Rexulti

Rexulti (brexpiprazole) is an oral medication belonging to the atypical antipsychotic class, approved by the FDA to treat major depressive disorder (as adjunctive therapy) and schizophrenia in adults. Additionally, it shows potential in managing agitation associated with dementia due to Alzheimer’s disease. Rexulti works by balancing the brain chemicals serotonin and dopamine, which are often imbalanced in these conditions. The medication comes in various strengths and is typically prescribed as a long-term treatment, with dosages adjusted based on individual response and tolerability. It’s crucial to follow a healthcare provider’s guidance when using Rexulti due to its potential side effects and specific dosage requirements.

Rexulti (brexpiprazole) is an oral antipsychotic medication used to manage several psychiatric conditions. It is approved for the treatment of major depressive disorder in adults as an adjunct to antidepressants and for treating schizophrenia. Additionally, it is used off-label for various conditions and is being studied for others, such as bipolar disorder and autism spectrum disorders. Rexulti functions by modulating the activity of brain chemicals, serotonin and dopamine, which are crucial for mood regulation. The drug binds to specific receptors in the brain, helping to correct the imbalance that contributes to the symptoms of depression and schizophrenia.

The medication is available as oral tablets in dosages ranging from 0.25 mg to 4 mg. Treatment usually starts with a low dose and is gradually adjusted based on the therapeutic response and side effects. Long-term use is common, although the dosage may be adjusted periodically by healthcare providers. Rexulti’s side effects range from mild, like weight gain and sleepiness, to severe, including an increased risk of stroke in elderly patients with dementia-related psychosis and tardive dyskinesia. It’s crucial for patients to have regular consultations with their healthcare provider to monitor the drug’s efficacy and manage any adverse effects.

Regarding cost, Rexulti can be expensive, with prices varying by insurance coverage and pharmacy location. To alleviate some of the financial burden, U.S. residents can buy Rexulti online from Canada. This approach helps manage treatment costs effectively, making it more accessible for those in need. Patients are advised to take Rexulti consistently, following the prescribed regimen to ensure optimal treatment outcomes. The medication can be taken with or without food and should be swallowed whole. Due to its potential to interact with other medications and its effect on various medical conditions, a comprehensive medical history and ongoing monitoring are essential when initiating treatment with Rexulti.

Rexulti is approved to treat various mental health conditions. Here are its primary and potential uses:

Schizophrenia

Agitation in Alzheimer’s Disease

Major Depressive Disorder in Adults

This medication is also used off-label for some conditions, such as:

• Depression with Anxiety
• Bipolar Disorder
• Autism Spectrum Disorder
• Borderline Personality Disorder (research is needed)

[Important Note: Rexulti is prescribed for managing certain types of agitation and must be taken daily. It is not designed to be used on an as-needed basis, meaning it should not be taken only during episodes of agitation.]

Forms & Strengths of Rexulti?

This drug comes in the form of oral tablets and has the following strengths:

• Rexulti tablets: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg.

What Are the Recommended Dosage for Rexulti?

Rexulti Dosage for Schizophrenia

Below is the standard dosage plan for adults with Schizophrenia:

• Starting Dosage: Treatment begins with 1 mg of Rexulti taken once daily. This dose is maintained for the first four days.
• Initial Increase: On days 5 through 7, the dosage is increased to 2 mg once daily.
• Further Increase: Starting from day 8, the dosage may be raised to 4 mg daily, which is the maximum approved dosage for treating schizophrenia with Rexulti.

Rexulti Dosage for Agitation in Alzheimer’s Disease

For managing agitation in adults with dementia related to Alzheimer’s disease. Here is how the dosage typically progresses:

• Starting Dosage: The treatment starts at 0.5 mg once daily. This dose is maintained for the first week (first 7 days).
• First Increase: From days 8 to 14, the dosage is increased to 1 mg once daily.
• Second Increase: Beginning on day 15, the dosage may be raised to 2 mg daily.
• Potential Further Increase: If further adjustment is needed based on your response and the doctor’s assessment, the dosage can be increased to a maximum of 3 mg daily. This is the highest approved dosage for treating agitation with Rexulti.

