Rexulti is a brand-name oral tablet that’s prescribed for certain conditions, such as depression. Rexulti contains the active drug brexpiprazole and belongs to the atypical antipsychotic drug class.

Rexulti is FDA-approved to treat the following in adults:

  • Major depressive disorder (MDD), which is often simply called depression. For this use, Rexulti is given in combination with an antidepressant drug.
  • Schizophrenia. For treating this condition, Rexulti may be taken alone or with other medication.
  • Agitation from dementia due to Alzheimer’s disease. For treating this type of agitation, Rexulti is usually taken alone. The drug is meant to be taken every day for this purpose. It isn’t used only when experiencing agitation.

Rexulti is also FDA-approved to treat schizophrenia in children ages 13 years and older.

Drug details

You’ll find key information about Rexulti below.

  • Drug form: oral tablet
  • Generic available? no
  • Prescription required? yes
  • Controlled substance? no
  • Year of FDA approval: 2015

Rexulti contains the active drug brexpiprazole. It’s available only as a brand-name medication. Rexulti doesn’t currently come in a generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Rexulti can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Rexulti. These lists don’t include all possible side effects.

For more information on the possible side effects of Rexulti, see this article. You can also talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Rexulti, you can do so through MedWatch.

Mild side effects

Mild side effects of Rexulti can include:*

  • restlessness
  • indigestion
  • headache
  • diarrhea
  • constipation
  • sleepiness, unusual dreams, or insomnia
  • fatigue
  • the common cold

Other mild side effects, explained in more detail below in “Side effect details,” include:

Some of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Rexulti. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Rexulti’s prescribing information.

Serious side effects

Serious side effects from Rexulti aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Stroke, which occurs more often in older people using the drug. Symptoms can include:
    • numbness or weakness in your face, arms, or legs
    • confusion
    • trouble speaking
    • trouble seeing from one or both of your eyes
  • Neuroleptic malignant syndrome (a condition that can occur with certain medications when dopamine activity is blocked). Symptoms can include:
  • Tardive dyskinesia (uncontrolled body movements). Symptoms can include:
    • trouble controlling movements of your face or tongue
    • excessive blinking
    • waving your arms without meaning to
  • High blood sugar level. Symptoms can include:
    • feeling very thirsty or hungry
    • weakness or tiredness
    • needing to urinate more often than usual
  • Low white blood cell level. Symptoms can include:
    • frequent infections
    • fevers
  • Orthostatic hypotension (decreased blood pressure when standing up or sitting up), which can result in falls. Symptoms can include:
    • feeling dizzy when you stand up after being seated or lying down
  • Seizures. Symptoms can include:
    • confusion
    • uncontrollable jerking movements of your arms or legs
    • loss of consciousness
  • Trouble swallowing due to spasm of your neck muscles. Symptoms can include:
    • having food get caught in your throat
    • difficulty breathing
  • Trouble with your body’s temperature regulation. Symptoms can include:
    • difficulty cooling down after exercising or exposure to heat
  • Slowed thinking or reflexes, which can make driving or operating heavy machinery unsafe.
  • Increased cholesterol or triglyceride levels in your blood, which usually doesn’t cause any symptoms.

Other serious side effects, explained in more detail below in “Side effect details,” include:

* Rexulti has boxed warnings regarding these risks. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Rexulti. But it’s not known how many people taking Rexulti have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Rexulti. But call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain or weight loss

You may have changes in your weight or metabolism while you’re taking Rexulti. (Your metabolism refers to all of the chemical reactions in your body.) Below, we describe these changes in more detail.

If you’re concerned about changes in your weight or metabolism while you’re taking Rexulti, talk with your doctor. They can recommend ways to help you manage a body weight and metabolism that are healthy for you.

Weight gain

In clinical trials, weight gain was a reported side effect of Rexulti. It can occur regardless of which condition a person takes Rexulti to treat. A small percentage of people stopped taking the drug due to this side effect in some of the trials.

If you have concerns about weight gain while taking Rexulti, talk with your doctor. They can recommend ways to maintain a healthy weight during treatment.

Weight loss

Some people in certain clinical trials reported losing weight while taking Rexulti. However, these people may have lost weight due to other reasons. The trials that reported this weight loss weren’t designed to show the side effects caused by Rexulti.

If you’re worried about weight loss during Rexulti treatment, talk with your doctor. They can discuss methods of maintaining a healthy weight.

Metabolism changes

Weight changes could be caused by changes in your metabolism while you’re using Rexulti. If your metabolism is affected by the drug, you may also have changes in your blood sugar, cholesterol, and triglyceride levels. Your doctor may recommend monitoring for some of these changes during treatment.

Fatigue

It’s possible to have increased fatigue while you’re taking Rexulti.

There were reports of fatigue in clinical trials of people taking Rexulti for depression. In clinical trials of Rexulti for schizophrenia and agitation from dementia due to Alzheimer’s disease, fatigue was not reported. However, there were reports of sleepiness in trials of the drug for these conditions.

If you have fatigue or excessive sleepiness while you’re taking Rexulti, talk with your doctor. They can recommend ways to help improve your energy level.

Anxiety

You may have new or worsened anxiety while you’re taking Rexulti. But keep in mind that anxiety is common in people with depression, which Rexulti is used to treat.

In clinical trials for depression, some people taking Rexulti had anxiety. However, in clinical trials of people with schizophrenia or agitation from dementia due to Alzheimer’s disease, this side effect was not reported.

