Rexulti Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Rexulti Tablet (brexpiprazole) is an atypical antipsychotic taken by mouth, usually once a day. It is used along with an antidepressant for major depressive disorder, to treat schizophrenia, and to treat agitation associated with dementia due to Alzheimer's disease. It works by helping to balance brain chemicals involved in mood, thinking, and behavior.

What is Rexulti Tablet

Rexulti is an atypical antipsychotic medicine taken as a tablet by mouth, usually once a day, to treat certain mental health conditions.

Rexulti Tablet uses

• Used along with an antidepressant to treat major depressive disorder (MDD) in adults
• Used to treat schizophrenia in adults and children aged 13 years and older
• Used to treat agitation associated with dementia due to Alzheimer's disease
• Not approved for use as an "as-needed" treatment for agitation in Alzheimer's dementia

Benefits of Rexulti Tablet

• In studies, Rexulti led to significant improvement compared to a placebo for depression, schizophrenia, and dementia-related agitation
• Can help keep schizophrenia symptoms under control and reduce the risk of relapse with continued treatment
• Some people notice early changes after 1 to 2 weeks, with the greatest benefit usually seen later

How Rexulti Tablet works

Rexulti works by helping to balance brain chemicals called dopamine and serotonin, which affect mood, thinking, and behavior. An imbalance in these chemicals is thought to be linked to conditions like schizophrenia, depression, and dementia-related agitation.

Rexulti Tablet dosage

Take Rexulti exactly as your healthcare provider tells you to, once a day. Take it at about the same time each day so it works best and is easier to remember. It can be taken with or without food. Swallow the tablet whole with a glass of water; do not cut, crush, split, or chew unless your prescriber or pharmacist says it is safe for you. Do not change the dose or stop taking Rexulti without talking to your healthcare provider first. Do not take Rexulti as an "as-needed" treatment for agitation related to Alzheimer's dementia.

If you miss a dose, take it as soon as you remember; if it is almost time for your next dose, skip the missed dose and continue your regular schedule. Do not take a double dose to make up for a missed one.

Available forms and strengths

• Oral tablet

Side effects of Rexulti Tablet

Common

• Weight gain
• Sleepiness
• Dizziness
• Common cold symptoms
• Restlessness or feeling like you need to move (akathisia)
• Difficulty moving or slow movement, tremors, abnormal eye movements, and muscle stiffness (in children 13-17)
• Diarrhoea
• Indigestion
• Shaking

Serious

• Increased risk of death in elderly people with dementia-related psychosis, including stroke
• Increased risk of suicidal thoughts and actions, especially in people 24 and younger
• Neuroleptic malignant syndrome (high fever, stiff muscles, confusion, changes in pulse/blood pressure/heart rate/breathing, increased sweating)
• Uncontrolled body movements (tardive dyskinesia) that may not go away even after stopping the medicine
• Unusual, strong urges such as compulsive gambling, sexual urges, shopping, or binge eating
• Low white blood cell count
• Decreased blood pressure on standing (orthostatic hypotension) and fainting
• Falls that can cause fractures or other injuries
• Seizures
• Problems controlling body temperature, increasing risk of overheating
• Difficulty swallowing, which can lead to food or liquid entering the lungs
• High blood sugar (hyperglycemia) and diabetes, which can be severe
• Increased cholesterol and triglyceride levels
• Severe allergic reactions (swelling of face/lips/tongue/throat, trouble breathing, hives, rash)
• Blood clots (leg swelling, pain, redness, chest pain, difficulty breathing)

Warnings and precautions

• Rexulti can increase the risk of death in elderly people with dementia-related psychosis caused by confusion and memory loss. It is not approved for this use without agitation linked to Alzheimer's disease.
• Rexulti and antidepressant medicines may increase the risk of suicidal thoughts and actions in people 24 years of age and younger, especially early in treatment or after a dose change.
• Avoid becoming too hot or dehydrated while taking Rexulti, since it can affect your ability to control body temperature.
• Do not stop taking Rexulti or lower the dose without checking with your doctor, as your condition may worsen if you stop suddenly.
• Do not share Rexulti with anyone else, even if they have the same condition, as it may harm them.
• Rexulti may harm an unborn baby. 
• Taking it during the third trimester may cause the newborn to have unusual muscle movements or withdrawal symptoms after birth. 
• Talk with your healthcare provider about the risks before taking Rexulti while pregnant.
• It is not known if Rexulti passes into breast milk. Talk to your healthcare provider about the best way to feed your baby while taking this medicine.
• Tell your healthcare provider if you have or have had kidney problems, since your dose may need to be adjusted.
• Tell your healthcare provider if you have or have had liver problems, since your dose may need to be adjusted for moderate to severe liver disease.
• It is not known exactly how alcohol affects Rexulti, but drinking alcohol may increase the risk of drowsiness and poor coordination, and you should avoid alcohol while taking this medicine.
• Do not drive, operate machinery, or do other activities that require alertness until you know how Rexulti affects you, since it can cause drowsiness or dizziness.

Storage

• Store Rexulti tablets at room temperature between 68°F to 77°F (20°C to 25°C)
• Can be exposed to temperatures between 59°F and 86°F (15°C to 30°C) for shorter periods, such as when transporting it
• Store in a cool, dry place, away from moisture, heat, or sunlight
• Keep in the original container
• Keep out of the reach of children
• If you no longer need the medicine or it is out of date, take it to a pharmacy for safe disposal; do not use after the expiry date

When to see a doctor

• Get emergency help right away for signs of a serious allergic reaction, such as swelling of the face, lips, mouth, tongue, or throat, trouble breathing or swallowing, or widespread rash or hives.
• Call your healthcare provider or go to the nearest emergency room right away if you notice signs of neuroleptic malignant syndrome, such as high fever, stiff muscles, confusion, changes in pulse, blood pressure, heart rate or breathing, and increased sweating.
• Call your healthcare provider right away if you notice new or sudden changes in mood, behavior, thoughts, or feelings, or if you have thoughts of suicide or self-harm.
• Call your doctor right away or go to the emergency department if you notice uncontrolled movements of the tongue or face, sudden high fever with sweating and muscle stiffness, or swelling, pain, or redness in the leg, chest pain, or trouble breathing.
• If you take too much Rexulti, contact your healthcare provider or a poison control center right away, or go to the nearest hospital emergency room.

Alternatives

• Quetiapine
• Vraylar
• Aripiprazole