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Brexpiprazole Medication: Uses, Dosage, Side Effects & Benefits
Summary of Key Points
Brexpiprazole is a prescription medication used to manage mental health conditions such as schizophrenia and major depressive disorder. It works by helping to balance certain brain chemicals, which can improve mood, thinking, and behavior. While most people tolerate Brexpiprazole well, it may cause side effects. Always consult your healthcare provider before starting or adjusting your dosage. You can also schedule a telemedicine appointment with one of our providers for personalized care.
Names of Medication
US Brand Name: Rexulti
Generic Name: Brexpiprazole
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. The generic name is often listed in parentheses.
Pharmacologic Category
Brexpiprazole belongs to a class of medications known as atypical antipsychotics.
Other medications in this category include aripiprazole (Abilify), risperidone (Risperdal), and quetiapine (Seroquel).
Brexpiprazole Dosage
Brexpiprazole is prescribed for various mental health conditions, and the dosage will vary depending on the condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. If you need guidance, you can schedule a telemedicine consultation with one of our providers.
Brexpiprazole for Schizophrenia (Adults)
Starting dose: 1 mg once daily
Maintenance dose: 2-4 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Major Depressive Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily, as an adjunct to antidepressants
Maintenance dose: 2 mg once daily
Maximum dose: 3 mg per day
Brexpiprazole for Generalized Anxiety Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Bipolar Disorder (Adults)
Starting dose: 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Obsessive-Compulsive Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Post-Traumatic Stress Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Autism Spectrum Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Attention-Deficit Hyperactivity Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Insomnia (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Brexpiprazole for Social Anxiety Disorder (Adults)
Starting dose: 0.5 mg to 1 mg once daily
Maintenance dose: 2-3 mg once daily
Maximum dose: 4 mg per day
Dosage Forms and Strengths
Brexpiprazole is available in the following tablet strengths:
- 0.25 mg
- 0.5 mg
- 1 mg
- 2 mg
- 3 mg
- 4 mg
Contraindications for Brexpiprazole
A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. If you have any of the following conditions, you should avoid taking Brexpiprazole or discuss it with your healthcare provider first.
Allergic reaction to Brexpiprazole or its ingredients: If you have previously experienced an allergic reaction to Brexpiprazole, taking it again could lead to serious symptoms such as rash, swelling, or difficulty breathing.
Severe liver or kidney disease: Brexpiprazole is processed by the liver and kidneys. If these organs are not functioning properly, the medication may accumulate in your system, increasing the risk of side effects.
History of seizures: Brexpiprazole may lower the seizure threshold, making seizures more likely if you have a history of epilepsy or other seizure disorders.
Heart conditions: Brexpiprazole can cause changes in heart rhythm (QT prolongation), which may be dangerous for individuals with pre-existing heart conditions such as arrhythmias.
Diabetes or high blood sugar: Brexpiprazole may raise blood sugar levels, which can be problematic for people with diabetes or those at risk of developing it.
Brexpiprazole Drug Interactions
Brexpiprazole can interact with other medications, potentially increasing side effects or reducing the effectiveness of either drug. Always inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Some common medications that may interact with Brexpiprazole include:
Fluoxetine (Prozac): This antidepressant may increase Brexpiprazole levels in your body, raising the risk of side effects.
Carbamazepine (Tegretol): This anti-seizure medication can reduce Brexpiprazole’s effectiveness by speeding up its metabolism.
Quinidine (Quinidex): This heart medication may increase the risk of heart rhythm problems when taken with Brexpiprazole.
Ketoconazole (Nizoral): This antifungal medication can raise Brexpiprazole levels, increasing the likelihood of side effects.
Rifampin (Rifadin): This antibiotic may reduce Brexpiprazole’s effectiveness by accelerating its breakdown in the liver.
