Brexpiprazole

Brexpiprazole

Clinical data
Trade names	Rexulti
License data	US FDA: Brexpiprazole
Pregnancy category	US: None assigned
Routes of administration	Oral (via tablets)
ATC code	N05AX16 (WHO)
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Bioavailability	95% (Tmax = 4 hours)
Protein binding	>99%
Metabolism	Hepatic (mainly mediated by CYP3A4 and CYP2D6)
Biological half-life	91 hours (brexpiprazole), 86 hours (major metabolite)
Excretion	Feces (46%), urine (25%)
Identifiers
IUPAC name 7-{4-[4-(1-benzothiophen-4-yl)piperazin-1-yl]butoxy}quinolin-2(1H)-one
CAS Number	913611-97-9 Y
PubChem CID	11978813
ChemSpider	10152155
KEGG	D10309 Y
ChEMBL	CHEMBL2105760
Chemical and physical data
Formula	C25H27N3O2S
Molar mass	433.6 g/mol
3D model (Jmol)	Interactive image
SMILES O=C5/C=C\c4ccc(OCCCCN3CCN(c1cccc2sccc12)CC3)cc4N5
InChI InChI=1S/C25H27N3O2S/c29-25-9-7-19-6-8-20(18-22(19)26-25)30-16-2-1-11-27-12-14-28(15-13-27)23-4-3-5-24-21(23)10-17-31-24/h3-10,17-18H,1-2,11-16H2,(H,26,29) Key:ZKIAIYBUSXZPLP-UHFFFAOYSA-N

Brexpiprazole (/brɛksˈpɪprəzoʊl/ breks-PIP-rə-zohl; brand name Rexulti recks-UL-tee, previously known as OPC-34712) is an atypical antipsychotic drug. It is a D2 dopamine partial agonist called serotonin-dopamine activity modulator (SDAM). The drug received FDA approval on July 13, 2015 for the treatment of schizophrenia, and as an adjunctive treatment for depression. Although it failed Phase II clinical trials for ADHD, it has been designed to provide improved efficacy and tolerability (e.g., less akathisia, restlessness and/or insomnia) over established adjunctive treatments for major depressive disorder (MDD).

The drug was developed by Otsuka and Lundbeck, and is considered to be a successor of Otsuka's top-selling antipsychotic agent aripiprazole (brand names: Abilify, Aripiprex). Otsuka's US patent on aripiprazole expired on October 20, 2014; however, due to a pediatric extension, a generic will become available in the near future.