| Schizophrenia
Geodon vs Rexulti
Side-by-side clinical, coverage, and cost comparison for schizophrenia.Deep comparison between: Geodon 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 Geodon based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Rexulti but not Geodon, including UnitedHealthcare
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Category
Geodon
Rexulti
At A Glance
Oral / IM injection
Twice daily
D2/5HT2 antagonist
Oral
Once daily
Atypical antipsychotic
Indications
- Schizophrenia
- Bipolar I disorder
- Major Depressive Disorder
- Schizophrenia
- Agitation in Dementia
Dosing
Schizophrenia Initiate at 20 mg twice daily with food; may adjust up to 80 mg twice daily at intervals of not less than 2 days.
Schizophrenia (acute agitation, IM) 10-20 mg IM as needed up to 40 mg/day; 10 mg may be given every 2 hours, 20 mg every 4 hours; limit to 3 consecutive days, then transition to oral.
Bipolar I disorder (acute manic/mixed episodes) Initiate at 40 mg twice daily with food; increase to 60 or 80 mg twice daily on day 2; subsequent doses adjusted within 40-80 mg twice daily range based on tolerability and efficacy.
Bipolar I disorder (maintenance, adjunct to lithium or valproate) Continue at the same dose on which the patient was initially stabilized, within the range of 40-80 mg twice daily with food.
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 history of QT prolongation, including congenital long QT syndrome
- Recent acute myocardial infarction
- Uncompensated heart failure
- Concomitant use with drugs that prolong the QT interval (e.g., dofetilide, sotalol, quinidine, Class Ia and III anti-arrhythmics, mesoridazine, thioridazine, chlorpromazine, droperidol, pimozide, sparfloxacin, gatifloxacin, moxifloxacin, halofantrine, mefloquine, pentamidine, arsenic trioxide, levomethadyl acetate, dolasetron mesylate, probucol, tacrolimus)
- Known hypersensitivity to ziprasidone or any excipient
- Concomitant use of MAOIs, or use within 14 days of stopping an MAOI
- Known hypersensitivity to brexpiprazole or any excipient (reactions include rash, facial swelling, urticaria, and anaphylaxis)
Adverse Reactions
Most common (>=5%) Somnolence, extrapyramidal symptoms, akathisia, dizziness, nausea, constipation, respiratory tract infection, headache, asthenia, abnormal vision
Serious QT prolongation, neuroleptic malignant syndrome, serotonin syndrome, tardive dyskinesia, DRESS, leukopenia, neutropenia, agranulocytosis, seizures
Postmarketing Torsade de pointes, facial droop, galactorrhea, priapism, somnambulism, angioedema, urinary incontinence, postural hypotension, syncope
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
Ziprasidone is a dopamine D2/D3 and serotonin 5HT2A/5HT2C antagonist with agonist activity at 5HT1A receptors and inhibition of synaptic reuptake of serotonin and norepinephrine; its antipsychotic and antimanic effects are thought to be mediated through combined D2 and 5HT2 antagonism.
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
Geodon
- Covered on 5 commercial plans
- PA (6/12) · Step Therapy (6/12) · Qty limit (0/12)
Rexulti
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Geodon
- 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
Geodon
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (1/3)
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
No savings programs available for Geodon.
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.