| Schizophrenia
Cobenfy vs Rexulti
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Cobenfy 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 Cobenfy based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rexulti but not Cobenfy, including UnitedHealthcare
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Category
Cobenfy
Rexulti
At A Glance
Oral
Twice daily
Muscarinic agonist/antagonist combination
Oral
Once daily
Atypical antipsychotic
Indications
- Schizophrenia
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
Dosing
Schizophrenia Starting dose 50 mg/20 mg orally twice daily for at least 2 days, then 100 mg/20 mg twice daily for at least 5 days; may increase to 125 mg/30 mg twice daily based on tolerability and response (maximum dose); take at least 1 hour before or 2 hours after a meal; do not open capsules. Geriatric patients: start at 50 mg/20 mg twice daily, maximum 100 mg/20 mg twice daily.
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
- Urinary retention
- Moderate (Child-Pugh Class B) or severe (Child-Pugh Class C) hepatic impairment
- Gastric retention
- History of hypersensitivity to COBENFY or trospium chloride
- Untreated narrow-angle glaucoma
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
Adverse Reactions
Most common (>=5%) Nausea, dyspepsia, constipation, vomiting, hypertension, abdominal pain, diarrhea, tachycardia, dizziness, gastroesophageal reflux disease
Serious Urinary retention, liver enzyme elevations, increases in heart rate, angioedema
Postmarketing Chest pain, hypertensive crisis, palpitations, supraventricular tachycardia, syncope, gastritis, rash, rhabdomyolysis, confusion, delirium, hallucinations, somnolence, vision abnormal, angioedema, anaphylactic reaction, Stevens-Johnson syndrome (reported with trospium chloride component)
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
Xanomeline is a muscarinic agonist with preferential activity at M1 and M4 receptors in the central nervous system, where its efficacy in schizophrenia is thought to arise; trospium chloride is a peripheral muscarinic antagonist included to reduce cholinergic adverse effects.
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
Cobenfy
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (8/12) · Qty limit (11/12)
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Cobenfy
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (8/8) · Qty limit (2/8)
Rexulti
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Cobenfy
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · 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
$0/fillfill
Cobenfy Copay Assistance ProgramCommercial 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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CobenfyView full Cobenfy profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.