Rexulti tablets for mental health conditions: Essentials

What is Rexulti?

Rexulti (“reks-UL-tee”) is a brand-name oral tablet prescribed for certain mental health conditions. The active ingredient in Rexulti is brexpiprazole, which belongs to a class of drugs called atypical antipsychotics.

Rexulti is manufactured by Otsuka Pharmaceutical Company (Tokyo, Japan) and distributed by Otsuka America Pharmaceutical, Inc.

What is Rexulti used for?

Rexulti is approved by the Food and Drug Administration (FDA) for use to treat the following conditions:

• depression (also called major depressive disorder, or MDD) in adults
• agitation related to dementia in adults with Alzheimer’s disease
• schizophrenia in adults and children ages 13 years and older

When used to treat depression, Rexulti is prescribed as an “add-on” medicine for adults who are currently taking an antidepressant medication but still have unresolved depression symptoms. This is called adjunctive therapy.

What exactly does Rexulti do?

Though Rexulti’s mechanism of action (how it works) is not fully understood, it is believed to improve symptoms by controlling and stabilizing levels of serotonin and dopamine in the brain.

How much Rexulti should you take?

The Rexulti dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking Rexulti to treat
• your age
• other medications you may take
• other medical conditions you may have, including your body’s ability to break down Rexulti

Rexulti side effects

Rexulti can cause mild or serious side effects, and adverse effects can vary based on the condition you are taking Rexulti for and other factors.

The most common side effects reported in clinical trials of Rexulti included:

• weight gain
• sleepiness
• dizziness
• common cold symptoms
• akathisia (restlessness or feeling like you need to move)

Rexulti interactions

Rexulti can interact with several other medications, including certain antibiotics, antidepressants, opioids, and blood pressure medications. It can also interact with certain dietary supplements and foods.

Before taking Rexulti, talk with your doctor and tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. This can help prevent potentially dangerous interactions with Rexulti.

How much does Rexulti cost? 

The cost and price you pay for Rexulti depends on several factors, including whether or not you have health insurance (and whether Rexulti is covered by your plan), your location, and the pharmacy you use.

Also, you may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.

Frequently asked questions about Rexulti

Rexulti warnings and precautions

Boxed warnings

This drug has the following boxed warnings. A boxed warning is the most serious warning required by the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death in certain older adults

Treatment with Rexulti may increase the risk of death in adults ages 65 years and older who have dementia-related psychosis. Dementia is a condition that can affect memory, thinking, and communication. Psychosis is a mental health condition that may cause confusion, hallucinations, or a loss of touch with reality.

This risk was not specifically reported in clinical trials of Rexulti. However, antipsychotic medications like Rexulti are thought to increase this risk.

Due to this risk, doctors typically recommend other treatments for older adults with dementia-related psychosis.

Risk of suicidal thoughts or actions in certain people

Use of Rexulti may increase the risk of suicidal thoughts or actions in people ages 24 years and younger.

This risk was not specifically reported in clinical trials of Rexulti. However, this warning is based on studies of other medications used to treat depression.

During treatment, your doctor will likely monitor you for changes in mood or behavior. They may also ask you, your family, or close friends to watch for warning signs. These may include feeling more agitated or irritable or having thoughts of self-harm or death.

If you have questions about this risk or notice changes in your mental health, talk with your doctor right away.

Precautions before you start Rexulti

Before taking Rexulti, discuss your health history with your doctor. Rexulti may not be right for you if you have certain medical conditions or other factors affecting your health.

Be sure to talk with your doctor if any of the following apply to you:

• liver or kidney problems
• high cholesterol or triglyceride levels
• high blood sugar or diabetes
• seizures
• stroke or cerebrovascular disease
• blood pressure or heart problems
• previous allergic reaction to this or a similar drug
• pregnancy and breastfeeding

Summary

Rexulti (brexpiprazole) is a brand-name atypical antipsychotic medication used to treat several mental health conditions. Rexulti works by modulating dopamine and serotonin levels in the brain to stabilize mood and behavior. More commonly reported side effects of Rexulti include sleepiness, restlessness, and weight gain. The drug has boxed warnings regarding an increased risk of death in older adults with dementia-related psychosis and an increased risk of suicidal thoughts in children and young adults. Potential users should also be aware of interactions with certain medications, supplements, and foods.

This is a summary article for general educational purposes. For more details about Rexulti, see its prescribing information or talk with your doctor or pharmacist.