It’s important to note that Rexulti should be taken daily as part of a regular treatment plan for agitation. It is not intended to be used on an as-needed basis.

Rexulti Dosage for Depression

Rexulti is prescribed as an additional treatment for depression in adults, meaning it is used alongside other antidepressant medications, not by itself. Here’s a breakdown of the typical dosing guidelines:

• Starting Dosage: The treatment usually begins with a low dose. Common starting doses are:
  • 0.5 mg once daily
  • 1 mg once daily
• Adjustment Period: After 1 to 2 weeks, depending on how you respond to the medication, your doctor may increase the dose to 2 mg daily.
• Maximum Dosage: If needed, the dosage can be further increased to a maximum of 3 mg daily, which is the highest approved dosage for treating depression with Rexulti.
• Dosage Adjustment: If you experience better results with a lower dose, such as 1 mg daily compared to 2 mg, your doctor might reduce the dose back to 1 mg.

Rexulti Dosage for Agitation in Alzheimer’s Disease

For managing agitation in adults with dementia related to Alzheimer’s disease. Here is how the dosage typically progresses:

• Starting Dosage: The treatment starts at 0.5 mg once daily. This dose is maintained for the first week (first 7 days).
• First Increase: From days 8 to 14, the dosage is increased to 1 mg once daily.
• Second Increase: Beginning on day 15, the dosage may be raised to 2 mg daily.
• Potential Further Increase: If further adjustment is needed based on your response and the doctor’s assessment, the dosage can be increased to a maximum of 3 mg daily. This is the highest approved dosage for treating agitation with Rexulti.

It’s important to note that Rexulti should be taken daily as part of a regular treatment plan for agitation. It is not intended to be used on an as-needed basis.

Rexulti Dosage for Children with Schizophrenia

It can be prescribed for children 13 years or older to help manage schizophrenia. Below is the typical dosage schedule for pediatric patients:

• Starting Dosage: The initial dose is 0.5 mg, and it is taken once daily. This dosage is continued for the first four days of treatment.
• First Increase: From days 5 to 7, the dosage is increased to 1 mg once daily.
• Second Increase: On day 8 of treatment, the dosage is typically raised to 2 mg daily.
• Further Adjustments: If necessary, the dosage can be further increased by 1 mg per week, up to a maximum of 4 mg once daily.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

• Always take Rexulti exactly as prescribed by your doctor or healthcare professional.
• Rexulti is available in the form of oral tablets.
• Take one tablet by mouth every day.
• There is no specific recommended time to take Rexulti, so you can take it at any time that suits you during the day unless directed otherwise by your doctor.
• To ensure you do not forget a dose, consider setting a reminder on your phone or using a medication timer.
• You can take Rexulti either with food or on an empty stomach.
• Do not break, crush, or chew the tablets; they should be swallowed whole.
• If you find it hard to swallow pills, ask your doctor or pharmacist for advice on how to make it easier.
• Rexulti is typically intended for long-term treatment. If it is effective and safe for you, you will likely be taking it over an extended period.
• The amount of Rexulti prescribed by your doctor will be based on various factors. These factors include:
  • Your age
  • The type and severity of the condition you are treating with Rexulti
  • Any other medications you are currently taking
  • How well your body processes (metabolizes) certain drugs
  • Any other health conditions you might have
• Initially, your doctor will likely start you on a low dose of Rexulti. They will then gradually adjust this dose to find the level that works best for you. The goal is to determine the lowest possible dose that still effectively manages your symptoms.
• The appropriate dosage of Rexulti for you will depend on all these factors and how you respond to the treatment.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Rexulti, containing the active ingredient brexpiprazole, is part of a category of medications known as atypical antipsychotics. It works by binding to specific receptors in the brain that are sensitive to the neurotransmitters serotonin and dopamine. These neurotransmitters play critical roles in regulating mood and are often imbalanced in individuals with certain psychiatric conditions.

