Precursor to metabolite: Desmethylcariprazine to Didesmethylcariprazine

Desmethylcariprazine is converted to Didesmethylcariprazine by CYP3A4.

The pair

Desmethylcariprazine — Cariprazine metabolite with the same D3-preferring partial agonism as the parent.
Didesmethylcariprazine — Cariprazine's long-lived second metabolite — the reason steady state takes weeks and washout takes longer.

Anything that inhibits or induces CYP3A4 shifts the balance between Desmethylcariprazine and Didesmethylcariprazine.