Can you take cariprazine while breastfeeding?
What LactMed says
The National Library of Medicine’s own summary, quoted in full. We do not write a verdict of our own on this question, and we do not compress theirs into a label.
Although amounts of cariprazine and its active metabolites in milk are relatively low, the metabolite half-lives are long. Two mothers taking cariprazine 4.5 mg daily reported lethargy and other side effects in their infant, possibly from metabolite accumulation in the infants’ bloodstreams. Cariprazine might decrease lactation. An alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Quoted from Cariprazine — Drugs and Lactation Database (LactMed®), National Institute of Child Health and Human Development, revised May 15, 2026.
What LactMed would consider instead
LactMed ends this record by naming the drugs it would consider in place of cariprazine. Whether any of them fits depends on what you are treating — this is the database’s list, not a recommendation from us.
How much cariprazine gets into breastmilk
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. Five nursing mothers who were taking cariprazine 1.5 to 4.5 mg daily collected timed milk samples at 0, 1, 2, 4, 6, 8, 10, 12, 18, and 24 hours after a dose at home. The relative infant dosages of cariprazine, desmethylcariprazine, and didesmethylcariprazine were 1.4%, 0.11%, and 1.45%, respectively for a total RID of 2.97%. When the authors normalized the RID for a dose of 3 mg daily, the total RID was 2.54%.
Infant Levels. Relevant published information was not found as of the revision date.
What has been seen in breastfed infants
Two mothers in a study who were taking cariprazine 4.5 mg daily during pregnancy and postpartum reported adverse effects in their breastfed infant. The first, who took cariprazine, buspirone and trazodone for bipolar disorder reported infant withdrawal, lethargy and low platelets, but no concern for developmental delay in her infant from 1 to 3 months postpartum. The second, who took cariprazine, levothyroxine, multivitamins, insulin lispro, and amitriptyline, reported lethargy, struggling to eat and weight faltering in her infant from 11 days to 4 weeks of age. After 2 weeks on a lowered cariprazine dose of 1.5 mg daily, the infant’s symptoms improved.
Effects on milk supply
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.
Frequently asked questions
Can you take cariprazine while breastfeeding?
Although amounts of cariprazine and its active metabolites in milk are relatively low, the metabolite half-lives are long. The full record is quoted on this page, and the decision is one to make with the person who prescribed it — LactMed itself states it is not a substitute for professional judgement.
What can I take instead of cariprazine while breastfeeding?
LactMed lists Haloperidol, Olanzapine, Quetiapine, Risperidone as alternate drugs to consider. That is the database's own list for this drug — whether any of them suits you depends on what you are treating.
Does cariprazine pass into breastmilk?
LactMed's measured drug levels for cariprazine are quoted in full on this page, under "How much gets into breastmilk".
Do I need to pump and dump after taking cariprazine?
LactMed does not frame its records that way — it reports measured drug levels in milk and what has been observed in breastfed infants, which is what this page quotes. "Pump and dump" advice for a specific drug and dose should come from your clinician or a pharmacist, not from a general rule.
More on cariprazine
LactMed states that the information it presents is not a substitute for professional judgement, and that you should consult your healthcare provider for breastfeeding advice related to your particular situation. Nothing on this page is medical advice.