brexpiprazole brexpiprazole brexpiprazole, sold under the brand name rexulti among others, is a medication used for the treatment of major depressive disorder, schizophrenia, and agitation associated with dementia due to alzheimer's disease. it is an atypical antipsychotic. brexpiprazoleclinical datapronunciation/brɛkˈspɪprəzoʊl/ brek-spip-rə-zohl trade namesrexulti, rxulti, othersother namesopc-34712ahfs/drugs.commonographmedlineplusa615046license data eu ema: by inn us dailymed: brexpiprazole pregnancycategory au: c routes ofadministrationby mouthdrug classatypical antipsychoticatc coden05ax16 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only us: ℞-only eu: rx-only in general: ℞ (prescription only) pharmacokinetic databioavailability95% (tmax = 4 hours)protein binding>99%metabolismliver (mainly mediated by cyp3a4 and cyp2d6)elimination half-life91 hours (brexpiprazole), 86 hours (major metabolite)excretionfeces (46%), urine (25%)identifiers iupac name 7-butoxy]quinolin-2(1h)-one cas number913611-97-9pubchem cid11978813drugbankdb09128chemspider10152155unii2j3ybm1k8ckeggd10309chebichebi:134716chemblchembl2105760comptox dashboard (epa)dtxsid40238527 echa infocard100.242.305 chemical and physical dataformulac25h27n3o2smolar mass433.57 g·mol−13d model (jsmol)interactive image smiles o=c5/c=c\c4ccc(occccn3ccn(c1cccc2sccc12)cc3)cc4n5 inchi inchi=1s/c25h27n3o2s/c29-25-9-7-19-6-8-20(18-22(19)26-25)30-16-2-1-11-27-12-14-28(15-13-27)23-4-3-5-24-21(23)10-17-31-24/h3-10,17-18h,1-2,11-16h2,(h,26,29)key:zkiaiybusxzplp-uhfffaoysa-n the most common side effects include akathisia (a constant urge to move) and weight gain. the most common side effects among people with agitation associated with dementia due to alzheimer's disease include headache, dizziness, urinary tract infection, nasopharyngitis, and sleep disturbances (both somnolence and insomnia). brexpiprazole was developed by otsuka and lundbeck, and is considered to be a successor to aripiprazole (abilify). it was approved for medical use in the united states in july 2015. a generic version was approved in august 2022. brexpiprazole is the first treatment approved by the us food and drug administration (fda) for agitation associated with dementia due to alzheimer's disease. medical uses in the united states and canada, brexpiprazole is indicated as an adjunctive therapy to antidepressants for the treatment of major depressive disorder and for the treatment of schizophrenia. in may 2023, the indication for brexpiprazole was expanded in the us to include the treatment of agitation associated with dementia due to alzheimer's disease. in australia and the european union, brexpiprazole is indicated for the treatment of schizophrenia. in 2020, it was approved in brazil only as an adjunctive to the treatment of major depressive disorder. side effects the most common adverse events associated with brexpiprazole (all doses of brexpiprazole cumulatively greater than or equal to 5% vs. placebo) were upper respiratory tract infection (6.9% vs. 4.8%), akathisia (6.6% vs. 3.2%), weight gain (6.3% vs. 0.8%), and nasopharyngitis (5.0% vs. 1.6%). brexpiprazole can cause impulse control disorders. pharmacology pharmacodynamics