Drug interactions
Cariprazine + Nefazodone
Severity: Major
Cariprazine and Nefazodone: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nefazodone is a strong CYP3A4 inhibitor and can markedly raise exposure to cariprazine and its active metabolites. This may lead to more akathisia, extrapyramidal symptoms, sedation and hypotension, with effects persisting after nefazodone is stopped.
What this interaction means in plain words
Cariprazine and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Inhibition of CYP3A4 reduces metabolic clearance of cariprazine and its active metabolites.
What to do
Lower the cariprazine dose according to labeling for strong CYP3A4 inhibitors and monitor for adverse effects. Consider an alternative antidepressant, and re-titrate cariprazine when nefazodone is withdrawn.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Cariprazine
Frequently asked questions
Can I take Cariprazine with Nefazodone?
MediHelp rates the interaction as major. Cariprazine and Nefazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nefazodone is a strong CYP3A4 inhibitor and can markedly raise exposure to cariprazine and its active metabolites. This may lead to more akathisia, extrapyramidal symptoms, sedation and hypotension, with effects persisting after nefazodone is stopped.
How serious is the interaction between Cariprazine and Nefazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Lower the cariprazine dose according to labeling for strong CYP3A4 inhibitors and monitor for adverse effects. Consider an alternative antidepressant, and re-titrate cariprazine when nefazodone is withdrawn.
What other medicines interact with Cariprazine?
MediHelp also lists interactions of Cariprazine with, for example, Alfentanil, Amisulpride, Amobarbital. The full list is on the Cariprazine page.
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