{"id":630159,"date":"2024-10-22T13:28:46","date_gmt":"2024-10-22T17:28:46","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630159"},"modified":"2024-10-25T09:41:03","modified_gmt":"2024-10-25T13:41:03","slug":"rexulti-and-breastfeeding","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/rexulti-and-breastfeeding\/","title":{"rendered":"Can you take Rexulti while breastfeeding?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/rexulti\/what-is\"><span style=\"font-weight: 400;\">Rexulti<\/span><\/a><span style=\"font-weight: 400;\"> (brexpiprazole) is an <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/atypical-antipsychotics\"><span style=\"font-weight: 400;\">atypical antipsychotic<\/span><\/a><span style=\"font-weight: 400;\"> approved by the Food and Drug Administration (FDA) to treat <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/depression-treatment-and-medications\"><span style=\"font-weight: 400;\">major depressive disorder<\/span><\/a><span style=\"font-weight: 400;\"> (MDD) in adults on antidepressants and <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/schizophrenia-treatment-and-medications\"><span style=\"font-weight: 400;\">schizophrenia<\/span><\/a><span style=\"font-weight: 400;\"> in adults and children 13 years of age and older. It was also <\/span><a href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-approves-first-drug-treat-agitation-symptoms-associated-dementia-due-alzheimers-disease\"><span style=\"font-weight: 400;\">recently approved to treat agitation associated with dementia<\/span><\/a><span style=\"font-weight: 400;\"> due to Alzheimer&rsquo;s disease. Rexulti was designed to adjust dopamine and serotonin levels in the brain, although the exact way it works is unknown.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you&rsquo;re <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/safe-medication-during-pregnancy\/\"><span style=\"font-weight: 400;\">pregnant<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/remembering-medication-prescriptions-new-mom\/\"><span style=\"font-weight: 400;\">postpartum<\/span><\/a><span style=\"font-weight: 400;\"> and have been prescribed <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/rexulti\"><span style=\"font-weight: 400;\">Rexulti<\/span><\/a><span style=\"font-weight: 400;\">, you might wonder: Is it safe to breastfeed on Rexulti? The answer is complicated because there isn&rsquo;t a lot of research on Rexulti and breastfeeding. Below, we&rsquo;ll look at what the limited research shows, what the risks of taking Rexulti while breastfeeding might be, and alternative medications to talk to your healthcare provider about.<\/span><\/p>\n<h2 id=\"can-you-take-rexulti-while-breastfeeding\"><span style=\"font-weight: 400;\">Can you take Rexulti while breastfeeding?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/otsuka-us.com\/sites\/g\/files\/qhldwo9566\/files\/media\/static\/Rexulti-PI.pdf\"><span style=\"font-weight: 400;\">Food &amp; Drug Administration<\/span><\/a><span style=\"font-weight: 400;\"> recommends the decision to take Rexulti while breastfeeding be made on a case-by-case basis. <\/span><a href=\"https:\/\/www.rexulti.com\/mdd\/questions-answers\"><span style=\"font-weight: 400;\">Rexulti&rsquo;s manufacturer<\/span><\/a><span style=\"font-weight: 400;\">, Otsuka Pharmaceutical, Inc., also advises talking to your healthcare provider about the best way to feed your baby while taking the medication. Together, breastfeeding parents and their healthcare providers can consider the health benefits of breastfeeding versus the potential negative side effects of Rexulti for the baby, along with the parent&rsquo;s need to remain on their prescription medication for their mental health.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Still, this is a difficult question, even for healthcare providers. &ldquo;When it comes to breastfeeding, there is limited data on Rexulti&rsquo;s safety,&rdquo; says<\/span> <a href=\"https:\/\/www.pharmasue.com\/\"><span style=\"font-weight: 400;\">Sue Ojageer, Pharm.D.<\/span><\/a><span style=\"font-weight: 400;\">, founder of<\/span> <a href=\"https:\/\/www.pharmacymentors.com\/\"><span style=\"font-weight: 400;\">Pharmacy Mentors<\/span><\/a><span style=\"font-weight: 400;\"> and a<\/span> <a href=\"https:\/\/www.singlecare.com\/pharmacy-awards\/winner\/2022-best-pharmacist-influencer\/\"><span style=\"font-weight: 400;\">SingleCare Best of the Best Pharmacy Awards winner<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><a href=\"http:\/\/www.keciagaither.com\/\"><span style=\"font-weight: 400;\">Kecia Gaither, MD<\/span><\/a><span style=\"font-weight: 400;\">, a double board-certified OB-GYN, agrees, saying there is a lack of information on Rexulti use while breastfeeding.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here&rsquo;s what we do know:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Brexiprarazole might have the potential to suppress milk supply. <\/b><span style=\"font-weight: 400;\">Dr. Gaither points to a single<\/span> <a href=\"https:\/\/www.liebertpub.com\/doi\/10.1089\/bfm.2020.29162.abstracts\"><span style=\"font-weight: 400;\">case report<\/span><\/a><span style=\"font-weight: 400;\"> of &ldquo;decreased lactation&rdquo; while taking Rexulti. In this instance, a postpartum woman on Rexulti who reported &ldquo;ample production&rdquo; while breastfeeding previous children experienced low milk production. Within 10 days of discontinuing Rexulti, her milk supply increased enough to almost exclusively breastfeed her newborn.