If you notice new or worsened anxiety with Rexulti, call your doctor right away. These changes could indicate that your depression is getting worse, instead of better, with Rexulti treatment. But if you have thoughts of harming yourself or attempting suicide, call 911 or your local emergency services right away.

Changes in sex drive or having other urges

Changes in sex drive, or experiencing other urges, may occur while you’re taking Rexulti. With these other urges, you may not be able to control impulses to do things such as gamble, have sex, go shopping, or binge eat.

These types of urges weren’t reported in clinical trials of Rexulti, but they were reported after the drug was approved and became available.

Keep in mind that if you’re taking Rexulti, you may not notice these urges happening to you. So it’s important that your family members or caregivers are aware of this possible side effect of the drug. This way, they may notice changes in your behavior and help point them out to you.

It’s also important to talk with your doctor if you have certain urges develop or worsen while you’re taking Rexulti. Your doctor may lower your dose of Rexulti, or they may switch you to a different medication.

Increased risk of death in certain older adults

Rexulti can increase the risk of death in older people (ages 65 years and older) with psychosis that’s related to dementia (memory loss). (With psychosis, you lose touch with reality and may hear or see things that aren’t really there.)

In fact, Rexulti has a boxed warning for this risk. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about a drug’s effects that may be dangerous.

In clinical trials, older people with psychosis related to dementia were given certain antipsychotics, drugs that are similar to Rexulti. In these trials, the risk of death was increased in older people taking an antipsychotic compared with older people taking a placebo. (A placebo is a treatment that contains no active drug.)

It’s not known why antipsychotics, such as Rexulti, can increase the risk of death in older people with psychosis that’s related to dementia. In studies of antipsychotics taken by people with this condition, death was often caused by heart problems or infections.

Because Rexulti may be dangerous for use in older people, the drug should generally be avoided by older people with dementia-related psychosis. However, the drug may be prescribed to older adults with this condition for treatment of agitation from dementia due to Alzheimer’s disease.

For more information about this boxed warning, talk with your doctor or pharmacist.

Suicidal thoughts or behaviors

Rexulti may increase the risk of suicidal thoughts or behaviors in some people. Specifically, this risk is increased in children and adults ages 24 years and younger who take Rexulti.

In fact, Rexulti has a boxed warning for the risk of suicidal thoughts or behaviors in people of this age group. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA). These warnings alert doctors and patients about a drug’s effects that may be dangerous.

People with a higher risk of suicidal thoughts or behaviors are those with a history of depression or other mental disorders. An example is bipolar disorder, which can cause both depression and mania (periods of excitement or euphoria).

While Rexulti is not approved to treat depression in children, it can be used to treat schizophrenia in children ages 13 years and older.

In clinical trials of Rexulti, there were no reports of attempted suicide. But this risk is possible with any drug that’s used to treat depression.

Other clinical trials looked at drugs besides Rexulti that are used to treat depression. (This included selective serotonin reuptake inhibitors [SSRIs] and other classes of antidepressant drugs.) In these trials, people ages 24 and younger had suicidal thoughts and behaviors more often than people older than this age group.

If you have thoughts of harming yourself or attempting suicide, call your doctor right away or call 911.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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

  • the type and severity of the condition you’re using Rexulti to treat
  • your age
  • other medical conditions you may have
  • other medications you may take
  • your body’s ability to metabolize (break down) certain medications

Typically, your doctor will start you on a low dosage of Rexulti. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect. Your dosage range for Rexulti will depend on the above factors and how well you respond to your medication.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

For additional details on Rexulti’s dosage, see this article.

Drug forms and strengths

Rexulti comes as oral tablets. It’s available in the following strengths: 0.25 milligrams (mg), 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg.

Dosage for depression

For depression in adults, Rexulti is used only as an adjunctive treatment. This means that Rexulti is taken with other drugs used to treat depression. It’s not used alone for this condition.

Usually, for depression, your doctor will start you at a low daily dose of Rexulti. Examples of starting dosages of Rexulti for depression are:

  • 0.5 mg taken once daily
  • 1 mg taken once daily

After 1 to 2 weeks of therapy, your doctor will likely increase your Rexulti dosage to 2 mg daily. And they’ll see how well your condition responds to the drug.

If your doctor feels that you need a higher dosage of Rexulti, they may increase your dosage to 3 mg each day. This is the maximum dosage of Rexulti that’s approved for depression treatment. But if you felt better taking 1 mg daily compared with taking 2 mg daily, your doctor may decrease your dosage back to 1 mg each day.

Dosage for schizophrenia

Rexulti may be prescribed to adults and certain children to treat schizophrenia. This section describes typical dosages for adults with this condition. For Rexulti dosages prescribed to children, see the “Children’s dosage” section below.

For schizophrenia, the typical starting dosage of Rexulti is 1 mg taken once each day. This starting dosage is taken for the first 4 days of treatment.

Then on days 5 through 7 of therapy, your doctor will increase your dosage to 2 mg once daily. And on day 8 of treatment, your doctor will likely have you begin taking 4 mg of Rexulti daily. This is the maximum dosage of Rexulti that’s approved for schizophrenia treatment.

Dosage for agitation

For agitation in adults who have dementia due to Alzheimer’s disease, the typical starting dosage of Rexulti is 0.5 mg taken once each day. This starting dosage is taken for the first 7 days of treatment.

