Drug interactions
Brexpiprazole + Butalbital
Severity: Major
Brexpiprazole and Butalbital: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Butalbital is a barbiturate and can add to the sedating effects of brexpiprazole, causing drowsiness, dizziness and impaired coordination. Butalbital also induces CYP3A4, which may modestly lower brexpiprazole exposure.
What this interaction means in plain words
Brexpiprazole and Butalbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive CNS depression, plus CYP3A4 induction by barbiturate that may reduce brexpiprazole concentrations.
What to do
Avoid regular combined use where possible; if needed, monitor for sedation and loss of antipsychotic efficacy and consider increasing the brexpiprazole dose when butalbital is used chronically.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Brexpiprazole and Butalbital, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Butalbital?
MediHelp rates the interaction as major. Brexpiprazole and Butalbital can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Butalbital is a barbiturate and can add to the sedating effects of brexpiprazole, causing drowsiness, dizziness and impaired coordination. Butalbital also induces CYP3A4, which may modestly lower brexpiprazole exposure.
How serious is the interaction between Brexpiprazole and Butalbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid regular combined use where possible; if needed, monitor for sedation and loss of antipsychotic efficacy and consider increasing the brexpiprazole dose when butalbital is used chronically.
What other medicines interact with Brexpiprazole?
MediHelp also lists interactions of Brexpiprazole with, for example, Alfentanil, Amisulpride, Apalutamide. The full list is on the Brexpiprazole page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
