Can Rexulti Tablets Be Split?
Do not split or break Rexulti (brexpiprazole) tablets in half, as this practice is potentially harmful for medications not specifically designed to be split and can compromise the intended dosing and therapeutic effect.
Why Splitting Is Not Recommended
Splitting medications that are not scored or designed for division can be hazardous, particularly when precise dosing is critical for psychiatric medications 1.
Brexpiprazole requires careful dose titration over 1-2 weeks to reach its target therapeutic dose of 2-4 mg/day for schizophrenia or 2-3 mg/day as adjunctive treatment for major depression, and splitting tablets interferes with this precise titration schedule 2.
The medication is formulated for once-daily dosing at specific strengths, and altering the tablet integrity may affect drug release and absorption characteristics 2.
Proper Dosing Approach
Brexpiprazole is available in multiple tablet strengths (0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg), allowing clinicians to prescribe the exact dose needed without requiring tablet splitting 3, 4.
If dose adjustment is needed, request a prescription for the appropriate tablet strength rather than attempting to split existing tablets 1.
The gradual titration schedule is essential because brexpiprazole's unique pharmacological profile as a dopamine D2 partial agonist with potent serotonin and noradrenergic activity requires careful dose escalation to minimize adverse effects like akathisia while achieving therapeutic benefit 3, 2.
Clinical Pitfalls to Avoid
Never crush or split medications without explicit confirmation from the prescriber or pharmacist, as this can lead to unintended consequences including altered pharmacokinetics, loss of therapeutic effect, or increased adverse events 1.
Patients who have difficulty swallowing should discuss alternative formulations or administration strategies with their healthcare provider rather than modifying tablets on their own 1.