If you’re looking at treatment options for depression or schizophrenia, your doctor might suggest Rexulti (brexpiprazole) for you.

Rexulti is a prescription drug that’s used in adults who have:

  • Major depressive disorder. This condition is often simply called depression. For this use, Rexulti is given with an antidepressant drug.
  • Schizophrenia. With schizophrenia, you may have delusions, hallucinations, or might speak and think in a disorganized way. For schizophrenia, Rexulti may be prescribed alone or with another drug.

Rexulti belongs to a drug class called atypical antipsychotics. (A drug class is a group of medications that work in a similar way.)

This article describes the dosage of Rexulti, as well as its form, strengths, and how to take the drug. To learn more about Rexulti, see this in-depth article.

Note: This article covers Rexulti’s typical dosages, which are provided by the drug’s manufacturer. But when using Rexulti, always take the dosage that your doctor prescribes.

Rexulti is taken by mouth. It can be taken with or without food.

What is Rexulti’s form?

Rexulti comes as a tablet you take by mouth.

What strengths does Rexulti come in?

Rexulti comes in a range of strengths. This allows your doctor to adjust your dosage as needed.

Rexulti comes in the following strengths: 0.25 milligrams (mg), 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg.

What are the typical dosages of Rexulti?

Your dosage of Rexulti will depend on many factors, such as:

  • the condition being treated
  • other medications you may be taking for your condition
  • medications you may be taking for other conditions
  • your body’s ability to metabolize (break down) Rexulti

Typically, your doctor will start you on a low dosage. Then they’ll adjust your dosage over time to find the right one for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The information below 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.

Dosage for depression

For adults with depression, Rexulti is prescribed as an adjunctive treatment. This means it’s given with other medications that treat depression. Rexulti is typically prescribed after you’ve tried a different antidepressant for at least 2 months and are still having symptoms of depression.

The two recommended starting doses in adults with depression are:

  • 0.5 mg once daily
  • 1 mg once daily

Your dosage will then be increased weekly until you reach the smallest dosage that is most effective and causes the least amount of side effects.

The recommended Rexulti dosage for treating depression is 2 mg daily. However, you and your doctor will determine what dosage is best for you. The maximum recommended daily dose is 3 mg.

If you’ve been on a steady dose but start to feel either symptoms of depression or side effects, be sure to talk with your doctor. Depending on your symptoms, your doctor may change your dosage or switch you to a different medication.

But don’t make any changes to your dosage on your own. This could worsen your symptoms or side effects.

Dosage for schizophrenia

The starting dosage of Rexulti for adults with schizophrenia is 1 mg once daily. The dosage is then slowly increased to 2 mg to 4 mg once daily.

An example of a dosing schedule your doctor may prescribe when you start treatment is:

  • 1 mg once daily on days 1 to 4
  • 2 mg once daily on days 5 to 7
  • if needed, 4 mg once daily from day 8 onward

Even when you’re on a steady dose, you’ll have regular visits with your doctor to make sure the medication continues to be effective. If you feel the return of symptoms, don’t make any changes to your dosage on your own. Be sure to call your doctor to discuss any possible changes.

Is Rexulti used long term?

Yes, Rexulti is typically used as a long-term treatment. If you and your doctor determine that Rexulti is safe and effective for you, it’s likely that you’ll use it long term.

But for some people, Rexulti may be used for a short period. If that’s true for you, when you’re ready, your doctor will slowly lower your Rexulti dosage until you stop taking it completely.

What’s the dosage of Rexulti for children?

Rexulti is approved for use in adults only.

It’s not known if Rexulti is safe or effective in children or teenagers, so Rexulti is not approved for use in these age groups. The drug may also raise the risk of suicidal thoughts or actions in children and teens. For more information, see the “Boxed warnings” section at the top of this article.

Dosage adjustments

In some situations, your doctor may need to make specific adjustments to your dosage.

  • In case of liver or kidney problems: If you have liver or kidney problems, your body may take longer to metabolize (break down) Rexulti. Your doctor will likely start you on a lower dosage to make sure the drug is safe for you to take. The maximum dosage may also be lower based on your liver or kidney function.
  • In case of drug interactions: Rexulti is metabolized by proteins in your body called enzymes. If you take certain medications with Rexulti, they can make those enzymes break down Rexulti more quickly or more slowly. Depending on what drug you’re taking along with Rexulti, your doctor may change your Rexulti dosage accordingly.

