Cariprazine use while Breastfeeding

Summary of Use during Lactation

No information is available on the use of cariprazine during breastfeeding. Because cariprazine and its active metabolites are >90% protein bound, it is unlikely that clinically important amounts are excreted into milk. Cariprazine might decrease lactation. Until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug Levels

Cariprazine is metabolized to two major active metabolites with a half-life of 2 to 4 days. Desmethylcariprazine has a half-life of 1 to 2 days, and didesmethylcariprazine has a half-life of 1 to 3 weeks. Both are considered to be equipotent to cariprazine. The drug and metabolites are all >90% bound to plasma proteins.

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Cariprazine has little to no effect on serum prolactin levels. It is possible that cariprazine might decrease lactation like aripiprazole and benznidazole because they are pharmacologically similar, but no cases have been reported.[1]

Alternate Drugs to Consider

Haloperidol, Olanzapine, Quetiapine, Risperidone

References

1.

Naughton S, O'Hara K, Nelson J, et al. Aripiprazole, brexpiprazole, and cariprazine can affect milk supply: Advice to breastfeeding mothers. Australas Psychiatry 2023;31:201-4. [PubMed: 36825499]

Substance Name

Cariprazine

CAS Registry Number

839712-12-8

Drug Class

Breast Feeding

Lactation

Milk, Human

Antipsychotic Agents