Comparative Pharmacology
Head-to-head clinical analysis: REXULTI versus SECUADO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: REXULTI versus SECUADO.
REXULTI vs SECUADO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Partial agonist at D2 and 5-HT1A receptors; antagonist at 5-HT2A and α1B/α2C adrenergic receptors.
SECUADO (asenapine) is an atypical antipsychotic with high affinity for serotonin 5-HT2A, 5-HT2C, 5-HT6, and 5-HT7 receptors, as well as dopamine D2, D3, and D4 receptors. It also exhibits moderate affinity for histamine H1 and alpha2-adrenergic receptors, and low affinity for alpha1 and muscarinic receptors. The therapeutic effect in schizophrenia and bipolar disorder is primarily mediated through antagonism at D2 and 5-HT2A receptors.
2 mg orally once daily initially; increase to 4 mg once daily no sooner than week 2; target dose 4 mg once daily; range 2-4 mg once daily.
Adults: 3.8 mg/24 hours applied transdermally once daily; initially 3.8 mg/24 hours, may titrate to 5.7 mg/24 hours, 7.6 mg/24 hours, or 11.4 mg/24 hours based on tolerability and efficacy. Maximum dose: 11.4 mg/24 hours.
None Documented
None Documented
Terminal elimination half-life is approximately 19–23 days for brexpiprazole and its major metabolite DM-3411, requiring up to 2–3 months to reach steady state.
Terminal elimination half-life: 20-24 hours; steady-state achieved within 5 days.
Approximately 25% of the dose is excreted in urine as unchanged drug and metabolites; about 54% is excreted in feces. Renal excretion of unchanged drug is minor (<1%).
Primarily renal: 50-80% as unchanged drug; biliary/fecal: <15%.
Category C
Category C
Atypical Antipsychotic
Atypical Antipsychotic