Then on days 8 through 14 of therapy, your doctor will increase your dosage to 1 mg once daily. And on day 15 of treatment, your doctor will likely have you begin taking 2 mg of Rexulti daily.

If your doctor feels that you need a higher dosage of Rexulti, they may increase your dosage to 3 mg each day. This is the maximum dosage of Rexulti that’s approved for the treatment of agitation.

Note that the drug is meant to be taken every day to treat agitation. It isn’t taken only when experiencing agitation.

Children’s dosage

Doctors may prescribe Rexulti to children ages 13 years and older for schizophrenia.

For this purpose, the typical starting dosage of Rexulti for your child is 0.5 mg taken once each day. This starting dosage is taken for the first 4 days of treatment.

Then on days 5 through 7 of therapy, your child’s doctor will increase the dosage to 1 mg once daily. And on day 8 of treatment, they’ll likely have your child begin taking 2 mg of Rexulti daily. If needed, they may increase your child’s dosage by another 1 mg per week until they reach the maximum dosage. This is 4 mg once per day.

What if I miss a dose?

If you miss a dose of Rexulti, take the missed dose as soon as you remember. But if it’s almost time for your next scheduled dose, just skip the missed dose. Then take your next dose at the regular time. Don’t double up on your dose of Rexulti by taking two doses at once.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Rexulti is meant to be used as a long-term treatment. If you and your doctor determine that Rexulti is safe and effective for you, you’ll likely take it long term.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Rexulti, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for adjunctive treatment of depression

Examples of drugs other than Rexulti that may be used as an adjunctive treatment* for depression include:

* An adjunctive treatment is one that’s used in addition to other drugs to treat a condition. As an adjunctive treatment for depression, Rexulti is taken with other drugs. It isn’t used alone to treat depression.

Alternatives for schizophrenia

Examples of other drugs that may be used to treat schizophrenia* include:

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

* Note that some of these alternatives may be prescribed to adults only. Rexulti may be used to treat schizophrenia in children ages 13 years and older as well as adults.

Alternatives for agitation

At this time, there are no approved alternatives to Rexulti for treating agitation from dementia due to Alzheimer’s disease.

You may wonder how Rexulti compares with other medications that are prescribed for similar uses. Here we look at how Rexulti and Abilify are alike and different. For additional details about how these two drugs compare, see this article, or talk with your doctor or pharmacist.

Note: Abilify comes in several forms, but this comparison is specific to Abilify oral tablets.

Ingredients

Rexulti contains the active drug brexpiprazole, while Abilify contains the active drug aripiprazole. Both of these medications belong to a class of drugs called atypical antipsychotics.

Uses

Both Rexulti and Ability are approved to treat the following conditions:

  • Major depressive disorder (MDD). This condition is often simply called depression. For this use, Rexulti and Abilify are given in combination with an antidepressant drug. Rexulti and Abilify aren’t used on their own to treat MDD.
  • Schizophrenia. For this use, Rexulti and Abilify may be taken on their own or with other drugs.

In addition, Abilify is approved to treat the following conditions:

Rexulti is also approved to treat agitation from dementia due to Alzheimer’s disease.

All of Rexulti’s uses are approved for adults, while certain children may take this drug to treat schizophrenia. Some of Abilify’s uses are approved only for adults, some only for certain children, and others for both adults and certain children.

Drug forms and administration

Rexulti comes as oral tablets. It should be taken once each day, either with or without food.

Abilify also comes as an oral tablet, as well as the following forms:

  • an oral tablet with sensor (available under the brand name Abilify MyCite)
  • extended-release liquid suspensions* for intramuscular injection (available under the brand names Abilify Maintena and Abilify Asimtufii)

The conditions Abilify treats may vary depending on the form.

Abilify oral tablets should be taken once each day, with or without food. How often you might take other forms of Abilify varies.

* “Extended release” means the drug is slowly released into your body over a long period of time.

Side effects and risks

Rexulti and Abilify are both atypical antipsychotics. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Rexulti, with Abilify, or with both drugs (when taken individually).

  • Can occur with Rexulti:
    • indigestion
    • decreased level of the hormone cortisol in the blood
  • Can occur with Abilify:
    • vomiting
    • toothache
    • muscle stiffness
  • Can occur with both Rexulti and Abilify:
    • constipation
    • headache
    • restlessness
    • sleepiness, unusual dreams, or insomnia
    • fatigue
    • diarrhea
    • weight gain
    • upper respiratory infections, such as the common cold
    • blurred vision
    • dizziness
    • anxiety

Serious side effects

These lists contain examples of serious side effects that can occur with Rexulti, with Abilify, or with both drugs (when taken individually).

* Both Rexulti and Abilify have boxed warnings regarding these risks. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information about Rexulti’s boxed warnings, see the “Rexulti side effects” section above.

Effectiveness

Rexulti and Abilify have different approved uses, but they’re both approved for treatment of MDD. (For this use, Rexulti and Abilify are given as an adjunctive treatment with other medications for the condition.) And Rexulti and Abilify are also both used to treat schizophrenia.

These drugs haven’t been directly compared in clinical trials. But studies have found both Rexulti and Abilify to be effective for their approved uses.

Costs

The actual price you’ll pay for either Rexulti or Abilify depends on your insurance plan, your location, and the pharmacy you use.

Rexulti is a brand-name drug, and there currently isn’t a generic form of Rexulti available. However, there is a generic form of Abilify available that’s called aripiprazole. Generic medications usually cost less than brand-name medications do.