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Brexiprarazole might be linked to lactation disorder.<\/b><span style=\"font-weight: 400;\"> A recent<\/span> <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37956832\/\"><span style=\"font-weight: 400;\">safety assessment report<\/span><\/a><span style=\"font-weight: 400;\"> found that out of 8,559 adverse drug event reports related to brexpiprazole, 10 included breast discharge and six included lactation disorder. However, this is a tiny percentage, and controlled clinical trials are needed to determine if these side effects were caused by the drug or some other factor concurrent with Rexulti use.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Brexiprarazole can pass into breast milk.<\/b><span style=\"font-weight: 400;\"> One<\/span> <a href=\"https:\/\/journals.lww.com\/drug-monitoring\/abstract\/2024\/10000\/pharmacokinetics_of_brexpiprazole,_quetiapine,.18.aspx\"><span style=\"font-weight: 400;\">case report<\/span><\/a><span style=\"font-weight: 400;\"> of a postpartum woman on Rexulti and her baby showed that the infant dose of brexpiprazole was less than 1.1% when passed from the mother to the baby through breast milk. This led the authors to determine that breastfeeding was &ldquo;still possible&rdquo; because the dose passed on to the infant was &ldquo;much less than 10%.&rdquo; Still, one case study is insufficient to inform clinical guidelines, and the report did not mention how the drug&rsquo;s presence affected the infant, if at all.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Brexiprarazole use has not been studied in infants.<\/b><span style=\"font-weight: 400;\"> This drug is approved for patients 13 years and older. &ldquo;Because the potential effects on a breastfeeding infant are unknown, many healthcare providers may advise caution or recommend against using Rexulti while breastfeeding,&rdquo; Dr. Ojageer says.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Side effects have been reported from infant exposure to atypical antipsychotics. <\/b><span style=\"font-weight: 400;\">A<\/span> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8106424\/\"><span style=\"font-weight: 400;\">small study<\/span><\/a><span style=\"font-weight: 400;\"> of 28 breastfeeding women admitted to the inpatient psychiatric unit of a hospital found that some of the infants exhibited signs of sedation, constipation, and developmental delays. However, these side effects might have been related to other maternal or infant risk factors rather than antipsychotic use.&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ultimately, there is not enough data to confirm that maternal Rexulti use is definitely safe for a breastfed infant. Since the risk to the infant cannot be ruled out, experts emphasize the importance of a thorough discussion between the patient and healthcare provider about the benefits versus risks of continuing the medication. &ldquo;If the medication is essential for the mother&rsquo;s mental health and other options are not suitable, careful monitoring of the infant for signs of side effects such as sedation, feeding difficulties, or developmental issues is recommended,&rdquo; Dr. Ojageer says.<\/span><\/p>\n<h2 id=\"what-are-the-risks-of-taking-rexulti-while-breastfeeding\"><span style=\"font-weight: 400;\">What are the risks of taking Rexulti while breastfeeding?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Due to limited data, the risk of taking Rexulti during breastfeeding is unknown. The drug may be <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/breastfeeding-and-medications\/\"><span style=\"font-weight: 400;\">present in breast milk<\/span><\/a><span style=\"font-weight: 400;\">, but the amount passed on to a breastfeeding baby is small and may or may not cause side effects. There isn&rsquo;t enough information to confirm one way or the other.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Likewise, the potential risk of a decreased milk supply or lactation disorder is not defined. Case reports provide helpful information to healthcare providers, but more research is needed. A case report states what happened, not why it happened. The authors did not investigate whether the lactation disorder might have been caused by a different medication or one of the mother&rsquo;s underlying conditions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Breastfeeding does not raise the risk of Rexulti side effects, but serious side effects could impact your ability to take care of your baby. Less serious side effects include sleepiness, irritability, and weight gain. Serious side effects include suicidal thoughts, increased cholesterol and triglyceride levels, high blood sugar, <\/span><a href=\"https:\/\/rarediseases.org\/rare-diseases\/neuroleptic-malignant-syndrome\/\"><span style=\"font-weight: 400;\">neuroleptic malignant syndrome<\/span><\/a><span style=\"font-weight: 400;\">, tardive dyskinesia, low white blood cell count, trouble regulating body temperature, and allergic reactions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&ldquo;In addition to having a maternal healthcare provider, postpartum patients on antipsychotic drugs should be under the care of a mental health provider,&rdquo; Dr. Gaither says. Medication use or discontinuation should be determined on &ldquo;a case-by-case basis,&rdquo; she adds.