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REXULTI is an atypical antipsychotic indicated for:
• Use as an adjunctive therapy to antidepressants for the treatment of major depressive disorder
• Treatment of schizophrenia
Most common adverse reactions caused by Rexulti were:
- MDD: Weight increased and akathisia (≥5% and at least twice the rate for placebo)
- Schizophrenia: Weight increased (≥4% and at least twice the rate for placebo)
Factors Dosage Adjustments for REXULTI
- Strong CYP2D6* or CYP3A4 inhibitors, Administer half of usual dose
- Strong/moderate CYP2D6
- Strong/moderate CYP3A4 inhibitors, Administer a quarter of usual dose
- Known CYP2D6 Poor Metabolizers taking strong/moderate CYP3A4
inhibitors Administer a quarter of usual dose - Strong CYP3A4 inducers Double the usual dose and further
adjust based on clinical response
Cerebrovascular Adverse Reactions in Elderly Patients with DementiaRelated Psychosis: Increased incidence of cerebrovascular adverse
reactions (e.g. stroke, transient ischemic attack)
• Neuroleptic Malignant Syndrome: Manage with immediate
discontinuation and close monitoring
• Tardive Dyskinesia: Discontinue if clinically appropriate
• Metabolic Changes: Monitor for hyperglycemia/diabetes mellitus,
dyslipidemia and weight gain
• Pathological Gambling and Other Compulsive Behaviors: Consider
dose reduction or discontinuation
• Leukopenia, Neutropenia, and Agranulocytosis: Perform complete blood
counts (CBC) in patients with pre-existing low white blood cell count
(WBC) or history of leukopenia or neutropenia. Consider discontinuing
REXULTI if a clinically significant decline in WBC occurs in absence
of other causative factors
• Orthostatic Hypotension and Syncope: Monitor heart rate and blood
pressure and warn patients with known cardiovascular or
cerebrovascular disease, and risk of dehydration or syncope
• Seizures: Use cautiously in patients with a history of seizures or with
conditions that lower the seizure threshold