You may wonder how Rexulti compares with other medications that are prescribed for similar uses. Here we look at how Rexulti and Latuda are alike and different.

Ingredients

Rexulti contains the active drug brexpiprazole, while Latuda contains the active drug lurasidone hydrochloride. Both of these medications belong to a class of drugs called atypical antipsychotics.

Uses

Both Rexulti and Latuda are approved to treat schizophrenia in adults and certain children. For this use, Rexulti and Latuda can be taken on their own or with other drugs.

Rexulti is also approved for use in adults to treat the following:

For treating MDD, Rexulti is used in combination with an antidepressant.

In addition to treating schizophrenia, Latuda is approved to treat depressive episodes (periods of depression) related to bipolar I disorder. The drug can be prescribed for adults and certain children with this condition. And it may be used either by itself or with other drugs.

Drug forms and administration

Rexulti comes as oral tablets. It should be taken once each day, either with or without food.

Latuda also comes as oral tablets. It should be taken once each day with food that contains at least 350 calories.

Side effects and risks

Rexulti and Latuda both contain atypical antipsychotics. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with Rexulti, with Latuda, or with both drugs (when taken individually).

  • Can occur with Rexulti:
  • Can occur with Latuda:
    • having trouble moving or moving slower than usual because of muscle stiffness
    • back pain
    • runny nose
    • vomiting
  • Can occur with both Rexulti and Latuda:
    • restlessness
    • sleepiness, unusual dreams, or insomnia
    • fatigue
    • the common cold
    • weight gain
    • diarrhea
    • tremors
    • anxiety

Serious side effects

These lists contain examples of serious side effects that can occur with Rexulti, with Latuda, or with both drugs (when taken individually).

* Both Rexulti and Latuda have boxed warnings regarding these risks. A boxed warning is the strongest warning required by the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous. For more information about Rexulti’s boxed warnings, see the “Rexulti side effects” section above.

Effectiveness

Rexulti and Latuda have different approved uses, but they’re both used to treat schizophrenia in adults and children ages 13 and older.

These drugs haven’t been directly compared in clinical trials. But separate studies have found both Rexulti and Latuda to be effective for their approved uses.

Costs

The actual price you’ll pay for either Rexulti or Latuda depends on your insurance plan, your location, and the pharmacy you use.

Rexulti and Latuda are both brand-name drugs. There isn’t a generic form of Rexulti available. However, a generic form of Latuda, called lurasidone, is available.

Generic drugs generally cost less than brand-name drugs do.

The Food and Drug Administration (FDA) approves prescription drugs such as Rexulti to treat certain conditions. Rexulti may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Rexulti for depression

Rexulti is approved as an adjunctive treatment for major depressive disorder (MDD), which is also simply called depression. As an adjunctive treatment, Rexulti is used with other medications for depression. It’s not used alone for this condition. (For more information, see the “Rexulti use with other drugs” section below.) Rexulti is approved for use in adults with MDD.

With depression, you may have intense feelings of sadness, loss, lack of caring, or anger. And your symptoms may interfere with your everyday life.

A variety of treatments for depression are available, including cognitive behavioral therapy (which is a type of talk therapy) and medications. But it’s important to note that only some people with depression experience improvement in their symptoms by taking just one antidepressant. Because of this, doctors often prescribe several antidepressants, and sometimes other types of drugs, to help relieve depression symptoms.

Rexulti is an atypical antipsychotic. It’s not an antidepressant, but it can be used in combination with antidepressants to treat MDD.

For details about MDD, visit our depression hub.

Effectiveness for depression

In clinical trials of Rexulti, the drug was found to be effective for treating MDD in adults when used in combination with an antidepressant. For more information, see Rexulti’s prescribing information.

Rexulti for schizophrenia

Rexulti is approved to treat schizophrenia in adults and children ages 13 years and older. This is a mental health condition that has an unknown cause. It usually starts to affect people during their teenage years or early adulthood.

Symptoms of schizophrenia can be split into the following three categories:

  • Positive. These symptoms can often be described as losing touch with reality. They may include having intrusive thoughts or hallucinations (hearing or seeing things that aren’t there). Positive symptoms may also include having delusions (believing things that aren’t true).
  • Negative. These symptoms can often be described as changes in your usual behavior or emotions. They may include having an absence of emotions or not enjoying everyday pleasures. Negative symptoms may also include not speaking as often as usual.
  • Cognitive and emotional. These symptoms can often be described as changes in your memory or way of thinking. They may include having trouble focusing, paying attention, or remembering things. Symptoms may also include having difficulty understanding information.

It’s not known for sure what causes schizophrenia. But genetics, environment, and brain chemicals could play a role. It’s also not known exactly how Rexulti treats schizophrenia. But Rexulti, which is an antipsychotic, is thought to help regulate mood.

To learn more about schizophrenia, refer to this list of articles on the condition.

Effectiveness for schizophrenia

In clinical trials of Rexulti, the drug was found to be effective for treating schizophrenia in adults and children ages 13 years and older. For more information, see Rexulti’s prescribing information.

Rexulti for agitation

Rexulti is approved to treat agitation in adults who have dementia due to Alzheimer’s disease.

Agitation causes feelings of irritability, restlessness, and worry. Having certain medical conditions, being in stressful situations, and taking certain medications are a few examples of possible causes of agitation.

