Comprehensive medication guide to {drug} including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Rexulti (Brexpiprazole) is an atypical antipsychotic medication manufactured by Otsuka Pharmaceutical in partnership with Lundbeck. It is FDA-approved for three indications: as an adjunctive treatment for major depressive disorder (MDD) in adults, for the treatment of schizophrenia in adults, and for the treatment of agitation associated with Alzheimer's dementia. Rexulti was first approved by the FDA in 2015 for MDD and schizophrenia, and received its Alzheimer's agitation indication in 2023.
Rexulti works as a serotonin-dopamine activity modulator. It acts as a partial agonist at serotonin 5-HT1A and dopamine D2 receptors, and as an antagonist at serotonin 5-HT2A receptors. This unique mechanism helps balance dopamine and serotonin activity in the brain, which can improve mood, reduce psychotic symptoms, and decrease agitation. Unlike some other antipsychotics, Rexulti's partial agonist activity means it modulates neurotransmitter activity rather than simply blocking receptors, which may contribute to its tolerability profile.
Your doctor will typically start you on a low dose and gradually increase it based on your response and tolerability.
Rexulti scores a 62 out of 100 on our findability scale. As a brand-name-only medication manufactured by Otsuka Pharmaceutical, Rexulti is generally available at most major pharmacies but can occasionally be harder to find at smaller or independent pharmacies. There is currently no FDA-approved generic version of Brexpiprazole, and generic availability is not expected until around 2030. Because it is a specialty brand medication, some pharmacies may not keep it consistently in stock, and you may need to call ahead or use Medfinder to locate availability near you.
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Rexulti is most commonly prescribed by psychiatrists, but it can also be prescribed by primary care physicians, neurologists, geriatric specialists, and nurse practitioners or physician assistants with prescriptive authority. For its use in Alzheimer's-related agitation, geriatric psychiatrists and neurologists are the most common prescribers. Any licensed prescriber can write a prescription for Rexulti, though many insurance plans may require prior authorization.
No, Rexulti is not a controlled substance. It is not classified under any schedule of the Controlled Substances Act. Rexulti does not have a known potential for abuse or dependence. However, it is a prescription-only medication and should only be taken under the supervision of a healthcare provider. Stopping Rexulti abruptly is not recommended without consulting your doctor.
Rexulti carries a black box warning regarding increased risk of suicidal thoughts in young adults and increased risk of death in elderly patients with dementia-related psychosis. Always discuss risks and benefits with your healthcare provider.
Rexulti is an effective atypical antipsychotic with a well-established safety profile for treating major depressive disorder, schizophrenia, and Alzheimer's-related agitation. Its main drawback is cost — as a brand-only medication with no generic alternative expected until around 2030, cash prices can exceed $1,400 per month. Patients should explore manufacturer savings programs through Otsuka's Rexulti savings card, which can significantly reduce out-of-pocket costs for eligible patients. If you're having trouble finding Rexulti in stock at your local pharmacy, Medfinder can help you locate availability nearby.
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