If you have liver or kidney problems or take other medications besides Rexulti, talk with your doctor. They can tell you more about how it may affect your dosage.

Here are answers to some common questions about Rexulti dosage.

Is Rexulti used for bipolar disorder and anxiety? If so, what are the dosages?

Rexulti is not approved as a treatment for bipolar disorder or anxiety. However, it may be used off-label for these conditions. (Off-label drug use is when an FDA-approved drug is used for a purpose other than what it’s approved for.)

One study found that Rexulti was effective at reducing symptoms of anxiety in people with depression.

And a different, small study found that Rexulti was effective in reducing symptoms of depression related to bipolar disorder. However, symptoms of mania were unchanged.

My doctor mentioned a “therapeutic dose” of Rexulti. What does that mean?

A therapeutic dose is one that’s effective for your condition. Your doctor will adjust your dose until it reaches a therapeutic level. They will also try to balance the effectiveness with limited to no side effects. When you reach a therapeutic dosage, you’ll likely stay at this dosage for as long as it works.

Like most medications, Rexulti is not a “one size fits all” drug. That means there’s no particular dosage that’s effective for everyone.

When you first start taking Rexulti, your doctor will start you at a low dosage. Then they’ll steadily increase your dosage each week while monitoring how you feel and what side effects you may have. When they reach the dosage that seems best for you, they’ll keep you at that dosage.

Don’t use more Rexulti than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Rexulti

Call your doctor right away if you think you’ve taken too much Rexulti. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use their online resource.

However, if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room.

The dosage of Rexulti you’re prescribed may depend on several factors. These include:

  • the type and severity of the condition being treated
  • your age
  • other conditions you may have (see “Dosage adjustments” under “What is Rexulti’s dosage?”)

Rexulti comes as a tablet that’s taken by mouth once a day. It can be taken with or without food.

It may be easier to remember to take Rexulti if you take your dose around the same time each day (although this isn’t required).

If you miss a dose of Rexulti, take it as soon as you remember. But if it’s almost time for your next dose, just skip the missed dose and take your next dose at the regular time. You shouldn’t take two doses at once to make up for a missed dose. Doing this could raise your risk for side effects from the drug.

If you have any questions about when to take your next dose after missing a dose, talk with your doctor.

If you need help remembering to take your dose of Rexulti on time, try using a medication reminder. This can include setting an alarm, downloading a reminder app, or setting a timer on your phone. A kitchen timer can work, too.

Studies of Rexulti didn’t show signs of withdrawal or dependence when people stopped using the drug. However, tardive dyskinesia has been reported in people using Rexulti. In some cases, this condition began after people stopped using Rexulti. With tardive dyskinesia, you may experience unusual and jerky movements of your body that you can’t control.

You should not make changes to your Rexulti dosage or stop taking the drug unless your doctor recommends it.

If you have questions about stopping your Rexulti treatment safely, talk with your doctor.

The sections above describe the typical Rexulti dosages provided by the drug manufacturer. If your doctor recommends Rexulti for you, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Rexulti without your doctor’s approval. Only take Rexulti exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • What if Rexulti stops working? Would a different dosage help me?
  • Would a different dosage raise or lower my risk for side effects from Rexulti?
  • If I have liver disease, can I still take Rexulti?
  • Does my dosage of Rexulti need to change if I’m taking other drugs along with it?

Q:

If I start to have side effects from Rexulti, will a lower dosage reduce the side effects and still treat my condition?

Anonymous patient

A:

Possibly. If you begin experiencing side effects that make taking Rexulti an issue, your doctor will likely lower your dose. However, they must also find a balance between treating your condition and managing the drug’s side effects.

If lowering your dose causes Rexulti to not treat your condition effectively, talk with your doctor. Together, you can weigh the benefits and risks of taking Rexulti. This can help you and your doctor determine if the drug is right for you or whether you should try another treatment.

Victor Nguyen, PharmD, MBAAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Healthline

If lowering your dose causes Rexulti to not treat your condition effectively, talk with your doctor. Together, you can weigh the benefits and risks of taking Rexulti. This can help you and your doctor determine if the drug is right for you or whether you should try another treatment.

Disclaimer: Healthline 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.