Rexulti is used to treat agitation specifically resulting from dementia associated with Alzheimer’s disease. Dementia causes problems with memory, communication, and thinking. Alzheimer’s disease is usually diagnosed in older adults (ages 65 years and older). It’s a type of dementia that worsens over time.

Rexulti is meant to be taken every day for this use. It isn’t taken only when experiencing agitation.

It’s not known how Rexulti works to treat agitation. It’s thought that the drug regulates levels of certain brain chemicals, which may help ease this condition.

To learn more about the condition that causes this type of agitation, visit our dementia hub.

Effectiveness for agitation

In clinical trials of Rexulti, the drug was found to be effective for treating agitation in adults who have dementia due to Alzheimer’s disease. For more information, see Rexulti’s prescribing information.

Rexulti for other conditions

In addition to the uses listed above, Rexulti may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one use is used for a different one that’s not approved. And you may wonder whether Rexulti is used for certain other conditions. Below is information on other possible uses for Rexulti.

Rexulti for depression with anxiety (off-label use)

Rexulti isn’t approved to treat anxiety. But sometimes it’s used off-label to treat depression in people who also have symptoms of anxiety.

One study looked at using Rexulti for depression in people with anxiety. For 6 weeks, people were given either Rexulti or a placebo (treatment with no active drug). Their depression and anxiety symptoms were measured using questionnaires and other tests. People who took Rexulti 2 mg or 3 mg daily had reduced symptoms of anxiety compared with those taking a placebo.

If you have questions about using Rexulti for depression with anxiety, talk with your doctor. They can recommend whether this drug is appropriate for you. And they can advise what dosage would work best for your treatment.

Rexulti for bipolar disorder (off-label use)

Rexulti isn’t approved to treat bipolar disorder. But sometimes the drug is used off-label for this condition.

One study looked at using Rexulti in adults with bipolar disorder during episodes of depression. The symptoms of depression and mania (moments of extremely high excitement and energy) were evaluated using tests and questionnaires. (Depression and mania are the two key symptoms of bipolar disorder.)

The study found that Rexulti was effective in reducing people’s depressive symptoms. But the drug didn’t have much effect on their manic symptoms.

If you have questions about using Rexulti for bipolar disorder, talk with your doctor. They can recommend whether this drug is a good treatment option for you.

Rexulti for autism spectrum disorder (under study)

Rexulti isn’t approved to treat autism spectrum disorder (ASD), a developmental condition that affects behavior and communication. The drug was being studied as a possible treatment for irritability related to ASD in children ages 5–17 years. The results of this study haven’t been published.

If you have questions about using Rexulti to treat autism, talk with your doctor. They can advise whether this drug is a good treatment option for you.

Rexulti for borderline personality disorder (research needed)

Rexulti isn’t approved to treat borderline personality disorder, a mental health condition that affects mood stability. But the drug has been studied as a possible treatment for this condition.

One study compared Rexulti to that of a placebo (treatment with no active drug). This study looked at adults with borderline personality disorder who have mood instability, impulsive behavior, and trouble with relationships. Results suggested that Rexulti may have an effect on this condition. But more research is needed to determine whether Rexulti may be safe and effective in treating borderline personality disorder.

Rexulti and children

Rexulti is FDA-approved to treat schizophrenia in children ages 13 years and older. For details about the drug’s use for this condition, see the “Rexulti for schizophrenia” section above.

In addition, Rexulti has a boxed warning that states it can increase the risk of suicidal thoughts or behaviors in children and adults ages 24 years and younger. A boxed warning is the strongest warning required by the FDA. Boxed warnings alert doctors and patients about a drug’s effects that may be dangerous. For more information about these boxed warnings, see the “Rexulti side effects” section above.

When used to treat major depressive disorder (MDD), Rexulti is only approved for use in combination with an antidepressant drug. (MDD is also simply called depression.) For schizophrenia, Rexulti may be taken alone or with other medication. For agitation from dementia due to Alzheimer’s disease, Rexulti is typically taken alone.

In clinical trials of people with depression, Rexulti had to be taken with an antidepressant drug. In fact, people had to take their antidepressant for at least 8 weeks before adding Rexulti to their treatment regimen.

Examples of other drugs that may be used along with Rexulti for depression include:

If you have questions about which other drugs you may need to use with Rexulti, talk with your doctor. They can recommend a treatment plan that’s right for you.

You shouldn’t stop taking Rexulti “cold turkey” (abruptly) without first talking with your doctor. If you would like to stop taking this drug, your doctor will recommend a plan for you to taper off (slowly decrease your dosage) of Rexulti. Tapering off of the drug is a safer way to stop using it than abruptly stopping.

If you stop Rexulti treatment abruptly, you could have withdrawal symptoms. In clinical trials, people taking Rexulti didn’t have withdrawal symptoms when they stopped taking the drug. However, there have been reports of withdrawal symptoms in people who took antipsychotics that are similar to Rexulti, such as aripiprazole (Abilify).

In addition, withdrawal may occur in newborns of people taking antipsychotics during the third trimester of pregnancy. (For more information, see the “Rexulti and Pregnancy” section below.)

Your body may become dependent on certain drugs. (With dependence, your body needs a drug in order to feel like it usually does.) And if you abruptly stop taking a drug that your body is dependent upon, you may have withdrawal symptoms.