By interacting with these receptors, Rexulti helps to balance the levels of serotonin and dopamine in the brain, which can alleviate symptoms of depression, schizophrenia, and agitation related to Alzheimer’s disease. The effectiveness and how quickly Rexulti works can vary depending on the individual and the severity of the condition being treated. Typically, Rexulti remains in the body for about 18 to 19 days, which is slightly under three weeks. This duration influences how the medication moderates brain chemistry over time.

Rexulti, like any medication, can lead to side effects that range from mild to severe. The following includes some of the more common side effects, but this list is not exhaustive. For a complete understanding of potential side effects, consult with your doctor or pharmacist. While many side effects from medications may resolve on their own within a few days to weeks, it’s important to contact your healthcare provider if they persist or become troublesome. Reported Rexulti mild side effects include:

• Constipation
• Nasopharyngitis (the common cold)
• Headache
• Strange dreams or insomnia (trouble sleeping)
• Tiredness
• Akathisia (feeling restless)
• Weight gain
• Sleepiness

While serious side effects from Rexulti are not common, they can occur and require immediate medical attention. If you experience any severe side effects while taking Rexulti, it is crucial to contact your doctor immediately. For emergencies, such as symptoms of a serious condition like Neuroleptic Malignant Syndrome (NMS), you should call 911 or your local emergency number right away. Serious side effects of Rexulti may include

• Orthostatic Hypotension: This is a decrease in blood pressure that occurs when standing up from sitting or lying down, potentially causing falls.
• Neuroleptic Malignant Syndrome: A serious condition resulting from blocked dopamine activity, commonly linked with certain medications.
• Stroke: This condition tends to occur more frequently in older adults who are using the medication.
• Tardive Dyskinesia: Characterized by uncontrolled body movements, often a side effect of medications.
• High Blood Sugar Levels: Monitoring is necessary as this can be a side effect.
• Low White Blood Cell Count: This can increase susceptibility to infections.
• Seizures: An increased risk of seizures can be a side effect for some individuals.
• Difficulty Swallowing: This can occur due to muscle spasms in the neck.
• Regulation of Body Temperature: Some individuals may have trouble maintaining normal body temperature.
• Slowed Thinking or Reflexes: This may impair the ability to drive or operate heavy machinery safely.
• Increased Cholesterol or Triglyceride Levels: These changes often do not show symptoms but can be a risk factor for other health issues.
• Allergic Reactions: Symptoms can range from mild to severe and require immediate attention.
• Changes in Sex Drive or Other Urges: This includes increases in compulsive behaviors.
• Increased Risk of Death in Older Adults: Particularly those with dementia-related psychosis.
• Suicidal Thoughts or Behaviors: Notably in children and younger adults, which must be monitored closely.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

FDA Boxed Warning

This medication includes boxed warnings, the most stringent alerts issued by the Food and Drug Administration (FDA). These warnings are designed to inform doctors and patients about potential serious risks associated with the drug. The boxed warnings for Rexulti are as follows:

• Risk of Death in Certain Older Adults: Rexulti is not recommended for older adults aged 65 and above who suffer from dementia-related psychosis (a condition where one may lose touch with reality, experiencing hallucinations or delusions). The use of Rexulti in these patients is linked to an increased risk of death. However, it may be prescribed to older adults with dementia-related psychosis specifically for managing symptoms of agitation due to Alzheimer’s disease.
• Risk of Suicidal Thoughts and Behaviors in Certain Individuals: Like other antidepressants, Rexulti may increase the risk of suicidal thoughts and behaviors in children and young adults up to 24 years old. If you are in this age group and taking Rexulti, your doctor will monitor you closely, especially when starting the medication or adjusting your dose. It is crucial to seek immediate medical assistance if you have thoughts of suicide or engage in self-harm. In certain cases, your doctor may recommend discontinuing Rexulti.