Brexpiprazole in Pregnancy
Is it safe to take Brexpiprazole during pregnancy? The safety of Brexpiprazole during pregnancy has not been fully established. While animal studies have shown some potential risks, there is limited data on its effects in pregnant women. As a result, Brexpiprazole should only be used during pregnancy if the potential benefits clearly outweigh the risks. If you are pregnant or planning to become pregnant, it’s important to discuss this with your healthcare provider. They can help you carefully weigh the risks and benefits and determine the most appropriate treatment plan for your situation.
Brexpiprazole While Breastfeeding
Is it safe to take Brexpiprazole while breastfeeding? It is currently unclear whether Brexpiprazole passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is generally recommended to avoid breastfeeding while taking Brexpiprazole. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to discuss the risks and explore possible alternative treatments.
Estimated Cost of Brexpiprazole Medication
The estimated cost of a 30-day supply of Brexpiprazole (Rexulti) without insurance typically ranges from $1,000 to $1,500. However, using a GoodRx coupon, the price may be reduced to around $900 for a 30-day supply. Prices can vary depending on the pharmacy and location, so it’s a good idea to compare prices using services like GoodRx. If you’re concerned about the cost of Brexpiprazole and insurance coverage, check with your insurance provider to explore potential savings options.
Possible Alternatives to Brexpiprazole
If Brexpiprazole isn’t the right fit for you, there are other treatment options available. Below are some alternatives for the conditions Brexpiprazole is commonly prescribed for. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options.
Schizophrenia
Other antipsychotic medications, such as Aripiprazole (Abilify) or Risperidone (Risperdal), may be effective alternatives. Additionally, lifestyle changes like reducing stress and improving sleep hygiene can help manage symptoms. If you’re considering Brexpiprazole for schizophrenia, talk to your doctor about these alternatives.
Major Depressive Disorder
Antidepressants like Sertraline (Zoloft) or therapies such as Cognitive Behavioral Therapy (CBT) can be effective alternatives. Regular exercise and mindfulness practices may also improve mood. If you’re using Brexpiprazole for depression, these options may complement or replace your current treatment.
Generalized Anxiety Disorder
Medications like Escitalopram (Lexapro) or Buspirone (Buspar) are potential alternatives. Additionally, relaxation techniques such as yoga or meditation can help reduce anxiety.
Bipolar Disorder
Mood stabilizers like Lithium or Valproate (Depakote) are commonly used to manage bipolar disorder. Maintaining a regular sleep schedule and avoiding alcohol can also help control symptoms.
Obsessive-Compulsive Disorder
Selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine (Prozac) or behavioral therapies may be effective. Exposure and response prevention (ERP) therapy is another option that can help manage symptoms.
Post-Traumatic Stress Disorder
Medications like Sertraline (Zoloft) or Prazosin (Minipress) for nightmares may be helpful. Trauma-focused therapy is also a key component of treatment for post-traumatic stress disorder.
Autism Spectrum Disorder
Behavioral therapies and support services are typically the first line of treatment for autism spectrum disorder. Medications like Risperidone (Risperdal) may help manage symptoms such as irritability or aggression.
Attention-Deficit Hyperactivity Disorder
Stimulants like Methylphenidate (Ritalin) or non-stimulants like Atomoxetine (Strattera) are common treatments for ADHD. Behavioral therapy and structured routines can also be beneficial in managing symptoms.
Insomnia
Medications like Zolpidem (Ambien) or lifestyle changes, such as improving sleep hygiene, reducing caffeine intake, and establishing a consistent bedtime routine, may help improve sleep quality.
Social Anxiety Disorder
SSRIs like Paroxetine (Paxil) or therapy options such as Cognitive Behavioral Therapy (CBT) can be effective in treating social anxiety disorder. Gradual exposure to social situations may also help reduce anxiety over time.
Recent Updates on Brexpiprazole Research
Recent studies have explored expanding the use of Brexpiprazole beyond schizophrenia and major depressive disorder. Ongoing research is investigating its potential benefits for treating agitation in patients with Alzheimer’s disease and managing symptoms of borderline personality disorder. Early findings suggest that Brexpiprazole may help reduce irritability and aggression in these populations, but further research is needed to confirm these results. Always consult your healthcare provider before considering any new treatment options.
