Drug interactions

Brexpiprazole + Indinavir

Severity: Major

Brexpiprazole and Indinavir: major interaction.

Last updated 29 Oct 2026 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

Indinavir is a strong CYP3A4 inhibitor and can markedly increase brexpiprazole exposure. This raises the risk of akathisia, sedation, orthostatic hypotension and other dose-related effects.

Brexpiprazole

What this interaction means in plain words

Brexpiprazole and Indinavir 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.

Evidence level: Moderate

Why it happens

Strong inhibition of CYP3A4-mediated brexpiprazole metabolism.

What to do

Give half of the usual brexpiprazole dose, or a quarter if a CYP2D6 inhibitor is also given. Monitor for adverse effects and restore the dose after indinavir is stopped.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Rexulti - FDA drug label (DailyMed) - section 7 Drug Interactions (class statement: strong CYP3A4 inhibitors; "Concomitant use of REXULTI with strong CYP3A4 inhibitors increased the exposure of brexpiprazole compared to the use of REXULTI alone") — DailyMed (FDA label)

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Frequently asked questions

Can I take Brexpiprazole with Indinavir?

MediHelp rates the interaction as major. Brexpiprazole and Indinavir 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. Indinavir is a strong CYP3A4 inhibitor and can markedly increase brexpiprazole exposure. This raises the risk of akathisia, sedation, orthostatic hypotension and other dose-related effects.

How serious is the interaction between Brexpiprazole and Indinavir?

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 of the usual brexpiprazole dose, or a quarter if a CYP2D6 inhibitor is also given. Monitor for adverse effects and restore the dose after indinavir is stopped.

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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