OverviewDosageSide EffectsInteractionsHalf-Life

As is the case with any other medication, there may be some instances where Rexulti (brexpiprazole) use is not recommended or usage will have to be adjusted in order to prevent or reduce the risk of negative interactions occurring from other drugs, medical conditions, or even food and drink.

Drug Interactions

Drugs that may interact with Rexulti include the following.

  • Wellbutrin (bupropion)
  • Zoloft (sertraline)
  • Sertraline (Zoloft)
  • Cymbalta (duloxetine)
  • Prozac (fluoxetine)
  • Fluoxetine (Prozac)
  • Lexapro (escitalopram)
  • Aripiprazole (Abilify Maintena, Abilify, Aristada)
  • Cariprazine (Vraylar, Reagila)
  • Prolactin (lactotropin)
  • St. John’s wort

Please note that this list may not be complete, and other interactions with drugs not listed here may occur.

Rexulti and Wellbutrin

Taking Rexulti and Wellbutrin together may increase the exposure of brexpiprazole compared to the use of Rexulti alone, potentially increasing the risk of side effects. It may be necessary to adjust dosing.

Rexulti and Zoloft

Zoloft may increase the blood level of brexpiprazole, potentially increasing the risk of side effects. It may be necessary to adjust dosing.

Brexpiprazole and Sertraline

Sertraline may increase the blood level of brexpiprazole potentially increasing the risk of side effects. It may be necessary to adjust dosing.

Rexulti and Cymbalta

Taking Rexulti together with Cymbalta may increase the exposure of brexpiprazole compared to the use of Rexulti alone, potentially increasing the risk of side effects. It may be necessary to adjust Rexulti dosing.

Rexulti and Prozac

Prozac may increase the blood level of brexpiprazole, potentially increasing the risk of side effects. It may be necessary to adjust dosing.

Brexpiprazole and Fluoxetine

Using Rexulti with fluoxetine increases the exposure of brexpiprazole compared to the use of Rexulti alone, increasing side effects. It may be necessary to adjust dosing.

Rexulti and Lexapro

Using Lexapro together with Rexulti may increase side effects, such as:

  • dizziness,
  • drowsiness,
  • confusion, and
  • difficulty concentrating.

Brexpiprazole and Aripiprazole

Aripiprazole may increase side effects of Rexulti, such as:

  • drowsiness,
  • blurred vision,
  • dry mouth,
  • heat intolerance,
  • flushing,
  • decreased sweating,
  • difficulty urinating,
  • abdominal cramping,
  • constipation,
  • irregular heartbeat,
  • confusion, and
  • memory problems.

Brexpiprazole and Cariprazine

Cariprazine may increase brexpiprazole’s side effects, such as:

  • drowsiness,
  • blurred vision,
  • dry mouth,
  • heat intolerance,
  • flushing,
  • decreased sweating,
  • difficulty urinating,
  • abdominal cramping,
  • constipation,
  • irregular heartbeat,
  • confusion, and
  • memory problems. 

Brexpiprazole and Prolactin

Brexpiprazole increases serum prolactin levels in mice and rats, a protein that helps mammals produce milk. Specifically, it potentially causes proliferative (rapidly increasing) and neoplastic (tumor growth) changes in the mammary (breast) and pituitary (major endocrine gland) glands. However, the effect of brexpiprazole on prolactin in humans is unknown.

Food Interactions

Sometimes the foods we eat and the beverages we drink can also interact with our medications.

Food and drink that may interact with Rexulti include:

  • Grapefruit and grapefruit juice
  • Alcohol
  • Nicotine

Please note that this list may not be complete, and there may be other foods and beverages that interact with this drug.

Rexulti and Grapefruit

Grapefruit and grapefruit juice can dangerously raise blood levels of some antipsychotic drugs, such as Rexulti. Therefore, people on this medication should avoid this fruit.

Rexulti and Alcohol

For more information, please visit our page on Rexulti and alcohol interactions.

Rexulti and Nicotine

Nicotine can decrease the effectiveness of Rexulti. Ask your doctor to help you stop smoking if you do.

Disease & Conditions Interactions

Sometimes certain medications can increase the risk of negative side effects for patients with certain diseases or other medical conditions.

According to the FDA, diseases and medical conditions that are known to negatively interact with Rexulti include:

  • Weight gain
  • Pregnancy
  • PTSD
  • Anxiety

Please note that this list may not be complete, and there may be other diseases and medical conditions where patients should not take Rexulti.

Rexulti and Weight Gain

Weight gain is one of the most common side effects of this medication.

Rexulti and Pregnancy

For more information, please visit our page on Rexulti and pregnancy risks.

Brexpiprazole and PTSD

When used in combination with Zoloft (sertraline), brexpiprazole can have positive effects in adult patients suffering from post-traumatic stress disorder.

Brexpiprazole and Anxiety

Adjunctive (in combination with) brexpiprazole therapy can reduce depressive symptoms in patients with clinically relevant anxiety symptoms who have not responded to antidepressant monotherapy. 

Other Interactions

Other potential interactions include the following.

Brexpiprazole and Weed

Smoking weed and use of marijuana may reduce the efficacy of some antipsychotic drugs. Cannabinoids in marijuana can produce psychotoxic effects and may exacerbate (worsen) psychiatric disorders. 

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.


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