider can determine whether Vraylar or Latuda may be best for you.