Before beginning treatment with Rexulti, it’s important to share your medical history with your doctor to determine if Rexulti is appropriate for you, given your health conditions and other factors. Consider the following precautions:

• Allergic Reactions: Do not use Rexulti if you have previously experienced an allergic reaction to it or any of its components. Talk to your doctor about alternative treatments that might be safer for you. If you’re not sure about your medication allergies, discuss them with your doctor.
• Liver Health: If you have a history of liver problems or liver damage, consult with your doctor before taking Rexulti. Your doctor may need to modify your dose to ensure the medication is safe for you.
• Challenges with Drug Metabolism: Due to genetic factors, some individuals have difficulty metabolizing certain medications. This can cause drugs to not break down properly, potentially accumulating in the body and causing dangerous side effects. It’s important to discuss with your doctor whether you have issues metabolizing certain drugs. If this is the case, your doctor may lower your dose of Rexulti to ensure it is safe for you.
• Kidney Health Concerns: If you have experienced kidney damage or have kidney-related health issues, consult your doctor before starting Rexulti. Your doctor may need to adjust your dosage to ensure the medication is safe for you to use.
• Hyperlipidemia: If you suffer from hyperlipidemia (elevated cholesterol or triglycerides), taking Rexulti could further increase your lipid levels. It’s important to discuss your current lipid levels with your doctor before you begin treatment with Rexulti.
• Low White Blood Cell Count: Rexulti has the potential to reduce white blood cell counts. If you already have low white blood cell counts, you may be at an increased risk for this side effect. Your doctor might conduct blood tests before starting you on Rexulti to monitor your blood cell levels. Discuss with your doctor whether regular checks of your blood cell levels are necessary.
• History of Compulsive Behaviors: Rexulti may intensify certain compulsive urges, such as gambling, increased sexual desires, binge eating, and compulsive shopping. If you have a history of compulsive behaviors or any addictions, it’s crucial to discuss these with your doctor before beginning Rexulti treatment.
• Difficulty Regulating Body Temperature: Rexulti may affect your body’s ability to regulate its temperature. If you have any health conditions that make it difficult to maintain a stable body temperature, inform your doctor before starting treatment with Rexulti.
• Epilepsy or Seizure Disorders: Rexulti may increase your risk of experiencing seizures, particularly if you have a history of epilepsy or have had seizures in the past. It’s important to discuss any history of seizures with your doctor before you begin treatment with Rexulti.
• Blood Pressure and Heart Conditions: Rexulti can cause a drop in blood pressure when you stand up or sit up quickly, leading to dizziness or even fainting. If you have low blood pressure, heart disease, or issues with your heart’s electrical pathways, ensure you discuss these conditions with your doctor before starting Rexulti. Your doctor may provide recommendations on managing your blood pressure effectively while on this medication.
• Falls: Rexulti may affect your blood pressure, potentially causing dizziness and increasing the risk of falls. If you are already prone to falling, taking Rexulti might heighten this risk. Discuss your fall risk with your doctor before starting Rexulti to ensure proper precautions are taken.
• Diabetes: Rexulti has the potential to raise blood sugar levels. If you have diabetes and are prescribed Rexulti, you may experience elevated blood sugar levels, which can sometimes lead to serious conditions such as diabetic ketoacidosis (DKA), diabetic coma, and, in rare instances, death. If you have diabetes, it is crucial to speak with your doctor about monitoring your blood sugar levels while on Rexulti.
• Driving or Operating Heavy Machinery: Rexulti may cause sleepiness, delayed thinking, and slow reflexes, which could impair your ability to drive or operate heavy machinery safely. If you frequently drive or use heavy equipment, be vigilant for these side effects. Should you experience any, it’s important to contact your doctor immediately.
• Rexulti and Pregnancy: The safety of Rexulti during pregnancy has not been established due to a lack of specific studies on pregnant individuals taking the medication. However, there have been instances where similar drugs were taken during the third trimester of pregnancy, leading to side effects or withdrawal symptoms in newborns. If you are pregnant or planning to become pregnant, discuss with your doctor the risks and benefits of taking Rexulti. They can advise whether it is safe for you to continue or start this medication.
• Rexulti and Birth Control: The safety of Rexulti during pregnancy is not established. If you are sexually active and there is a possibility of pregnancy, it is important to discuss your birth control options with your doctor while you are using Rexulti.
• Rexulti and Breastfeeding: The safety of Rexulti during breastfeeding has also not been confirmed. Studies in animals have shown that brexpiprazole (the active ingredient in Rexulti) can pass into breast milk. However, animal studies do not always reflect human outcomes. The effects of Rexulti on a breastfed child are not known. If you are breastfeeding or planning to breastfeed, consult your doctor. They will help determine whether it is safe for you to continue or start taking Rexulti.

