Brexpiprazole is used to treat major depressive disorder in adults (in addition to other medications), schizophrenia in adults and children aged 13 years and older, and agitation that may happen with dementia due to Alzheimer’s disease. It is an oral tablet taken once a day.

Brexpiprazole belongs to the drug class called atypical antipsychotics.

Brexpiprazole first gained FDA approval on July 10, 2015 under the brand name Rexulti. There is a generic brexpiprazole but it is only approved for adults with depression or schizophrenia. The brand Rexulti has additional approvals for adolescents 13 years and older with schizophrenia and for Alzheimer’s disease-related agitation.

Mechanism

Brexpiprazole works by correcting the imbalance of natural chemical messengers  (neurotransmitters), such as dopamine and serotonin in the brain. This imbalance is thought to be associated with several psychiatric disorders such as schizophrenia, depression, and agitation associated with Alzheimer’s disease.

Brexpiprazole uses

Brexpiprazole is an atypical antipsychotic used:

• along with antidepressant medicines to treat major depressive disorder (MDD) in adults
• to treat schizophrenia in adults and children ages 13 years and older
• to treat agitation that may happen with dementia due to Alzheimer’s disease.

Brexpiprazole should not be used as an “as needed” treatment for agitation that may happen with dementia due to Alzheimer’s disease.

Clinical trials have not been conducted in children so it is not known if brexpiprazole is safe and effective for the treatment of MDD in children under the age of 18 or for the treatment of schizophrenia in children under 13 years.

Brexpiprazole side effects

The most common side effects of brexpiprazole are:

• weight gain
• sleepiness
• dizziness
• common cold symptoms
• restlessness or feeling like you need to move (akathisia).

Serious side effects and warnings

Brexpiprazole carries a Boxed Warning for an increased risk of death in elderly patients with dementia-related psychosis.

Increased risk of death in elderly people with dementia-related psychosis. Trials have reported medicines like brexpiprazole can raise the risk of death in elderly people who have lost touch with reality (psychosis) due to confusion and memory loss (dementia). Brexpiprazole is not approved for dementia-related psychosis without agitation that may happen with Alzheimer’s disease.

Increased risk of suicidal thoughts and actions. Brexpiprazole and antidepressant medicines increase the risk of suicidal thoughts and actions in people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Depression and other mental illnesses are the most important causes of suicidal thoughts and actions.

• Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings, or if you develop suicidal thoughts or actions. This is very important when brexpiprazole or the antidepressant medicine is started or when the dose is changed.
• Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions.
• Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms.

Call a healthcare provider right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worry you:

• thoughts about suicide or dying
• attempts to commit suicide
• new or worsening depression
• new or worsening anxiety
• feeling very agitated or restless
• panic attacks
• trouble sleeping (insomnia)
• new or worsening irritability
• acting aggressive, being angry, or violent
• acting on dangerous impulses
• an extreme increase in activity or talking (mania)
• other unusual changes in behavior or mood.

Other serious side effects of brexpiprazole include the following.

Cerebrovascular problems (these involve the blood vessels of the brain), including stroke, in elderly people with dementia-related psychosis that can lead to death.

Neuroleptic malignant syndrome (NMS), which is a rare and life-threatening reaction to antipsychotic drugs. Call your healthcare provider or go to the nearest hospital emergency room right away if you have some or all of the following signs and symptoms of NMS:

• high fever
• stiff muscles
• confusion
• changes in your pulse, blood pressure, heart rate, and breathing
• increased sweating.

Uncontrolled body movements (tardive dyskinesia). Brexpiprazole may cause movements that you cannot control in your face, tongue, or other body parts. Tardive dyskinesia may not go away, even if you stop taking brexpiprazole. Tardive dyskinesia may also start after you stop taking brexpiprazole.

Brexpiprazole may also cause problems with your metabolism such as:

• High blood sugar (hyperglycemia) and diabetes. Increases in blood sugar can happen in some people who take brexpiprazole. Extremely high blood sugar can lead to coma or death. Your healthcare provider should check your blood sugar before you start, or soon after you start brexpiprazole and then regularly during long term treatment with brexpiprazole. Call your healthcare provider if you have any of these symptoms of high blood sugar during treatment with brexpiprazole:
  • feel very thirsty
  • feel very hungry
  • feel sick to your stomach
  • need to urinate more than usual
  • feel weak or tired
  • feel confused, or your breath smells fruity
• Increased fat levels (cholesterol and triglycerides) in your blood. Your healthcare provider should check the fat levels in your blood before you start, or soon after you start brexpiprazole, and then periodically during treatment with brexpiprazole.
• Weight gain. You and your healthcare provider should check your weight before you start and often during treatment with brexpiprazole.

Unusual and uncontrollable (compulsive) urges. Some people taking brexpiprazole have had strong unusual urges, to gamble and gambling that cannot be controlled (compulsive gambling). Other compulsive urges include sexual urges, shopping, and eating or binge eating. If you or your family members notice that you are having new or unusual strong urges or behaviors, talk to your healthcare provider.

