Drug interactions
Brexpiprazole + Conivaptan
Severity: Major
Brexpiprazole and Conivaptan: major interaction.
Last updated Sources: US FDA label
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
Conivaptan is a strong CYP3A4 inhibitor and can raise brexpiprazole levels. This may increase sedation, akathisia and orthostatic hypotension.
What this interaction means in plain words
Brexpiprazole and Conivaptan 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
Conivaptan inhibits CYP3A4, reducing the metabolism of brexpiprazole.
What to do
Give half the usual brexpiprazole dose while conivaptan is in use. Use a quarter dose if a CYP2D6 inhibitor is also given.
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?
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References
Other interactions of Brexpiprazole
Frequently asked questions
Can I take Brexpiprazole with Conivaptan?
MediHelp rates the interaction as major. Brexpiprazole and Conivaptan 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. Conivaptan is a strong CYP3A4 inhibitor and can raise brexpiprazole levels. This may increase sedation, akathisia and orthostatic hypotension.
How serious is the interaction between Brexpiprazole and Conivaptan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give half the usual brexpiprazole dose while conivaptan is in use. Use a quarter dose if a CYP2D6 inhibitor is also given.
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.
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