Symptoms that have happened in people who abruptly stopped taking atypical antipsychotics (the class of drugs Rexulti belongs to) include:

  • atypical or uncontrollable movements in certain parts of the body
  • trouble staying still
  • nausea and vomiting
  • headache
  • insomnia
  • increased heart rate
  • anxiety
  • blurred vision
  • sudden return of psychosis

Because of the risk of withdrawal symptoms, abruptly stopping Rexulti treatment should be avoided.

If you want to stop taking Rexulti, talk with your doctor. They can recommend safe and effective ways to stop treatment that will reduce your risk of withdrawal symptoms.

Rexulti contains the active drug brexpiprazole. It belongs to a class of drugs called atypical antipsychotics.

Rexulti is approved to treat the following conditions in adults:

The drug is also approved to treat schizophrenia in certain children.

It’s not known exactly how Rexulti works to treat these conditions. But it’s believed that the drug binds to certain receptors (attachment sites) in your brain. The receptors affected by Rexulti usually respond to the brain chemicals serotonin and dopamine.

Serotonin and dopamine are responsible for regulating your moods. These brain chemicals are thought to be unbalanced in people with the conditions listed above.

By interacting with receptors in your brain for these chemicals, Rexulti is thought to help balance serotonin and dopamine levels. This may be how Rexulti treats depression, schizophrenia, and agitation.

How long does it take for Rexulti to work?

The length of time it takes for Rexulti to work will vary from person to person. And it very much depends on the severity of the condition you’re using Rexulti to treat.

How long does Rexulti stay in your system?

Rexulti may stay in your system for about 18 to 19 days, which is a little less than 3 weeks.

It’s not known whether it’s safe to consume alcohol while you’re taking Rexulti.

But keep in mind that excessive alcohol intake can cause liver damage. And in people with liver damage, Rexulti can build up and cause increased side effects.

If you drink alcohol and you’re taking Rexulti, talk with your doctor. They can recommend whether it’s safe to drink alcohol during treatment with Rexulti.

Here are answers to some frequently asked questions about Rexulti.

Will Rexulti make me feel high?

No, Rexulti won’t make you feel high. While it’s not known exactly how Rexulti works, it’s thought that the drug binds to certain receptors (attachment sites) in your brain. These receptors usually respond to the brain chemicals serotonin and dopamine.

Serotonin and dopamine are responsible for regulating your moods. But they’re thought to be unbalanced in people with certain conditions. These include depression, schizophrenia, and agitation from dementia due to Alzheimer’s disease, which Rexulti is approved to treat. (For information about these conditions, see the “Rexulti uses” section above.)

By affecting these brain receptors, Rexulti is thought to help balance serotonin and dopamine levels. This is how the drug may work to treat the conditions it’s approved for. But Rexulti’s effect on your brain shouldn’t make you feel high.

Is Rexulti an SSRI?

No, Rexulti isn’t a selective serotonin reuptake inhibitor (SSRI). SSRIs are a class of antidepressants used for a variety of medical conditions, including depression.

Instead, Rexulti contains the drug brexpiprazole, which is an atypical antipsychotic. To learn how Rexulti works, see the “How Rexulti works” section above.

Keep in mind that when used to treat depression, Rexulti is approved for use in combination with an antidepressant. It’s not used alone for this condition. (For more information, see the “Rexulti use with other drugs” section above.) In some cases, your doctor may recommend that you take an SSRI with Rexulti to treat your depression.

But when Rexulti is used to treat schizophrenia, it may be taken alone or with other medication. For agitation from dementia due to Alzheimer’s disease, the drug can be taken alone.

Which drug class does Rexulti belong to?

Rexulti contains the active drug brexpiprazole. It belongs to a class of drugs called atypical antipsychotics. (A class of drugs describes a group of medications that work in the same way.)

To learn how Rexulti works, see the “How Rexulti works” section above.

Is Rexulti used to treat ADHD?

No, Rexulti isn’t approved to treat attention deficit hyperactivity disorder (ADHD).

Instead, Rexulti is approved to treat major depressive disorder (MDD), which is also simply called depression. (For this condition, Rexulti is approved for use in combination with an antidepressant.) In addition, Rexulti is also approved to treat schizophrenia and agitation from dementia due to Alzheimer’s disease.

Rexulti contains the active drug brexpiprazole, which belongs to a class of drugs called atypical antipsychotics.

Other medications, called stimulants, are usually given to treat ADHD. Examples of stimulants that are approved to treat ADHD include:

  • amphetamine/dextroamphetamine (Adderall)
  • lisdexamfetamine dimesylate (Vyvanse)

If you have questions about treatment options for ADHD, talk with your doctor.

Do side effects of Rexulti go away?

Yes, some side effects of Rexulti may go away as you continue with treatment. Examples of these side effects include:

However, other side effects of Rexulti may last as long as you’re taking the drug. For example, weight gain and restlessness may continue long term while you’re using Rexulti.

For more information about the side effects that Rexulti may cause, see the section “Rexulti side effects” above.

Will I have sun sensitivity while I’m taking Rexulti?

No, Rexulti doesn’t increase your sensitivity to sunlight.

A 2009 study showed that some people reported having sun sensitivity when taking selective serotonin reuptake inhibitors (SSRIs) to treat depression. (SSRIs are a group of drugs used to treat depression. Rexulti belongs to a different group of drugs called atypical antipsychotics.) But sun sensitivity hasn’t been reported with Rexulti use.

