Rexulti Dosage/Direction for Use

Adjunctive Treatment of Major Depressive Disorder: The recommended starting dosage for Brexpiprazole (Rexulti) as adjunctive treatment is 500 mcg or 1 mg once daily, taken orally with or without food [see Pharmacology: Pharmacokinetics under Actions].
Titrate to 1 mg once daily, then up to the target dosage of 2 mg once daily. Dosage increases should occur at weekly intervals based on the patient's clinical response and tolerability. The maximum recommended daily dosage is 3 mg. Periodically reassess to determine the continued need and appropriate dosage for treatment.
Treatment of Schizophrenia: The recommended starting dosage for Brexpiprazole (Rexulti) is 1 mg once daily on Days 1 to 4, taken orally with or without food [see Pharmacology: Pharmacokinetics under Actions].
The recommended target Brexpiprazole (Rexulti) dosage 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. The maximum recommended daily dosage is 4 mg. Periodically reassess to determine the continued need and appropriate dosage for treatment.
Dosage Adjustments for Hepatic Impairment: For patients with moderate to severe hepatic impairment (Child-Pugh score ≥7), the maximum recommended dosage is 2 mg once daily for patients with MDD, and 3 mg once daily for patients with schizophrenia [see Hepatic Impairment under Precautions, Pharmacology: Pharmacokinetics under Actions].
Dosage Adjustments for Renal Impairment: For patients with moderate, severe or end-stage renal impairment (creatinine clearance CL_cr<60 mL/minute), the maximum recommended dosage is 2 mg once daily for patients with MDD and 3 mg once daily for patients with schizophrenia [see Renal Impairment under Precautions, Pharmacology: Pharmacokinetics under Actions].
Dosage Modifications for CYP2D6 Poor Metabolizers and for Concomitant use with CYP Inhibitors or Inducers: Dosage adjustments are recommended in patients who are known cytochrome P450 (CYP) 2D6 poor metabolizers and in patients taking concomitant CYP3A4 inhibitors or CYP2D6 inhibitors or strong CYP3A4 inducers (see Table 4). If the coadministered drug is discontinued, adjust the Brexpiprazole (Rexulti) dosage to its original level. If the coadministered CYP3A4 inducer is discontinued, reduce the Brexpiprazole (Rexulti) dosage to the original level over 1 to 2 weeks [see Drugs Having Clinically Important Interactions with Brexpiprazole (Rexulti) under Interactions, Pharmacology: Pharmacokinetics under Actions]. (See Table 4.)

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Patients with Lactose Intolerance: Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should be aware that brexpiprazole tablets contain lactose.