Brexpiprazole

Medication Information Leaflet

What is this medication for?

Brexpiprazole belongs to a class of medications known as atypical (second-generation) antipsychotics. It is used to treat and prevent the return of symptoms in Schizophrenia and other mental health related conditions such as:
  • Hearing, seeing or sensing things that are not real
  • Having mistaken beliefs
  • Uncontrolled anger
  • Being overly suspicious
It can also be used to treat symptoms of depression (low mood) (in combination with other medications) such as:
  • Feelings of sadness
  • Feelings of hopelessness or worthlessness
  • Feeling bad about yourself
  • Suicidal thoughts
  • Poor sleep, energy or appetite
Brexpiprazole may also be used for other conditions. Check with your healthcare professional if you are unsure why you are given this medication.

How should I take/use this medication?

  • Follow the instructions on your medication label and take this medication as prescribed by your doctor.
  • This medication may be taken with or without food.
  • This medication needs to be taken regularly for a few weeks before you feel its full benefits. You should not stop taking this medication even if you do not feel better at the beginning. Continue to take this medication even after you feel better to prevent your symptoms from returning.
  • Do check with your doctor on how long you will have to be on this medication.
  • Do not stop taking your medication without checking with your healthcare professional.

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose. Then take the next dose at your usual timing. Do not take two doses to make up for the missed dose.

What precautions should I take?

Inform your healthcare professional if: 

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side-effects with you and should you have further questions or concerns, do consult your doctor.
  • You are taking any other medications including over-the-counter medications, supplements, traditional Chinese medicine and herbal remedies. Some of them may affect how this medication works or cause serious drug interactions.
  • You have diabetes. Brexpiprazole may sometimes worsen blood glucose control in diabetes. Maintain regular check-ups with your doctor.
  • You have or have ever had:
    • Other drug allergies
    • Medical conditions such as:
      • Heart, kidney or liver disease, stroke
      • Dementia, seizure (fits), high or low blood pressure, high cholesterol/fats in the blood, swallowing difficulties, blood disorders
IMPORTANT:
In some cases, particularly in young people below the age of 25 years, this medication may cause the following changes to a person’s mental condition, especially in the first few weeks of treatment or during dose changes:
  • New or worsening thoughts of harming yourself or ending your life
  • Worsening agitation, restlessness, violent behaviour, or
  • Other changes in mood or behaviour
Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own. 

Do not stop taking this medication on your own without discussing with your doctor. 

It is important to note that your doctor has prescribed this medication as he/ she feels you will benefit more from taking this medication over the possible risks that it may cause, which have a low chance of occurring, and most people take this medication without any of such problems.

What are some common side-effects of this medication?

The mentioned side effects generally affect up to 10% of patients.
  • Nausea, stomach discomfort 
    • Take this medication with or after food
    • Take simple meals and avoid rich or spicy foods
  • Dry mouth
    • Chew sugar-free gum, suck on sugar-free hard candies or ice chips, sip water regularly
  • Constipation
    • Drink more water (if not on fluid-restricted diet), eat more high-fibre foods, and exercise regularly
    • Speak to your doctor or pharmacist if you need a medication to help with your constipation
  • Diarrhoea 
    • Drink plenty of water to replace the loss of fluids
  • Difficulty sleeping
    • Discuss with your doctor if you can take this medication at a different time of the day
    • Avoid daytime naps, listen to relaxing music at bedtime
    • Avoid overeating or drinking before bedtime
    • Limit caffeine intake at least 8 hours before bedtime
  • Light-headedness (especially during a sudden change in posture)
    • Get up slowly from a sitting or lying down position
  • Feeling tired or drowsy
    • Discuss with your doctor if you can take this medication at a different time of the day
    • Avoid driving or engaging in activities requiring concentration
  • Headache 
    • Speak to your doctor if it becomes bothersome
  • Involuntary shaking of limbs (tremors) and/or restlessness or need to keep moving constantly (akathisia)
    • Speak to your doctor if it affects your daily life
  • Increase appetite, weight gain
    • Observe healthy dietary habits and exercise regularly
  • Inflammation of the nose or throat (nasopharyngitis)
    • Speak to your doctor if it becomes bothersome
Most of the side effects listed here will improve with time. Speak to your doctor if they continue, get worse or are affecting your daily life.

What are some rare but serious side-effects that I need to seek medical advice immediately?

The symptoms of a drug allergy include one or more of the following: 
  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body
Rarely this medication may cause:
  • High fever, severe muscle stiffness, confusion, irregular blood pressure (signs and symptoms of neuroleptic malignant syndrome)
  • Muscle stiffness and spasms (such as in the face, neck and back), difficulty in speaking or swallowing, twitching, or upward rolling of eyes (symptoms of dystonia)
  • Uncontrollable movements such as in the face, tongue, jaw or other parts of the body (tardive dyskinesia)
  • Fainting episodes
  • Sudden weakness or numbness in the face, arms or legs, and speech or vision problems
  • Excessive hunger, unusual increase in thirst or passing large amount of urine (symptoms of high blood sugar)
  • Blurred vision
  • Seizures (fits)
  • Strong, uncontrollable urges and behaviours such as gambling, excessive eating, shopping or having sex
  • Fever, sore throat and/or mouth ulcers that do not go away (symptoms of blood dyscrasias) 
  • Increased prolactin hormone in the body (hyperprolactinemia):
    • Changes in menstrual cycle in females (Irregular or stopping of menstrual periods) and/or
    • Abnormal breast swelling, soreness or secretion (in both men and women)
    • Speak to your doctor for further management
If you experience any of these side effects, you should stop your medication and inform your healthcare professional immediately.

Please also take note that not all possible side effects are listed above. If you have any concerns about your medication, please consult your doctor or pharmacist.

What food or medication should I avoid when I take this medication?

Avoid drinking alcohol while taking this medication as it can cause excessive drowsiness.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How should I throw away this medication safely?

Pack this medication into a black trash bag and seal it tightly before throwing it into the rubbish chute or bin.


Disclaimers
If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Last updated on Oct2021
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Brexpiprazole

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