Rexulti (Brexpiprazole)

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Rexulti (Brexpiprazole) Medication Information

Uses

Rexulti (brexpiprazole) is a prescription medication used to treat the following mental health disorders in adults:

• Major depressive disorder (MDD, commonly known as depression) 
• Schizophrenia

MDD is a common but serious mood disorder that affects how you think, feel, and handle daily activities.  If you experience at least two weeks of some of the following symptoms, you may have depression:  

• Persistent sad or anxious mood
• Feelings of hopelessness, guilt, or worthlessness
• Loss of interest in activities once enjoyed
• Decreased energy levels or irritability
• Moving or talking slowly
• Trouble with concentration, memory, or making decisions
• Difficulty sleeping or oversleeping
• Changes in appetite
• Weight loss or gain
• Thoughts of death or suicide

Not everyone with depression experiences every symptom listed.  If you think you have depression, speak with your healthcare provider about treatment options such as Rexulti.  Rexulti (brexpiprazole) may be used along with other antidepressant medications and therapy.

Rexulti is also used to treat schizophrenia, a serious mental disorder that affects how a person thinks, feels, and behaves.  People with schizophrenia may show an altered sense of reality, abnormal thinking, and unusual behaviors.  They may experience the world differently, which is often distressing to their friends and family. Medications such as Rexulti (brexpiprazole) may reduce the severity of schizophrenia symptoms.

Dosage

Rexulti is an oral tablet that comes in several strengths: 

• 0.25 milligrams (mg)
• 0.5 mg
• 1 mg
• 2 mg
• 3 mg
• 4 mg

Rexulti is usually prescribed once daily.  Be sure to take Rexulti according to your healthcare provider’s directions.

Precautions

Rexulti may not be safe for everyone.  Be sure to discuss your past and current health conditions with your doctor. If you have any of the following conditions, they may still want you to take Rexulti if they feel that the benefits of this medication outweigh your risks, but they’ll likely monitor you more carefully.

• Dementia
• High cholesterol levels 
• High blood sugar 
• Seizures
• Low levels of white blood cells
• Low or high blood pressure
• Heart problems or past stroke 
• Pregnant or plans to become pregnant
• Breastfeeding or plans to breastfeed

Side Effects

Like all medications, Rexulti may cause side effects.  The most common side effects of Rexulti are mild, but severe side effects are also possible.

Common side effects may include:

• Weight gain
• Uncontrolled movements, such as fidgeting or rocking
• Restlessness (a frequent urge to move around)

Notify your doctor immediately if you experience the following symptoms of a rare but severe reaction called Neuroleptic Malignant Syndrome. These may include:

• High fever 
• Stiff muscles 
• Confusion 
• Sweating
• Fast pulse or blood pressure

For more information about the side effects of Rexulti, talk to your doctor or pharmacist.

Interactions

Some potential drug interactions might cause harmful effects with Rexulti.  A few examples include:

• Clarithromycin
• Fluoxetine
• Ketoconazole
• Paroxetine
• St. John’s Wort, an herb
• Rifampin

Talk to your doctor or pharmacist before taking any medications (including prescription and over-the-counter products) or herbal supplements with Rexulti.

Storage

Store Rexulti at room temperature between 68°F and 77°F (20°C and 25°C).

Pharmacists Tips

• If you miss a dose of Rexulti, take it as soon as possible.  If it is almost time for your next dose, skip the missed dose.  Do not take two doses of Rexulti at the same time.  
• Take Rexulti exactly as prescribed by your doctor.  Do not change your dose or stop taking this medication without first talking to your doctor.

Rexulti FAQs

What should I avoid while taking Rexulti?

Avoid driving or operating heavy machinery until you know how Rexulti affects you.  Rexulti may make you feel sleepy.  You should also take precautions so that you don’t become dehydrated or overheated while taking Rexulti.  Do not over-exercise, limit your time in hot or humid conditions, and drink plenty of fluids.

Is it true that Rexulti can cause unusual behaviors, and what can I do if I experience them?

Some people taking Rexulti have had unusual compulsive behaviors, such as gambling, binge eating, impulsive spending, and sexual urges. If you or your family members notice that you have unusual urges or actions, talk to your doctor.  They may advise you to change your dose or stop taking Rexulti.

Can Rexulti make me have suicidal thoughts?

Both antidepressant medications and mental illnesses can cause suicidal thoughts or actions.  Suicidal thoughts are considered a rare side effect of Rexulti but are more likely at the start of treatment or after your dose has been changed. Pay close attention to any sudden changes in your mood, behaviors, or thoughts. Call your doctor right away if this occurs.  

Related Drugs

• Abilify
• Invega
• Latuda
• Risperdal
• Seroquel 
• Zyprexa 

References:

1. Rexulti Prescribing Information.  Rockville, MD.  Otsuka America Pharmaceutical, Inc.; 2020. https://otsuka-us.com/sites/g/files/qhldwo2286/files/media/Rexulti-PI.pdf, Accessed February 14, 2021.
2. National Institute of Mental Health. Depression; 2018. https://www.nimh.nih.gov/health/topics/depression/index.shtml, Accessed February 14, 2021. 
3. National Institute of Mental Health. Schizophrenia; 2020. https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml, Accessed February 14, 2021.