Reagila

Reagila is the brand name for cariprazine, a second-generation antipsychotic (SGA) used to treat schizophrenia and bipolar I disorder. In the United States, cariprazine is marketed as Vraylar; in the European Union and other markets, the brand name is Reagila. The drug acts as a partial agonist at dopamine D2 and D3 receptors, with a higher affinity for D3 receptors, and also exhibits activity at serotonin receptors, acting as a partial agonist at 5-HT1A and antagonizing 5-HT2A receptors. This receptor profile aims to provide antipsychotic efficacy with a potentially lower risk of metabolic side effects compared with some other SGAs. Cariprazine has two active metabolites, DCAR and DDCAR, which contribute to its therapeutic effects and extend its pharmacological activity after dosing.

Indications include schizophrenia and episodes of mania in bipolar I disorder, with some markets also approving treatment of bipolar depression. Dosing typically starts at 1.5 mg once daily, with gradual increases to 3, 4.5, and up to 6 mg daily based on response and tolerability. Dosing may be adjusted for hepatic impairment and when co-administered with potent CYP3A inhibitors or inducers, since the drug is metabolized primarily by CYP3A4 and to a lesser extent by CYP2D6.

Common adverse effects include akathisia (restlessness), insomnia, headache, nausea, and weight changes. As with other SGAs, cariprazine carries a risk of extrapyramidal symptoms and metabolic effects, though the incidence varies among individuals. Reagila is typically taken orally once daily, with or without food, and may require several days to weeks to reach full therapeutic effect due to its long-acting metabolites.