Rexulti side effects and how to avoid them

Rexulti is a brand-name medication manufactured by Otsuka America Pharmaceutical, Inc. It is classed as an atypical antipsychotic and is used in combination with other antidepressants for the treatment of mental illnesses such as major depressive disorder (MDD) and the symptoms of schizophrenia. While Rexulti is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Rexulti include constipation and diarrhea. Less common, but more serious side effects, can include seizures and allergic reactions.

Learn more about the side effects of Rexulti and what you can do to avoid them.

What is Rexulti (brexpiprazole)?

Rexulti is a medicine prescribed to adults who have major depressive disorder or schizophrenia. If you have major depressive disorder, Rexulti is often prescribed alongside your current antidepressant when that antidepressant isn’t effectively treating your depression.

The active ingredient in Rexulti is called brexpiprazole which reduces your symptoms of depression or schizophrenia by changing the levels of two neurotransmitters in your brain (serotonin and dopamine). Neurotransmitters allow chemical signals to pass between the cells in your brain (neurons) and help regulate brain functions such as thinking, emotion, mood, learning, motivation, reward, and many others.

Rexulti dosage

Rexulti is available in tablet form, in the following doses: 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg.

Take Rexulti once daily with or without food. Your exact dosage will be based on your age and the condition you are being treated for. If you miss a dose, take it as soon as you remember. Skip the missed dose if it is almost time for your next dose.

You are advised to read the prescribing information and medication guide provided with this medicine for the drug information and patient information, and always speak with your healthcare provider for medical advice about any changes to your dose so they can monitor and evaluate your condition.

Rexulti side effects

The most common possible side effects of Rexulti include:

  • Weight gain
  • Indigestion
  • Constipation
  • Diarrhea
  • Tremors
  • Sedation
  • Tiredness
  • Restlessness/feeling like you need to move (akathisia)

Rexulti can cause more serious side effects, including:

  • An increased risk of suicidal thoughts and suicide, particularly in young adults
  • Considerable weight gain
  • Strokes, particularly in elderly people
  • Severe allergic reactions to the medication – rash, itching, swelling of the face, tongue, or throat, severe dizziness, trouble breathing
  • Neuroleptic Malignant Syndrome (NMS) – a rare but potentially fatal condition caused by a reaction to the medication
  • Tardive dyskinesia – uncontrolled body movements, often in your face and tongue
  • High blood sugar (hyperglycemia) – increased thirst and/or urination, dry mouth, fruity breath odor
  • High cholesterol and triglycerides – this may increase your risk of developing heart disease and diabetes
  • Low white blood cell counts
  • Low blood pressure (orthostatic hypotension)
  • Unusual urges and an increase in impulsive behaviors, including sexual urges, gambling, compulsive eating, and compulsive shopping
  • Seizures
  • Problems with swallowing, that can cause food or liquid to get into your lungs
  • Difficulty controlling body temperature that can lead to you overheating and getting dehydrated

If you experience any of these serious side effects, stop taking Rexulti and seek medical attention immediately. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

Rexulti drug interactions

Rexulti can interact with other medications including:

  • Any other antidepressants – fluoxetine, paroxetine
  • Any other medications that can affect your serotonin or dopamine levels
  • Any other medications taken to treat mental states and conditions, like mood and thought disorders, anxiety, or psychotic disorders
  • An herbal supplement called St. John’s Wort

Before taking Rexulti, be sure to tell your doctor about all of the medications you are taking to ensure they are safe to take at the same time.

Rexulti warnings & precautions

Don’t take Rexulti if:

  • Are allergic to the active ingredient brexpiprazole
  • Are allergic to any of the other ingredients in Rexulti
  • You are an older adult with dementia-related psychosis, due to an increased risk of death
  • Are under 18 years of age

Talk to your doctor before taking Rexulti if you:

  • Are taking any of the medications that could interact with Rexulti
  • Have previously had suicidal thoughts or have tried to commit suicide
  • Have a family history of diabetes
  • Have high levels of blood fats, like cholesterol or triglycerides
  • Have ever had seizures (convulsions)
  • Have high blood pressure
  • Have heart problems
  • Have, or have had a stroke
  • Have, or have had, a low white blood cell count
  • Are pregnant – Taking antipsychotic medication in the final 3 months of pregnancy may cause problems with breathing or feeding, extrapyramidal symptoms (uncontrolled movements), and withdrawal symptoms in the newborn
  • Are breastfeeding or are planning to breastfeed – It is not known if this medication passes into breast milk

You should always check with your doctor or pharmacist before taking any medication, including Rexulti, to make sure it is safe for you.

Other warnings you should know about

Antidepressants can increase your risk of suicidal thoughts and suicide, especially in children and young adults, often during the first few months of treatment. Rexulti is not for use in children, but young adults taking it should be monitored for signs of sudden changes in behavior, mood, thoughts, or feelings. Seek urgent medical attention if you, or someone you care for notice worsening depression or other psychiatric conditions.

Stopping Rexulti suddenly can cause a condition called discontinuation syndrome. This can cause withdrawal-like side effects, some of which can be serious. Talk to your doctor if you want to stop taking Rexulti. They may decrease your dose slowly to avoid discontinuation syndrome.

Rexulti can cause drowsiness which can impair your ability to drive, use machinery, or perform other dangerous tasks. Don’t do so after taking Rexulti until you’re confident it doesn’t make you drowsy.

How to avoid Rexulti side effects

The best way to avoid side effects is to take Rexulti as directed by your doctor. Follow your doctor’s instructions carefully and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Rexulti that has been recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Rexulti. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Avoid alcohol

Avoid drinking alcohol while taking Rexulti as it can increase your risk of falling.

5. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet for any cuts, sores, or redness regularly. Tell your doctor if you experience any problems with your feet while taking Rexulti.

7. Know the signs and symptoms of Rexulti side effects

Signs and symptoms of side effects include drowsiness and tiredness. If you experience any of these symptoms speak to your doctor for medical advice.

8. Monitor your weight

Rexulti may cause serious weight gain. If you experience this side effect while taking Rexulti, get medical advice from your doctor.

9. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Rexulti.

10. Get regular medical check ups

It is important to get regular medical check ups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Rexulti as needed.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.