Rexulti

• Risk factors: Older adults with dementia-related psychosis

Older adults with dementia sometimes have symptoms like hallucinations or delusions, which is called dementia-related psychosis. People with this condition who take antipsychotic medications like Rexulti (brexpiprazole) have a higher risk of death, usually from heart problems or infections. Studies have also shown that older adults with dementia who took similar medications had a higher chance of having a stroke.

Rexulti (brexpiprazole) isn't approved to treat dementia-related psychosis unless it's for agitation caused by Alzheimer’s disease. If you have questions about the risks, talk to your prescriber.

• Risk factors: People age 24 or younger | Taking antidepressants

Taking Rexulti (brexpiprazole) can put you at risk for having suicidal thoughts and behaviors. Your risk is higher if you're 24 years old or younger, or taking antidepressants like sertraline (Zoloft) or fluoxetine (Prozac). Look out for worsening depression or sudden changes in your mood, behavior, thoughts, or feelings, especially during the first few months of treatment or after a dose changes. Family members and caregivers should also watch for any unusual behavior and contact your prescriber right away if they’re concerned.

Rexulti (brexpiprazole) can cause neuroleptic malignant syndrome (NMS), a rare but serious condition that can be life-threatening. Symptoms include a very high fever, stiff muscles, confusion, a fast or uneven heartbeat, and sweating. Stop taking Rexulti (brexpiprazole) and get medical attention right away if you have these symptoms.

• Risk factors: Older adults | Women | Higher than recommended doses of Rexulti (brexpiprazole) | Taking Rexulti (brexpiprazole) for a long time

Rexulti (brexpiprazole) can cause uncontrolled and possibly permanent muscle movements in your face, tongue, arms, or legs. This is known as tardive dyskinesia). To lower your risk, your mental health provider will prescribe the lowest dose needed to manage your symptoms. Get medical help right away if you notice any unusual movements you can't control. This side effect can sometimes occur even after you stop the medication.

Rexulti (brexpiprazole) can raise your blood sugar levels, and in some cases, this might lead to diabetes. Let your prescriber know if you notice symptoms like feeling very hungry or thirsty, urinating more often, stomach pain, weakness, or fruity-smelling breath.

Rexulti (brexpiprazole) can also cause high cholesterol and triglycerides (fat), which can raise your risk of heart problems. The medication can also cause weight gain.

Your prescriber will likely check your blood sugar, cholesterol, and weight before you start and regularly while you’re taking this medication.

Rexulti (brexpiprazole) can make it harder to control your actions and might lead to strong urges or behaviors like gambling, eating, shopping, or sex. Many people don’t realize these behaviors are unusual, so it’s important for you and your loved ones to watch for any new or intense urges. If you notice this happening while taking Rexulti (brexpiprazole), tell your prescriber right away. In some cases, the urges went away when the dose was lowered or the medication was stopped. If left untreated, these behaviors can cause harm to you or others.

• Risk factors: History of low white blood cell counts | Taking other medications that lower white blood cell counts

Rexulti (brexpiprazole) can lower your white blood cells count, which can raise your risk for serious infection. You might need to get lab work done regularly to make sure your white blood cell count is healthy. If your levels drop too low, your prescriber might need to stop the medication. Talk to your prescriber right away if you experience symptoms of an infection, including fever, weakness, or sore throat, while taking Rexulti (brexpiprazole).

• Risk factors: Starting Rexulti (brexpiprazole) for the first time | Higher dose of Rexulti (brexpiprazole) | Older adults | History of dehydration | Not enough fluids in your body | History of heart problems | Taking medications that lower blood pressure

Rexulti (brexpiprazole) can cause sleepiness, dizziness, balance problems, and a drop in blood pressure when you sit up or stand up too quickly. This can result in fainting and falling. Your risk of falls is higher if you have heart problems, are dehydrated, or are also taking blood pressure lowering medications. To lower your risk, sit or stand up slowly — especially in the first few days after starting the medication or if your dose has been raised. Talk to your prescriber if you keep feeling dizzy while taking this medication.

• Risk factors: History of seizures | Health conditions that raise the risk of seizures | Older adults

Like other antipsychotic medications, Rexulti (brexpiprazole) can cause seizures. The risk is higher if you’ve had seizures before or have health problems that make seizures more likely. Let your care team know if you have a history of seizures or start to feel unusual symptoms while taking this medication.

Atypical antipsychotics like Rexulti (brexpiprazole) can make it harder for your body to cool down properly. Things like intense exercise, hot weather, dehydration, or taking other medications that affect body temperature can make this worse. Talk to your prescriber if you have questions or notice problems with staying cool.

Rexulti (brexpiprazole), like other antipsychotic medications, can cause trouble swallowing and raise your risk of aspiration, which is when food or liquid accidentally goes into your lungs instead of your stomach. Let your care team know if you notice trouble swallowing while taking this medication.

Rexulti (brexpiprazole) can cause drowsiness and might affect your judgment, thinking, or movement. Be careful with activities that need you to stay alert, like driving or using heavy machinery, until you know how this medication affects you. Talk to your prescriber if you feel very sleepy or have trouble thinking clearly while taking this medication.