What is the recommended dosage and usage of Rexulti (brexpiprazole) for treating schizophrenia and major depressive disorder?

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Rexulti (Brexpiprazole) Drug Information

Indications

Brexpiprazole is FDA-approved for two specific indications: adjunctive treatment of major depressive disorder (MDD) in adults and treatment of schizophrenia in adults. 1


Dosing for Major Depressive Disorder (Adjunctive Treatment)

Starting and Target Doses

  • Start with 0.5 mg or 1 mg orally once daily, then titrate to 1 mg once daily 1
  • The target dose is 2 mg once daily, with weekly dose increases based on clinical response and tolerability 1
  • Maximum dose is 3 mg once daily 1

Titration Schedule

  • Increase dosage at weekly intervals to reach the target of 2 mg/day 1
  • Periodically reassess to determine continued need and appropriate dosage 1

Clinical Efficacy in MDD

  • When pooling data from Phase III trials at recommended doses (1-3 mg), 23.2% of brexpiprazole-treated patients were responders versus 14.5% for placebo, yielding a number needed to treat (NNT) of 12 2
  • Brexpiprazole 2 mg/day is the recommended target dose for adjunctive treatment 2, 3

Dosing for Schizophrenia

Starting and Target Doses

  • Start with 1 mg orally once daily on Days 1-4 1
  • Titrate to 2 mg once daily on Days 5-7 1
  • On Day 8, increase to the target range of 2-4 mg once daily based on clinical response 1
  • Maximum dose is 4 mg once daily 1

Clinical Efficacy in Schizophrenia

  • Pooled responder rates were 45.5% for brexpiprazole 2-4 mg/day versus 31.0% for placebo, resulting in an NNT of 7 2
  • In a 52-week relapse prevention study, significantly fewer patients relapsed with brexpiprazole compared to placebo (13.5% vs 38.5%), yielding an NNT of 4 4, 2

Administration

  • Administer once daily with or without food 1
  • Oral administration only 1

Dose Adjustments for Special Populations

Hepatic Impairment

  • For moderate to severe hepatic impairment (Child-Pugh score ≥7):
    • Maximum 2 mg once daily for MDD 1
    • Maximum 3 mg once daily for schizophrenia 1

Renal Impairment

  • For creatinine clearance <60 mL/minute:
    • Maximum 2 mg once daily for MDD 1
    • Maximum 3 mg once daily for schizophrenia 1

CYP2D6 Poor Metabolizers and Drug Interactions

  • For CYP2D6 poor metabolizers: administer half the recommended dosage 1
  • With strong CYP2D6 or CYP3A4 inhibitors: administer half the recommended dosage 1
  • With strong/moderate CYP2D6 AND strong/moderate CYP3A4 inhibitors: administer one-quarter the recommended dosage 1
  • With strong CYP3A4 inducers: double the recommended dosage over 1-2 weeks 1
  • Exception: For MDD patients taking strong CYP2D6 inhibitors (paroxetine, fluoxetine), no dose adjustment needed as this was factored into clinical trial dosing 1

Pharmacology

  • Brexpiprazole is a dopamine D2 partial agonist with partial agonist activity at serotonin 5-HT1A receptors and antagonist activity at serotonin 5-HT2A and adrenergic alpha-1B and alpha-2C receptors 4
  • Compared to aripiprazole, brexpiprazole is more potent at 5-HT1A receptors and displays less intrinsic activity at D2 receptors 4

Safety and Tolerability

Most Common Adverse Effects

For MDD:

  • Weight gain, somnolence, and akathisia (≥5% and at least twice the rate of placebo) 1
  • Akathisia occurred in 8.6% of MDD patients, with an NNH of 15 2
  • Discontinuation due to adverse events: 3% for brexpiprazole versus 1% for placebo (NNH of 53) 2

For Schizophrenia:

  • Weight gain (≥4% and at least twice the rate of placebo) 1
  • Akathisia occurred in 5.5% versus 4.6% for placebo, yielding an NNH of 112 4
  • Discontinuation rates due to adverse events were lower for brexpiprazole (7.1-9.2%) versus placebo (14.7%) 3

Weight and Metabolic Effects

  • Approximately 10% of patients receiving brexpiprazole 1-4 mg/day gained ≥7% body weight from baseline, compared with 4% for placebo (NNH of 17) 4
  • More outliers with ≥7% weight gain were evident in 52-week open-label studies 4
  • Effects on glucose and lipids were small 4
  • Minimal effects on prolactin 4

Cardiovascular Effects

  • No clinically relevant effects on ECG QTc interval 4

Boxed Warnings

Increased Mortality in Elderly with Dementia-Related Psychosis

  • Elderly patients with dementia-related psychosis treated with antipsychotics are at increased risk of death 1
  • Brexpiprazole is NOT approved for dementia-related psychosis 1

Suicidal Thoughts and Behaviors

  • Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients 1
  • Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts 1
  • Safety and effectiveness have NOT been established in pediatric patients with MDD 1

Important Warnings and Precautions

  • Neuroleptic malignant syndrome: manage with immediate discontinuation and close monitoring 1
  • Tardive dyskinesia: discontinue if clinically appropriate 1
  • Metabolic changes: monitor for hyperglycemia/diabetes, dyslipidemia, and weight gain 1
  • Pathological gambling and other compulsive behaviors: consider dose reduction or discontinuation 1
  • Orthostatic hypotension and syncope: monitor heart rate and blood pressure, especially in patients with cardiovascular disease 1
  • Seizures: use cautiously in patients with history of seizures or conditions that lower seizure threshold 1
  • Potential for cognitive and motor impairment: use caution when operating machinery 1

Available Strengths

  • Tablets available in: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg 1

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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