| Major Depressive Disorder
Aplenzin vs Rexulti
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Aplenzin vs Rexulti with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRexulti has a higher rate of injection site reactions vs Aplenzin based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rexulti but not Aplenzin, including UnitedHealthcare
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Category
Aplenzin
Rexulti
At A Glance
Oral
Once daily
Norepinephrine-dopamine reuptake inhibitor
Oral
Once daily
Atypical antipsychotic
Indications
- Major Depressive Disorder
- Seasonal Affective Disorder
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
Dosing
Major Depressive Disorder Starting dose 174 mg once daily in the morning; after 4 days, increase to target dose of 348 mg once daily.
Seasonal Affective Disorder Starting dose 174 mg once daily; after 7 days, increase to target dose of 348 mg once daily in the morning; initiate in autumn, continue through winter, taper and discontinue in early spring.
Hepatic Impairment Moderate to severe (Child-Pugh 7-15): maximum 174 mg every other day; mild (Child-Pugh 5-6): consider reducing dose and/or frequency.
Renal Impairment Consider reducing dose and/or frequency in patients with GFR less than 90 mL/min.
Major Depressive Disorder Start 0.5 mg or 1 mg orally once daily; titrate to target 2 mg once daily; maximum 3 mg once daily.
Schizophrenia Adults: start 1 mg once daily, titrate to target 2-4 mg once daily (max 4 mg); pediatric patients 13-17 years: start 0.5 mg once daily, titrate to target 2-4 mg once daily (max 4 mg).
Agitation in Dementia Start 0.5 mg orally once daily; titrate to target 2 mg once daily; maximum 3 mg once daily.
Contraindications
- Seizure disorder
- Current or prior diagnosis of bulimia or anorexia nervosa
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Concomitant use or use within 14 days of an MAOI intended to treat psychiatric disorders
- Starting APLENZIN in a patient being treated with reversible MAOIs such as linezolid or intravenous methylene blue
- Known hypersensitivity to bupropion or any ingredient of APLENZIN
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
Adverse Reactions
Most common (>=5%) Anorexia, dry mouth, rash, sweating, tinnitus, tremor at 300 mg/day bupropion HCl SR equivalent; insomnia, headache, nausea, dizziness, constipation, anxiety also reported.
Serious Suicidal thoughts and behaviors, seizure, hypertension, activation of mania or hypomania, psychosis and other neuropsychiatric events, angle-closure glaucoma, hypersensitivity reactions including anaphylaxis and Stevens-Johnson Syndrome.
Postmarketing Stroke, complete atrioventricular block, myocardial infarction, Brugada pattern/syndrome, angioedema, DRESS, acute generalized exanthematous pustulosis, rhabdomyolysis, hepatitis, pancreatitis, aseptic meningitis.
Most common (>=5%) weight increased, akathisia, headache, somnolence, insomnia
Serious neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, orthostatic hypotension, falls, seizures, body temperature dysregulation
Postmarketing neuroleptic malignant syndrome
Pharmacology
Bupropion is an aminoketone antidepressant whose action is presumed to be mediated by noradrenergic and/or dopaminergic mechanisms; it is a relatively weak inhibitor of neuronal norepinephrine and dopamine reuptake and does not inhibit MAO or serotonin reuptake.
Brexpiprazole is an atypical antipsychotic whose efficacy may be mediated through partial agonist activity at serotonin 5-HT1A and dopamine D2 receptors combined with antagonist activity at serotonin 5-HT2A receptors; the exact mechanism of action in the approved indications is unknown.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Aplenzin
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (10/12) · Qty limit (9/12)
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Aplenzin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Rexulti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Aplenzin
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (3/3) · Qty limit (2/3)
Rexulti
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$100/momo
Aplenzin Copay Savings Program - Non-covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.