• If you forget to take a dose of Rexulti, take it as soon as you remember.
• However, if it’s nearly time for your next scheduled dose, skip the missed dose.
• Continue with your next dose at its regular time.
• Do not take two doses at once to make up for the missed one.
• Consider setting a reminder on your phone or using a medication timer to help ensure you don’t miss a dose in the future.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Taking more Rexulti than prescribed by your doctor can lead to serious consequences, including unwanted side effects or an overdose. If you suspect that you’ve taken too much Rexulti, it’s crucial to seek immediate medical attention. Contact your doctor or call the American Poison Centers at 800-222-1222 for guidance. If you’re experiencing severe symptoms from a possible overdose, such as extreme drowsiness, confusion, or agitation, call 911 or head to the nearest emergency room right away. Always follow your healthcare provider’s instructions to avoid the risks associated with exceeding the recommended dosage.

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

• Keep Rexulti tablets at room temperature, ideally between 68–77°F (20–25°C).
• Store them in a tightly sealed container to protect them from moisture and light.
• Do not store the medication in damp or wet areas, such as bathrooms, to prevent damage.
• When traveling, it is acceptable to store Rexulti tablets in temperatures ranging from 59–86°F (15–30°C) for short periods.
• If you have leftover Rexulti that you no longer need, ensure it is disposed of safely.
• Proper disposal helps prevent accidental ingestion by children, pets, and others.
• It also reduces the risk of environmental harm.
• Check with your pharmacist or local waste disposal guidelines on how to properly dispose of medications.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Rexulti can interact with a variety of other medications, each interaction potentially causing different effects. Some of these interactions may hinder the effectiveness of the drug, while others could intensify side effects or make them more severe. It’s important to discuss all your current medications with your doctor to ensure Rexulti is safe to use in combination with them.

Rexulti and Other Medications

Rexulti is metabolized in your body by specific enzymes that also process other medications. Taking Rexulti alongside certain drugs can overload these enzymes, preventing them from fully breaking down both Rexulti and the different medications. Below, we provide more detailed information about these potential interactions.

• Rexulti and Drugs That Decrease the Level of Rexulti in Your Body: Certain medications can lower the levels of Rexulti in your body. If you are taking any of these drugs along with Rexulti, your doctor might increase your dose of Rexulti to ensure it remains effective for treating your condition. Here are examples of medicines that may decrease your Rexulti levels:
  • Seizure Medications:
    • Trileptal (oxcarbazepine)
    • Dilantin (phenytoin)
    • Tegretol (carbamazepine)
    • Phenobarbital (phenobarbital)
  • Other Medications:
    • Provigil (modafinil, used to treat narcolepsy)
    • Sustiva (efavirenz, used to treat HIV)
• Rexulti and Drugs That Increase the Level of Rexulti in Your Body: Some medications can raise the level of Rexulti in your body. If you are taking any of these medications along with Rexulti, your doctor might reduce your Rexulti dosage to maintain safe levels in your system. Here are examples of drugs that may increase your Rexulti levels:
  • Mood Disorder Medications:
    • Prozac (fluoxetine)
    • Paxil (paroxetine)
    • Wellbutrin SR, Wellbutrin XL (bupropion)
  • Antifungal Medications:
    • Sporanox (itraconazole)
    • Ketoconazole (ketoconazole)
  • Antibacterial Medications:
    • Clarithromycin
  • Antiviral Medications:
    • Norvir (ritonavir)
  • Other Medications:
    • Sensipar (cinacalcet, used to lower calcium levels)
    • Quinidine (used to treat irregular heart rhythms)

What Are the Other Rexulti Interactions?

