Brexpiprazole is used to treat schizophrenia (an illness that causes changes in perception, thoughts and behaviour). It helps relieve symptoms common in schizophrenia, such as distorted thinking and emotional instability.
This medicine is also used together with other medicines to treat depression.
Take Brexpiprazole exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Brexpiprazole must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Inform your doctor if you have the following conditions:
- heart disease
- risk factors for low blood pressure e.g. dehydration
- high blood pressure
- fits or seizures
- blood disorders or a low white blood cell count
- Parkinson's disease (a disorder that affects the movement of a person)
- Alzheimer's disease (a progressive disease which destroys memory and other important mental functions)
- past experience with excessive gambling or other compulsive behaviours
- sleep apnoea (a sleep disorder where your breathing is interrupted during sleep)
- kidney disease
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Brexpiprazole is not suitable for elderly people with dementia-related psychosis.
Individuals who are poor metabolizers of CYP2D6 may experience enhanced side effects of this medicine (e.g. drowsiness). If you know you have this gene type, inform your doctor.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and heart function, blood test, cholesterol/sugar/electrolyte levels, eye examination) may be done before or while you are being treated with this medicine.
- Your blood pressure may change from time to time without you noticing it. Monitor your blood pressure during treatment.
- Regular monitoring of changes in menstruation or sexual function and involuntary muscle movements may also be needed.
Your doctor will advise you about how often you need to have these tests.
Medicines for depression such as Brexpiprazole may increase the risk of suicidal thoughts and behaviour. As depression and some psychiatric disorders are themselves associated with an increased risk of suicide, it is important for you or your family members to monitor your condition especially at the start of treatment and if your dosage is still being adjusted. If you experience new or sudden changes in mood, behaviour, thoughts or feelings or a worsening of your depression with suicidal thoughts or attempts, harm to self or harm to others, contact your doctor immediately.
What lifestyle changes should I make?
Brexpiprazole may affect the ability of your body to adjust to temperature changes in the environment. Avoid exposure to very cold or very hot environments. Avoid strenuous exercise and activities like going to the sauna. Drink more water to prevent dehydration.
Regular exercise and eating a healthy diet will help increase energy and hormones in the body such as serotonin, endorphins and other feel-good chemicals that minimise mood swings. Get enough sleep, as lack of sleep may cause irritability, moodiness, sadness, and tiredness.
Brexpiprazole may cause drowsiness, dizziness or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Other side effects include any of the following: headache, nausea, vomiting, indigestion, constipation, dry mouth, excessive salivation, tiredness, anxiety, restlessness, difficulty sleeping, and weight gain.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- having thoughts of self-harm
- unusual changes in mood or behaviour (being aggressive, agitated, or having compulsive and impulsive behaviour) or uncontrollable urges
- sudden high fever, high blood pressure, fast heartbeat, muscle cramps or stiffness, severe headache, excessive sweating and convulsion
- abnormal movements of your body or face, such as sticking out of the tongue, smacking of the lips
- swelling, pain and redness in the leg, chest pain or difficulty in breathing, or difficulty in swallowing
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines to treat depression e.g. paroxetine, fluoxetine
- medicines to treat fungal infections e.g. ketoconazole, itraconazole
- medicines for HIV infection e.g. ritonavir
- medicines to treat TB (lung infection known as tuberculosis) e.g. rifampicin
- quinidine (medicine for irregular heartbeat)
- St. John's wort (herbal medicine)
This list does not include all medicines that may interact with Brexpiprazole.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the drowsiness caused by Brexpiprazole.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.