Rexulti (brexpiprazole) is a prescription drug used to treat agitation caused by dementia due to Alzheimer’s disease. It’s prescribed for this use in adults. Rexulti does not come as a generic drug.

Rexulti comes as an oral tablet.

The active ingredient in Rexulti is brexpiprazole. Rexulti belongs to a group of drugs called atypical antipsychotics.

Rexulti has boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What should I know before taking Rexulti?” section.

Dementia refers to a severe decline in your cognitive function. Cognitive function refers to behavior, thinking, memory, judgment, and language. A decline in cognitive function is a typical part of aging, but dementia is not. With dementia, the decline in cognitive function is severe enough that it affects daily life, emotions, and personality.

Alzheimer’s disease is the most common type of dementia. It’s a progressive condition, which means symptoms gradually worsen over time. It’s also a degenerative condition, meaning it causes a slow decline in cognitive function. That said, symptoms may appear more rapidly or worsen more quickly in some people.

Agitation is a common symptom of Alzheimer’s disease. It may involve excessive physical movements or restlessness. It can even cause someone to lash out physically or verbally at anyone nearby.

What are the symptoms of Alzheimer’s disease?

Symptoms of dementia due to Alzheimer’s disease include:

  • memory loss that affects the ability to carry out tasks of daily living, such as remembering appointments
  • mood and personality changes, such as acting unusually agitated or aggressive
  • problems with familiar tasks, such as using a microwave or oven
  • difficulty with problem solving, speech, or writing
  • disorientation with respect to time or place

It’s important to note that each person’s experience with dementia due to Alzheimer’s disease is different, and that these symptoms may change over time.

Who is Rexulti prescribed for?

Rexulti is prescribed to treat agitation from dementia due to Alzheimer’s disease in adults.

Note: Rexulti should not be used “as needed” to treat agitation due to dementia caused by Alzheimer’s disease. (When a drug is prescribed “as needed”, a dose is taken only when symptoms appear or suddenly worsen.) Rexulti is only approved to be taken regularly on a scheduled basis.

Rexulti is approved for treating agitation from dementia due to Alzheimer’s disease in adults. If you’re prescribed Rexulti for this use, you may want to know how it works to treat your condition. How a drug works is also referred to as its mechanism of action.

How does Rexulti work?

It’s currently not known how Rexulti works to treat agitation from dementia due to Alzheimer’s disease. It may be related to Rexulti’s action to regulate the levels of dopamine and serotonin in the brain. Dopamine and serotonin are neurotransmitters, which are chemical messengers used by your nervous system.

More research is needed to understand exactly how Rexulti works.

Is Rexulti used in children?

Typically, dementia and Alzheimer’s disease are viewed as conditions affecting older adults. Childhood Alzheimer’s is a term used to refer to rare conditions that cause memory loss and other symptoms associated with Alzheimer’s disease in children.

Studies of Rexulti for treating agitation due to dementia related to Alzheimer’s disease did not include children. So it’s not clear whether Rexulti is safe or effective for treating agitation related to childhood Alzheimer’s.

Rexulti is approved for treating schizophrenia in children ages 13 years and older. Your child’s doctor or pharmacist can provide more information about this use if you’re interested in learning more.

If you’re prescribed Rexulti to treat agitation from dementia due to Alzheimer’s disease, you may want to know more about how effective the medication is for this use.

Clinical studies found Rexulti effective at managing agitation from dementia due to Alzheimer’s disease. To learn more about these studies, talk with your doctor or pharmacist. You can also read more about these studies in Rexulti’s prescribing information.

Guidelines from the American Psychological Association recommend using an antipsychotic (such as Rexulti) to treat agitation from dementia due to Alzheimer’s disease in certain situations. Your doctor or pharmacist can provide more information on these guidelines.

The following sections contain information on how Rexulti is taken for treating agitation from dementia due to Alzheimer’s disease.

These dosages are recommended by the manufacturer based on clinical studies of Rexulti, but your doctor may prescribe a different dosage for you. Follow your doctor’s directions for taking Rexulti, and let them know if you have questions about the dosage you’re prescribed.

What is the usual dosage for Rexulti?

For treating agitation from dementia due to Alzheimer’s disease, you’ll likely start with a low Rexulti dose. Then, your doctor may slowly increase your dose over time, depending on how your symptoms respond to treatment.