Before starting Rexulti, it is important to discuss with your doctor and pharmacist all the medications you are currently taking. This includes any vitamins, herbs, or supplements. If you have any concerns or questions about how other drugs might interact with Rexulti, be sure to ask your doctor or pharmacist for more information. This conversation can help you avoid adverse interactions and ensure the safe usage of your medications.

Rexulti and Herbs and Supplements

Rexulti may interact with certain herbs and supplements. It’s important to inform your doctor about all the herbs and supplements you are using before you start taking Rexulti. Below is an example of one such interaction, but there could be others.

• Rexulti and St. John’s wort: St. John’s wort is an herbal supplement often used for managing mood disorders such as depression. This herb affects an enzyme in your body that is involved in metabolizing some medications. Because of this interaction, St. John’s wort may decrease the effectiveness of Rexulti by reducing its levels in your body. If you are taking St. John’s wort, discuss with your doctor whether you should continue using it. Depending on your situation, your doctor might adjust your Rexulti dosage while you are taking St. John’s wort.

Rexulti and Foods

Rexulti may interact with certain foods and beverages, so it’s important to be aware of these potential interactions:

• Rexulti Can Interact with Grapefruit: Consuming grapefruit or grapefruit-containing products while taking Rexulti can interfere with how your body metabolizes the medication. This interference can lead to an accumulation of Rexulti in your system, potentially increasing the risk of experiencing side effects. If you have any questions about the compatibility of certain foods with Rexulti, be sure to discuss them with your doctor.
• Rexulti and Alcohol: The safety of consuming alcohol while on Rexulti is not well-established. However, it is important to consider that excessive alcohol consumption can lead to liver damage. Since Rexulti is processed by the liver, any existing liver damage could cause the drug to accumulate in your body, heightening the risk of side effects. If you consume alcohol and are prescribed Rexulti, discuss with your doctor whether it is safe for you to drink alcohol during your treatment.

[Note: This isn’t a complete list, and there could be other drugs that interact with Rexulti. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

There are various medications available that can effectively manage your condition. Depending on your specific needs and health status, some of these alternatives might be more suitable for you than Rexulti. If you are interested in exploring alternatives to Rexulti, it’s important to have a discussion with your doctor. They can provide information on other medications that might be appropriate for your treatment.

Alternatives for Adjunctive Treatment of Depression

Here are some examples of medications that can be used as an adjunctive treatment for depression, similar to how Rexulti might be used:

• Vraylar (cariprazine)
• Cymbalta (duloxetine)
• Trintellix (vortioxetine)
• Wellbutrin SR, Wellbutrin XL (bupropion)
• Latuda (lurasidone)
• Seroquel, Seroquel XR (quetiapine)
• Remeron (mirtazapine)
• Zyprexa (olanzapine)
• Abilify (aripiprazole)
• Lithobid (lithium)
• Trazodone (trazodone)

Alternatives for Schizophrenia

Here are some commonly used medications for the treatment of schizophrenia:

• Saphris (asenapine)
• Invega (paliperidone)
• Clozaril (clozapine)
• Latuda (lurasidone)
• Seroquel, Seroquel XR (quetiapine)
• Haldol (haloperidol)
• Risperdal (risperidone)
• Abilify (aripiprazole)
• Geodon (ziprasidone)
• Fanapt (iloperidone)
• Chlorpromazine (chlorpromazine)
• Perphenazine (perphenazine)

[Note: Depending on the specific case, the most suitable alternatives will vary, and your doctor can provide detailed guidance based on your health profile.]

The cost of Rexulti can vary significantly depending on your insurance coverage for prescription medications. However, it’s worth noting that not all insurance plans offer coverage for Rexulti. To help manage the costs of Rexulti, many individuals explore alternative purchasing options. One such option is to buy Rexulti online from Canada, where it may be available at a lower price. Purchasing Rexulti from Canadian pharmacies can be a cost-effective solution, especially for those living in the USA. At Polar Bear Meds, a popular choice for buying medications from Canada, you can use the Rexulti coupon code WELCOMEPB10 to get a 10% discount on your first purchase. Looking for more perks? Join our referral program and receive a free coupon for your next purchase!

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