Rexulti, made simple.
Rexulti is a once a day tablet used for a few different conditions. This guide explains how it works, what to expect, and what to watch for, written plainly for the person taking it and the family who often helps. A Mississippi pharmacist wrote it for you, with care.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Rexulti is and why your doctor gave it to you
Rexulti is a once a day tablet. Its other name is brexpiprazole.
Doctors use Rexulti for a few different things: schizophrenia in adults and adolescents 13 and older, as an add-on to an antidepressant for major depression, and for agitation in people with Alzheimer's disease.
If Rexulti was added to an antidepressant you were already taking, that is a normal and intended use, meant to give the antidepressant more to work with.
The simple version: Rexulti is a once a day tablet that helps steady mood, thinking, or agitation, depending on why your doctor chose it for you or your loved one.
How Rexulti works
Rexulti works on brain chemicals involved in mood and thinking, mainly dopamine and serotonin.
It works in a balancing way. Rather than simply blocking these signals, it steadies them, calming a signal where it runs too high and supporting it where it runs too low.
Like several medicines in this family, Rexulti stays in the body for a good while, so it works gradually rather than all at once. Give it the time your doctor asks for.
Your dose
Rexulti is one tablet, once a day. You can take it with or without food. Take it at about the same time each day.
Your doctor picks your dose and your pharmacist checks it. This page will not tell you what dose to take. Your doctor will usually start low and increase gradually.
One important point if Rexulti is being used for agitation in Alzheimer's disease: it is a daily medicine, taken every day. It is not an as needed pill to use only during a difficult moment. Taking it daily, as prescribed, is how it works.
Timing, and what to do if you miss a dose
Take Rexulti once a day, at about the same time each day. Tie it to a daily habit, or for a loved one with Alzheimer's, to a daily caregiving routine.
Because Rexulti stays in the body a while, one missed dose is unlikely to cause a sudden setback. Consistent daily use is still what keeps treatment steady.
If you miss a dose:
- If you miss a dose, take it as soon as you remember that day.
- If it is almost time for the next dose, skip the one you missed. Just take the next one.
- Never take two doses at once to catch up.
- If you are not sure what to do, call your pharmacist.
Side effects, what is normal and what is not
Common, and often mild.
- Restlessness, or a feeling of needing to keep moving, called akathisia.
- Feeling drowsy, or some trouble sleeping.
- Some weight gain.
- Dizziness, or a common cold type feeling.
Call your doctor if you notice:
- Restlessness or movement changes that bother you. A dose adjustment often helps.
- New movements you cannot control, of the face, tongue, or hands.
- Signs of higher blood sugar, or notable weight gain.
- Feeling dizzy or faint when standing up.
Go to the emergency room right away if:
- You have a high fever, very stiff muscles, sweating, and confusion all together.
- You, or the person you care for, have new thoughts of self-harm. You can also call or text 988 at any time.
What to be careful with
Rexulti is handled by two pathways in your liver, and several common medicines use those same pathways. Some antidepressants, some antifungal and antibiotic medicines, and others can change the amount of Rexulti in your body. Your doctor may adjust the dose around them.
There is one helpful detail. When Rexulti is used as an add-on for depression, the recommended doses already take common antidepressant interactions into account, so an extra dose change for those is often not needed. For other uses, an adjustment may be needed.
The simple rule: before you start or stop any medicine or supplement, tell your pharmacist you take Rexulti. Every single time.
Alcohol is best avoided or kept minimal, because both alcohol and Rexulti can make you drowsy.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Rexulti works best alongside some regular checks that keep you safe and confirm it is helping.
Your doctor should check, now and then:
- How you, or your loved one, are feeling and doing.
- Your weight, your blood sugar, and your cholesterol.
- Restlessness or any new movements.
- Your blood pressure, including dizziness on standing.
Your pharmacist should, now and then:
- Check every new medicine and supplement against Rexulti.
- Answer questions about side effects and timing.
- Help with cost and assistance programs.
- Keep your information private, always.
At Fairview, we keep an eye on our Rexulti patients. If a refill is running late, we call you. Your care is handled discreetly and with respect.
Special situations
Rexulti for Alzheimer's agitation.
Rexulti is the one medicine FDA approved for agitation in Alzheimer's disease. If it is being used for a loved one for that reason, two things matter. First, it is taken every day, not just during a hard moment. Second, antipsychotic medicines carry an increased risk of death in older adults with dementia, so this is a decision a prescriber should weigh carefully with the family. It can still be the right choice, but it should be a clear-eyed, informed one.
Mood and safety.
When Rexulti is used with an antidepressant, especially in younger people, there is a known caution about new or worsening thoughts of self-harm in the early months. Stay in close touch with the doctor at the start. If you or the person you care for has thoughts of self-harm, call the doctor, or call or text 988.
Restlessness.
If you feel restless or unable to sit still, that is a known Rexulti effect and it is manageable. Tell your doctor rather than pushing through it. A dose change often settles it.
Liver or kidney problems.
If you have significant liver or kidney disease, your maximum dose of Rexulti is lower. Always tell your prescriber about any liver or kidney condition.
Cost should never be the reason you stop.
There is a manufacturer savings program. If cost is a worry, call Fairview before you ever skip a dose, and we will help you find the lowest price and any program you qualify for.
How Fairview helps Rexulti patients
When you fill Rexulti at Fairview, here is what you get. This is normal care for us, and it is always private.
At your first fill:
- We check all your medicines and supplements against Rexulti.
- We explain what to expect, and that it works gradually.
- We talk through cost and help you find any program you qualify for.
At every refill:
- We check your file for any new medicines.
- We ask how the medicine is working.
- We answer any new questions, privately.
On our own, without being asked:
- If a refill is running late, we call you.
- If we see a medicine that does not mix with Rexulti, we call your doctor.
- We check your cost at every fill to keep it as low as possible.
- We keep your care discreet and respectful, always.
Questions people ask about Rexulti
Rexulti is approved for schizophrenia in adults and adolescents 13 and older, as an add-on to an antidepressant for major depression, and for agitation in people with Alzheimer's disease.
Related guides
Have a question about your Rexulti? Ask a pharmacist you can trust.
Whether Rexulti is for you or for a loved one, the questions that come with it deserve clear answers. Fairview is here to give them, privately and without judgment. If something made you wonder, ask us.