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Indications & Uses
Brexpa is indicated for:
Pharmacology
Brexpiprazole is an atypical antipsychotic. Its effects are believed to come from how it modulates the serotonin and dopamine systems. It works as a partial agonist at serotonergic 5-HT1A receptors and at dopaminergic D2 receptors, and as an antagonist at serotonergic 5-HT2A receptors. Its affinity is similarly high at all of these receptors. Brexpiprazole also acts as an antagonist at noradrenergic a1B/2c receptors.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adjunctive Treatment of Major Depressive Disorder
When Brexpiprazole is added to other treatment for major depressive disorder, the recommended starting dose is 0.5 mg or 1 mg once daily, taken by mouth with or without food. The dose is raised to 1 mg once daily, then up to the target of 2 mg once daily. Increases are made at weekly intervals, depending on how the patient responds and how well the medicine is tolerated. The maximum recommended daily dose is 3 mg. Doctors should reassess from time to time whether treatment is still needed and whether the dose is right.
Treatment of Schizophrenia
For schizophrenia, Brexpiprazole is started at 1 mg once daily on Days 1 to 4, taken by mouth with or without food. The recommended target is 2 mg to 4 mg once daily. Titrate to 2 mg once daily on Day 5 through Day 7, then to 4 mg on Day 8, based on the patient's clinical response and tolerability. Maximum recommended daily dose is 4 mg.
Side Effects
Extrapyramidal symptoms, akathisia, suicidality, QT prolongation, weight gain, neuroleptic malignant syndrome, nausea.
Cautions & Contraindications
Warnings & Precautions
Elderly patients with dementia-related psychosis who take Brexpiprazole have a higher incidence of cerebrovascular adverse reactions, such as stroke and transient ischemic attack. If neuroleptic malignant syndrome develops, stop the medicine immediately and monitor the patient closely. With tardive dyskinesia, discontinue if clinically appropriate. Watch for metabolic changes, meaning hyperglycemia or diabetes mellitus, dyslipidemia and weight gain. If pathological gambling or other compulsive behaviors appear, consider reducing the dose or stopping the medicine. For leukopenia, neutropenia and agranulocytosis, perform complete blood counts (CBC) in patients who already have a low white blood cell count (WBC) or a history of leukopenia or neutropenia. Consider discontinuing Brexpiprazole if a clinically significant decline in WBC occurs and there are no other causative factors. For orthostatic hypotension and syncope, monitor heart rate and blood pressure. Warn patients with known cardiovascular or cerebrovascular disease, and those at risk of dehydration or syncope. Use the medicine cautiously in patients with a history of seizures or with conditions that lower the seizure threshold.
Contraindications
Brexpiprazole must not be given to anyone who is known to be hypersensitive to brexpiprazole or to any of the other ingredients in the medicine. Reactions seen so far have included rash, swelling of the face, urticaria and anaphylaxis.
Pregnancy & Breastfeeding
There is a pregnancy exposure registry that follows pregnancy outcomes in women who were exposed to Brexpiprazole while pregnant. No lactation studies have been done, so we don't know whether brexpiprazole passes into human milk, what it does to a breastfed infant, or whether it changes milk production. It is present in rat milk. When deciding about breastfeeding, the mother's clinical need for Brexpiprazole should be weighed together with the development and health benefits of breastfeeding. Any possible adverse effects on the breastfed infant, whether from the medicine or from the mother's underlying condition, should also be considered.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Dosage adjustments for hepatic impairment: If a patient has moderate to severe hepatic impairment, the maximum recommended dose is 2 mg once daily for MDD and 3 mg once daily for schizophrenia.
Dosage adjustments for renal impairment: If a patient has moderate, severe or end-stage renal impairment (creatinine clearance ClCr<60 mL/minute), the maximum recommended dose is 2 mg once daily for MDD and 3 mg once daily for schizophrenia.
Pediatric use: Safety and effectiveness of brexpiprazole in pediatric patients have not been established. Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric patients.
Geriatric use: In general, the dose for an elderly patient should be chosen with caution, usually starting at the low end of the dosing range. This is because decreased hepatic, renal and cardiac function, other diseases and other drug therapy are more frequent in older people.
Storage
Store Brexpiprazole at a temperature no higher than 30°C. Keep it away from light and from damp places. Keep it out of reach of children.
Common questions about Brexpa 1 mg
What is Brexpa 1 mg Tablet?
Brexpa 1 mg Tablet is a medicine that contains Brexpiprazole. It is made by Renata PLC. It belongs to the Benzodiazepine antagonist group of medicines.
What is Brexpa used for?
Brexpa is used for: Depression, Schizophrenia.
What are the side effects of Brexpa?
Extrapyramidal symptoms, akathisia, suicidality, QT prolongation, weight gain, neuroleptic malignant syndrome, nausea.
Can I take Brexpa during pregnancy or while breastfeeding?
There is a pregnancy exposure registry that follows pregnancy outcomes in women who were exposed to Brexpiprazole while pregnant. No lactation studies have been done, so we don't know whether brexpiprazole passes into human milk, what it does to a breastfed infant, or whether it changes milk production. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
How should I store Brexpa?
Store Brexpiprazole at a temperature no higher than 30°C. Keep it away from light and from damp places.
Is there a cheaper medicine with the same ingredient?
Brexpa is already among the lowest-priced brands of Brexpiprazole at this strength.
Do I need a prescription for Brexpa?
Brexpa is a prescription (Rx) medicine. Take it as your doctor advises.