From the FDA Drug Label
DOSAGE AND ADMINISTRATION Administer brexpiprazole tablets orally once daily with or without food. (2,12.3) Indication Starting Dosage Recommended Target Dosage Maximum Dosage MDD Adults (2.2) 0.5 mg/day or 1 mg/day 2 mg/day 3 mg/day Schizophrenia Adults (2.3) 1 mg/day 2 to 4 mg/day 4 mg/day
The maximum dose of Rexulti (brexpiprazole) is 3 mg/day for Major Depressive Disorder (MDD) and 4 mg/day for Schizophrenia in adults 1.
From the Research
The maximum recommended dose of Rexulti (brexpiprazole) is 4 mg once daily for adults with major depressive disorder (MDD) and 4 mg once daily for adults with schizophrenia. For MDD, patients typically start at 0.5-1 mg daily and gradually increase to the target dose of 2 mg daily, with the option to increase to 3 mg or the maximum 4 mg if needed. For schizophrenia, patients usually start at 1 mg daily for 4 days, then increase to 2-4 mg daily. Dose adjustments are necessary for patients taking strong CYP2D6 or CYP3A4 inhibitors/inducers and those who are known CYP2D6 poor metabolizers. In these cases, the dose should be reduced by half or potentially increased. Rexulti should be taken once daily with or without food at approximately the same time each day. The medication works by acting as a partial agonist at serotonin 5-HT1A and dopamine D2 receptors while also blocking serotonin 5-HT2A receptors, helping to balance neurotransmitters in the brain.
According to the most recent study 2, brexpiprazole has been shown to be effective in the treatment of schizophrenia and MDD, with a favorable side effect profile. The study found that brexpiprazole was well tolerated, with a low incidence of adverse events, including akathisia and weight gain.
Key points to consider when prescribing Rexulti include:
- Starting dose: 0.5-1 mg daily for MDD, 1 mg daily for 4 days for schizophrenia
- Target dose: 2 mg daily for MDD, 2-4 mg daily for schizophrenia
- Dose adjustments: necessary for patients taking strong CYP2D6 or CYP3A4 inhibitors/inducers and those who are known CYP2D6 poor metabolizers
- Administration: once daily with or without food at approximately the same time each day
Overall, Rexulti is a effective and well-tolerated treatment option for adults with MDD and schizophrenia, with a maximum recommended dose of 4 mg once daily.