| Major Depressive Disorder
Trintellix vs Rexulti
Side-by-side clinical, coverage, and cost comparison for major depressive disorder.Deep comparison between: Trintellix 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 Trintellix based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rexulti but not Trintellix, including UnitedHealthcare
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Category
Trintellix
Rexulti
At A Glance
Oral
Once daily
Antidepressant
Oral
Once daily
Atypical antipsychotic
Indications
- Major Depressive Disorder
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
Dosing
Major Depressive Disorder Starting dose 10 mg once daily without regard to meals; increase to 20 mg/day as tolerated. May decrease to 5 mg/day for patients who do not tolerate higher doses. Maximum 20 mg/day (10 mg/day in CYP2D6 poor metabolizers). Taper from 15-20 mg/day to 10 mg/day for one week before discontinuation if possible.
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
- Hypersensitivity to vortioxetine or any component of the formulation
- Use of MAOIs intended to treat psychiatric disorders concurrently or within 21 days of stopping TRINTELLIX
- Use within 14 days of stopping an MAOI intended to treat psychiatric disorders
- Initiation in patients being treated with linezolid or intravenous methylene blue
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
Adverse Reactions
Most common (>=5% and twice placebo) Nausea (21-32%), constipation (3-6%), vomiting (3-6%), diarrhea (7-10%), dry mouth (6-8%), dizziness (6-9%)
Serious Serotonin syndrome, increased bleeding risk, activation of mania/hypomania, angle closure glaucoma, hyponatremia, hypersensitivity reactions including anaphylaxis and angioedema
Postmarketing Hyperprolactinemia, acute pancreatitis, seizure, aggression, agitation, anger, hostility, irritability, anosmia, hyposmia, weight gain, rash, generalized rash, hyperhidrosis
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
Vortioxetine's antidepressant effect is thought to be related to enhancement of serotonergic activity in the CNS through inhibition of serotonin reuptake, along with 5-HT3 receptor antagonism and 5-HT1A receptor agonism.
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.
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Most Common Insurance
Anthem BCBS
Trintellix
- Covered on 5 commercial plans
- PA (3/12) · Step Therapy (3/12) · Qty limit (11/12)
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Trintellix
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (4/8) · Qty limit (5/8)
Rexulti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Trintellix
- 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
$10/fillfill
Trintellix Savings CardCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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.