However, Rexulti can make it more difficult for your body to regulate its temperature. This means that after you exercise or you’re exposed to heat from the sun, it may be more difficult than usual for your body to cool down. But Rexulti doesn’t increase your skin’s sensitivity to sunlight or your risk of sunburn or skin irritation.

If you’re concerned about sun sensitivity while you’re using Rexulti, talk with your doctor.

Don’t use more Rexulti than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you’ve taken too much Rexulti

If you think you’ve taken too much of this drug, call your doctor. You can also call American’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

You should take Rexulti according to your doctor’s or healthcare professional’s instructions.

Rexulti comes as oral tablets that you’ll take by mouth once each day.

When to take

The manufacturer of Rexulti hasn’t stated a time of day that’s best to take its drug. You can take Rexulti once daily at any time of the day. (Unless your doctor recommends otherwise.)

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Rexulti with food

You can take Rexulti with food or on an empty stomach.

Can Rexulti be crushed, split, or chewed?

Rexulti tablets should be swallowed whole. According to the manufacturer, they shouldn’t be cut in half, crushed, or chewed.

If you have trouble swallowing pills, see this article. Your doctor or pharmacist can also suggest ways to help make taking Rexulti easier for you.

Rexulti can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Rexulti and other medications

Rexulti is broken down in your body by a set of enzymes (certain proteins) that also break down other medications. If you take Rexulti with certain drugs, the enzymes may not be able to fully break down either Rexulti or the other drugs. And this can affect your levels of either Rexulti or the other drugs.

Below, we describe these possible interactions in more detail. But keep in mind that this isn’t a complete list of all the medications that can interact with Rexulti.

Before taking Rexulti, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Rexulti and drugs that increase the level of Rexulti in your body

Some drugs can increase the level of Rexulti in your body. If you take any of these drugs with Rexulti, your doctor may lower your dosage of Rexulti. This helps to keep safe levels of Rexulti in your body.

Examples of drugs that may increase your Rexulti level include:

Rexulti and drugs that decrease the level of Rexulti in your body

Some drugs can decrease the level of Rexulti in your body. If you take any of these drugs with Rexulti, your doctor may increase your dose of Rexulti so that it’s effective for your condition.

Examples of drugs that may decrease your Rexulti level include:

Rexulti and herbs and supplements

It’s possible that Rexulti may interact with certain herbs and supplements. Below, we describe one such interaction. But there may be others as well. Be sure to talk with your doctor about all the herbs and supplements you take before starting Rexulti.

Rexulti and St. John’s wort

The herbal supplement St. John’s wort is sometimes used by people with certain mood disorders, such as depression. However, St. John’s wort interacts with an enzyme (certain protein) in your body that’s used to break down some medications.

Because of this interaction, St. John’s wort may reduce the level of Rexulti in your body. And this could make Rexulti less effective for you.

If you’re taking St. John’s wort, talk with your doctor. They’ll recommend whether you should continue to take this herb. In some cases, your doctor may increase your dose of Rexulti while you’re taking St. John’s wort.

Rexulti and foods

Rexulti can interact with grapefruit.

Taking Rexulti with grapefruit or products containing grapefruit may inhibit your body from metabolizing (breaking down) the drug. This can cause Rexulti to build up in your body, which could increase your risk of side effects from the drug.

If you have any questions about eating certain foods with Rexulti, talk with your doctor.

As with all medications, the cost of Rexulti can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Rexulti, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Rexulti, contact your insurance company.

Drug coupons

You can visit Optum Perks* for price estimates of Rexulti. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.

To save money on your Rexulti prescription, explore these Optum Perks coupons.

* Optum Perks is a sister site of Medical News Today.

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Financial and insurance assistance

If you need financial support to pay for Rexulti, or if you need help understanding your insurance coverage, help is available.

Otsuka America Pharmaceutical, Inc., the manufacturer of Rexulti, offers financial support for this medication. Visit this website for information and ways to save on the cost of Rexulti, such as a savings card you may be eligible for.

Generic version

Rexulti is not available in a generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.) Generics tend to cost less than brand-name drugs.

It’s not known whether Rexulti is safe to take during pregnancy. This is because there haven’t been any studies of pregnant people taking the drug.

However, there have been reports of pregnant females* who took a drug that’s similar to Rexulti during their third trimester of pregnancy. The infants who were exposed to the drug during pregnancy had side effects or withdrawal symptoms after they were born.

Withdrawal symptoms are side effects that can occur when you stop taking a drug your body has become dependent on. (With dependence, your body needs a drug in order to feel as it usually does.)

Examples of side effects and withdrawal symptoms the infants had include:

  • agitation
  • tremors
  • sleepiness
  • trouble breathing
  • trouble feeding
  • problems with muscle movements

If you’re pregnant or thinking of becoming pregnant, talk with your doctor. They can recommend whether it’s safe for you to take Rexulti.

* Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

What to do if you take Rexulti during pregnancy

If your doctor recommends that you take Rexulti during pregnancy, there is a pregnancy registry that you’re encouraged to join.

A pregnancy registry collects information about pregnant people who take certain drugs during pregnancy and their infants who were exposed to the drugs. This information can be helpful for doctors and people considering using these drugs in pregnancy.

You can also sign up for the registry if you think you were exposed to Rexulti while you were pregnant in the past.

For more information and to enroll in Rexulti’s pregnancy registry, visit the registry’s site.

It’s not known whether Rexulti is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Rexulti.

For more information about taking Rexulti during pregnancy, see the section “Rexulti and pregnancy” above.