<\/span><\/p>\n<h2 id=\"what-can-i-take-instead-of-rexulti-while-breastfeeding\"><span style=\"font-weight: 400;\">What can I take instead of Rexulti while breastfeeding?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It&rsquo;s essential that postpartum parents living with <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/schizophrenia-statistics\/\"><span style=\"font-weight: 400;\">schizophrenia<\/span><\/a><span style=\"font-weight: 400;\"> or major <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/depression-causes\"><span style=\"font-weight: 400;\">depression<\/span><\/a><span style=\"font-weight: 400;\"> receive treatment. Left untreated, these medical conditions can increase the risk of side effects such as suicidal thoughts and psychosis. Consequently, maternal and infant health are at risk.&nbsp;<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/rexulti\"><span style=\"font-weight: 400;\">Rexulti<\/span><\/a><span style=\"font-weight: 400;\"> is not the only FDA-approved drug for schizophrenia or major depression. Other antipsychotic agents have been studied more extensively and are considered generally safer for breastfeeding mothers, according to Dr. Ojageer.&nbsp;<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/rexulti-alternatives\/\"><span style=\"font-weight: 400;\">Rexulti alternatives<\/span><\/a><span style=\"font-weight: 400;\"> to discuss with your healthcare provider include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/zyprexa\"><b>Zyprexa<\/b><\/a><b> (<\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/olanzapine\"><b>olanzapine<\/b><\/a><b>)<\/b><span style=\"font-weight: 400;\">: &ldquo;This drug has relatively more data supporting its safety during breastfeeding,&rdquo; Dr. Ojageer says. &ldquo;While small amounts are excreted into breast milk, the risk to infants appears to be minimal.&rdquo;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/seroquel\"><b>Seroquel<\/b><\/a><b> (<\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/quetiapine-fumarate\/what-is\"><b>quetiapine<\/b><\/a><b>)<\/b><span style=\"font-weight: 400;\">: This antipsychotic is &ldquo;excreted in low amounts in breast milk and is considered safer for breastfeeding. It is often recommended when antipsychotic treatment is necessary during breastfeeding,&rdquo; Dr. Ojageer says.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/abilify\"><b>Abilify<\/b><\/a><b> (<\/b><a href=\"https:\/\/www.singlecare.com\/prescription\/aripiprazole\"><b>aripiprazole<\/b><\/a><b>)<\/b><span style=\"font-weight: 400;\">: While data is limited, Dr. Ojageer says it is considered to have a lower risk profile compared to other antipsychotics like Rexulti.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">RELATED: <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/vraylar-vs-rexulti\/\"><span style=\"font-weight: 400;\">Vraylar vs. Rexulti <\/span><\/a><span style=\"font-weight: 400;\">&#9474; <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/abilify-vs-rexulti\/\"><span style=\"font-weight: 400;\">Abilify vs. Rexulti<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\">In any case of maternal <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/tag\/mental-health\/\"><span style=\"font-weight: 400;\">mental health<\/span><\/a><span style=\"font-weight: 400;\"> disorders, it is crucial to weigh the benefits of treatment against the potential risks to the baby. Never discontinue an antipsychotic medication without consulting your healthcare team, as withdrawal symptoms may occur. Choosing which treatment to use while breastfeeding should involve a thorough discussion between a patient and her healthcare provider.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rexulti (brexpiprazole) is an atypical antipsychotic approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD) in adults on antidepressants and schizophrenia in adults and children 13 years of age and older. It was also recently approved to treat agitation associated with dementia due to Alzheimer&rsquo;s disease. Rexulti was designed to [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":630160,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[788,8615],"coauthors":[20942],"class_list":["post-630159","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-drug-safety","tag-pregnancy","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Rexulti and breastfeeding: What we know<\/title>\n<meta name=\"description\" content=\"Deciding whether to breastfeed while on Rexulti should involve a thorough discussion with your healthcare provider about the risks versus benefits.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, 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