The recommended starting dose of Rexulti for this use is 0.5 milligrams (mg) once per day. You’ll likely take this dose for 7 days, after which your doctor will likely increase your dose to 1 mg once per day. After another 7 days, your doctor will likely increase your dose again to 2 mg once per day. This is the recommended Rexulti dose for treating agitation from dementia due to Alzheimer’s disease. The maximum recommended dose for this use is 3 mg once per day.

Your Rexulti dosage will depend on several factors, including other medications you take and whether you have kidney or liver problems. Before you start taking Rexulti, be sure your doctor is aware of all medications you take and other medical conditions you have.

Note: Rexulti has other uses in addition to treating agitation from dementia due to Alzheimer’s disease. The dosage may be different for these other uses. To learn more, talk with your doctor. You can also refer to this in-depth Rexulti dosage article.

How do you take Rexulti?

Rexulti comes as a tablet that you swallow. Rexulti tablets are available in the following strengths:

  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg
  • 3 mg
  • 4 mg

Rexulti tablets may be taken with or without food. But the manufacturer hasn’t stated whether it’s safe to chew, crush, or split Rexulti tablets. If you have difficulty swallowing pills, let your pharmacist or doctor know.

How often should I take Rexulti?

Rexulti is typically taken once per day.

It’s important to note that Rexulti is not approved for “as needed” use to treat agitation from dementia due to Alzheimer’s disease. (With as needed use, a medication is only taken if symptoms appear or suddenly worsen.) Rexulti should be taken once per day, even if you aren’t having agitation symptoms.

Taking Rexulti to treat agitation from dementia due to Alzheimer’s disease* may cause side effects in some people. These side effects can be mild or serious.

The following lists include some of the main side effects that have been reported in people taking Rexulti. For information about other possible side effects of this medication, talk with your doctor or pharmacist.

You can also learn more from the Rexulti side effects article or from Rexulti’s prescribing information.

* Rexulti is also approved to treat other conditions. It’s important to note that side effects from Rexulti may differ depending on the condition it’s being taken to treat.

What are Rexulti’s mild side effects?

Rexulti may cause mild side effects in some people. These include:

In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage, too. But if side effects last for a longer time, or if they bother you or become severe, talk with your doctor or pharmacist.

What are Rexulti’s serious side effects?

Taking Rexulti may lead to rare but serious side effects. Examples include:

Call your doctor right away if you have any serious side effects while taking Rexulti. If the side effects seem life threatening or if you think you’re having a medical emergency, call 911 or your local emergency number immediately.

* A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details about this side effect, see the “What should I know before starting Rexulti?” section.

Allergic reaction

For some people, Rexulti can cause an allergic reaction.

But it’s not clear whether this side effect occurred in the drug’s studies.

In general, symptoms of allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should continue Rexulti treatment.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Rexulti, they may have you switch to a different treatment.

Before you start Rexulti, there’s some important information to keep in mind. The drug may not be a safe option for you if you have certain medical conditions or other factors that affect your health. Some of these are mentioned in the following sections.

Boxed warnings

This drug has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Increased risk of death if used to treat dementia-related psychosis in older adults: Rexulti is not approved for treating dementia-related psychosis in older adults. Studies show that taking antipsychotics (such as Rexulti) to treat dementia-related psychosis in older adults increases the risk of death.

Because of this risk, doctors typically won’t prescribe Rexulti for dementia-related psychosis without agitation. Instead, they’ll prescribe other treatments that don’t carry this risk.

Risk of suicidal thoughts and behaviors in certain people: Medications used to treat depression, including Rexulti, can cause a short-term increase in the risk of suicidal thoughts and behaviors. (Rexulti is used to treat depression in certain adults.)

This risk applies to adults ages 24 years and under, and children of any age. Rexulti may still cause these side effects even when used to treat agitation due to dementia related to Alzheimer’s disease. This risk is higher when starting treatment and any time your doctor changes your Rexulti dosage.

During treatment with Rexulti, you and your doctor should monitor for changes to your behaviors, feelings, mood, or thoughts. Immediately report any changes to your doctor. If you’re comfortable doing so, let a close family member or friend know you’re taking Rexulti. They can help monitor for these changes during your treatment.

What other warnings should I know about?

In addition to boxed warnings, Rexulti has other warnings. If any of the following medical conditions or other health factors apply to you, tell your doctor before starting Rexulti.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

The price of Rexulti depends on several factors. These can include your treatment plan, your insurance plan, the pharmacy you use, and your location.

Rexulti is a brand-name drug that is not available as a generic. Brand-name drugs usually cost more than generics.

To save money on your Rexulti prescription, explore these Optum Perks coupons. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)

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.