It’s not known whether Rexulti is safe to take while breastfeeding. Animal studies have shown that brexpiprazole (the active drug in Rexulti) can pass into breast milk. But keep in mind that animal studies don’t always predict what will happen in people. In addition, it’s not known how Rexulti would affect a child who’s breastfed.

If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can recommend whether it’s safe for you to take Rexulti.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Risk of death in certain older adults. Rexulti shouldn’t be used in older people (ages 65 years and older) who have psychosis that’s related to dementia. This is because Rexulti can increase the risk of death in older adults with this condition. However, doctors may prescribe this drug to people with this condition to treat agitation from dementia due to Alzheimer’s disease.

Risk of suicidal thoughts and behaviors in certain people. Rexulti, like other drugs used to treat depression, can increase the risk of suicidal thoughts and behaviors in children and adults ages 24 years and younger. If you’re in this age group and you’re using Rexulti, your doctor will monitor you closely. They’ll do this especially at times when you’re starting a new treatment or when your medication dose is adjusted.

If you have thoughts of suicide or you attempt to harm yourself, seek medical attention right away. In some cases, your doctor may recommend that you stop using Rexulti.

For more information about these boxed warnings, see the “Rexulti side effects” section above.

Other precautions

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

Allergic reaction. If you’ve had an allergic reaction to Rexulti or any of its ingredients, you shouldn’t take Rexulti. Ask your doctor what other medications are better options for you. And if you’re not sure about your medication allergies, talk with your doctor.

Liver damage. If you have a history of liver damage or other liver problems, talk with your doctor before taking Rexulti. Your doctor may adjust your dose of Rexulti to make sure it’s safe for you to take the drug.

Poor metabolizer of certain drugs. Because of genetics, some people’s bodies are poor metabolizers of certain drugs. This means the drugs don’t break down like usual, so they may build up and lead to potentially dangerous side effects. Talk with your doctor to find out if your body doesn’t metabolize certain drugs well. If so, your doctor may reduce your dose of Rexulti to help make sure the drug is safe for you to take.

Kidney damage. If you have a history of kidney damage or other kidney problems, talk with your doctor before taking Rexulti. Your doctor may adjust your dose of Rexulti to make sure it’s safe for you to take the drug.

Hyperlipidemia. If you have hyperlipidemia (high cholesterol or high triglyceride level), Rexulti can further increase your lipid levels. Talk with your doctor about your lipid levels before starting Rexulti.

Low white blood cell count. Rexulti may lower levels of white blood cells. If you already have low white blood cell counts, you have a higher risk of this side effect. Your doctor may order blood tests for you before you start Rexulti treatment. Talk with your doctor to determine whether you’ll need to have your blood cell levels checked.

History of compulsive behaviors, such as gambling. Rexulti may increase certain urges such as gambling, sexual desires, binge eating, and compulsive shopping. If you have a history of compulsive behavior or any addictions, talk with your doctor before starting Rexulti.

Trouble regulating body temperature. Rexulti can make it harder for the body to regulate its temperature. If you have a condition that causes difficulty with regulating body temperature, be sure to tell your doctor before you start taking Rexulti.

Epilepsy or other seizure disorders. Rexulti can increase your risk of seizures, especially if you have a history of epilepsy or have had seizures before. Make sure you talk with your doctor about any history of seizures before you start treatment with Rexulti.

Low blood pressure, high blood pressure, heart disease, or problems with your heart’s electrical pathways. Rexulti may lower your blood pressure when you stand up or sit up, which can cause dizziness or sometimes fainting. If you already have low blood pressure, or a problem with your heart’s electrical pathways, talk with your doctor before taking Rexulti. They can recommend ways to manage your blood pressure while you’re taking Rexulti.

Falls. Rexulti can cause problems with blood pressure. This could lead to dizziness and falls. If you’re already at risk of falls, Rexulti may increase your risk. Before you take Rexulti, talk with your doctor about your risk of falls.

Diabetes. Rexulti may increase blood sugar levels in some people. If you have diabetes and you take Rexulti, your blood sugar level may increase to a dangerous level. This can sometimes result in diabetic ketoacidosis (DKA),* diabetic coma, and in rare cases, death. If you have diabetes, talk with your doctor about how to monitor your blood sugar level while you’re taking Rexulti.

Driving or operating heavy machinery. Rexulti can cause sleepiness, delayed thinking, and slow reflexes. If you drive a lot or operate heavy machinery, make sure you aren’t having these side effects. If you do develop any of these side effects, talk with your doctor immediately.

Pregnancy. It’s not known whether Rexulti is safe to take during pregnancy. Some reports have shown that infants exposed to a similar drug during the third trimester of pregnancy have withdrawal symptoms after birth. For more information, see the “Rexulti and pregnancy” section above.

Breastfeeding. It’s not known whether Rexulti is safe to use while you’re breastfeeding. For more information, see the “Rexulti and breastfeeding” section above.

Note: For more information about the potential negative effects of Rexulti, see the section “Rexulti side effects” above.

* DKA is a life threatening condition that’s related to diabetes.

When you get Rexulti from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, ask your pharmacist how to correctly dispose of it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Rexulti tablets should be stored at room temperature between 68–77°F (20–25°C). They should be kept in a tightly sealed container away from light. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms. For short periods of time, such as when you’re traveling, Rexulti tablets may be stored between 59–86°F (15–30°C).

Disposal

If you no longer need to take Rexulti and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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