| Schizophrenia
Abilify Maintena vs Rexulti
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Abilify Maintena 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 Abilify Maintena based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rexulti but not Abilify Maintena, including UnitedHealthcare
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Category
Abilify Maintena
Rexulti
At A Glance
IM injection
Every 4 weeks
Dopamine D2 partial agonist
Oral
Once daily
Atypical antipsychotic
Indications
- Schizophrenia
- Bipolar I disorder
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
Dosing
Schizophrenia, Bipolar I disorder 400 mg IM injection monthly (deltoid or gluteal); reduce to 300 mg if adverse reactions occur; initiate via 1-day (two 400 mg injections + single oral aripiprazole 20 mg) or 14-day (one 400 mg injection + 14 days oral aripiprazole) protocol; CYP2D6 poor metabolizers start and maintain at 300 mg monthly.
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
- Known hypersensitivity to aripiprazole
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
Adverse Reactions
Most common (>=5%) Increased weight, akathisia, injection site pain, sedation
Serious Neuroleptic malignant syndrome, tardive dyskinesia, metabolic changes, leukopenia, neutropenia, agranulocytosis, seizures, orthostatic hypotension
Postmarketing Anaphylactic reaction, angioedema, laryngospasm, pruritus/urticaria, oropharyngeal spasm, pathological gambling, hiccups, blood glucose fluctuation, DRESS, fecal incontinence
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
Aripiprazole is an atypical antipsychotic whose efficacy may be mediated through a combination of partial agonist activity at dopamine D2 and serotonin 5-HT1A receptors and antagonist activity at 5-HT2A receptors.
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
Abilify Maintena
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Abilify Maintena
- 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
Abilify Maintena
- Covered on 0 commercial plans
- PA (1/3) · Step Therapy (0/3) · Qty limit (3/3)
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
Cost estimate not availableHealthWell: Cancer-Related Behavioral Health
Commercial 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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Abilify MaintenaView full Abilify Maintena profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.