Low white blood cell count. Your healthcare provider may do blood tests during the first few months of treatment with brexpiprazole.

Decreased blood pressure (orthostatic hypotension) and fainting. You may feel dizzy, lightheaded, or pass out (faint) when you rise too quickly from a sitting or lying position.

Falls. Brexpiprazole may make you sleepy or dizzy, may cause a decrease in your blood pressure when changing position (orthostatic hypotension), and can slow your thinking and motor skills which may lead to falls that can cause fractures or other injuries.

Seizures (convulsions). Brexpiprazole may increase your risk of seizures.

Problems controlling your body temperature so that you feel too warm. See “What should I avoid while taking brexpiprazole?”

Difficulty swallowing that can cause food or liquid to get into your lungs.

Sleepiness, drowsiness, feeling tired, difficulty thinking and doing normal activities. See “What should I avoid while taking brexpiprazole?”

Brexpiprazole may harm an unborn baby.

These are not all the possible side effects of brexpiprazole. Call your doctor for medical advice about side effects.

Before taking

Do not take brexpiprazole if you are allergic to brexpiprazole, Rexulti, or any inactive ingredient in the tablets.

Before taking brexpiprazole, tell your healthcare provider about all of your medical conditions, including if you:

• have or have had heart problems or a stroke
• have or have had low or high blood pressure
• have or have had diabetes or high blood sugar or a family history of diabetes or high blood sugar.
• have or have had high levels of total cholesterol, LDL cholesterol, or triglycerides, or low levels of HDL cholesterol
• have or have had seizures (convulsions)
• have or have had kidney or liver problems
• have or have had a low white blood cell count
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed.

Pregnancy

Brexpiprazole may harm your unborn baby. Taking brexpiprazole during your third trimester of pregnancy may cause your baby to have abnormal muscle movements or withdrawal symptoms after birth. Talk to your healthcare provider about the risk to your unborn baby if you take brexpiprazole during pregnancy.

Tell your healthcare provider if you become pregnant or think you are pregnant during treatment with brexpiprazole.

There is a pregnancy exposure registry for women who are exposed to brexpiprazole during pregnancy. If you become pregnant during treatment with brexpiprazole, talk to your healthcare provider about registering with the National Pregnancy Registry for Psychiatric Medications. You can register by calling 1-866-961-2388 or visit http://womensmentalhealth.org/clinical-and-researchprograms/pregnancyregistry/.

Breastfeeding

It is not known if brexpiprazole passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby during treatment with brexpiprazole.

How should I take brexpiprazole?

Take brexpiprazole exactly as your healthcare provider tells you to take it. Your healthcare provider may change your dose if needed. Do not change the dose or stop taking brexpiprazole without first talking to your healthcare provider.

• Take brexpiprazole 1 time each day.
• Brexpiprazole may be taken with or without food.

Brexpiprazole dosing

The dosage of Brexpiprazole varies depending on the condition being treated and the age of the patient.

The dosage may need to be adjusted for moderate to severe liver disease, kidney disease, and interacting medications.

Note that generic brexpiprazole is only approved for depression and schizophrenia in adults, not for all the uses Rexulti is approved for.

What should I avoid while taking brexpiprazole?

Do not drive a car, operate machinery, or do other dangerous activities until you know how brexpiprazole affects you. Brexpiprazole may make you feel drowsy.

Do not become too hot or dehydrated during treatment with brexpiprazole.

• Do not exercise too much.
• In hot weather, stay inside in a cool place if possible.
• Stay out of the sun.
• Do not wear too much clothing or heavy clothing.
• Drink plenty of water.

What happens if I take too much brexpiprazole?

If you take too much brexpiprazole, call your healthcare provider or Poison Help Line or go to the nearest hospital emergency room right away.

What other drugs affect brexpiprazole?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Brexpiprazole and other medicines may affect each other causing possible serious side effects. Brexpiprazole may affect the way other medicines work, and other medicines may affect how brexpiprazole works. Especially tell your healthcare provider if you take:

• Strong CYP2D6 or CYP3A4 inhibitors, such as clarithromycin, diltiazem, erythromycin, itraconazole, ketoconazole, paroxetine, fluoxetine, or bupropion. Administer half the recommended dosage of brexpiprazole
• Strong/moderate CYP2D6 with strong/moderate CYP3A4 inhibitors: Administer one-quarter of the recommended dosage of brexpiprazole
• strong/moderate CYP3A4 inhibitors and you are a known CYP2D6 poor metabolizer: Administer one-quarter of the recommended dosage of brexpiprazole
• Strong CYP3A4 inducers, such as phenobarbital, phenytoin, rifampicin, St. John’s Wort, or glucocorticoids. Double the recommended dosage of brexpiprazole and further adjust based on the clinical response.

Your healthcare provider can tell you if it is safe to take brexpiprazole with your other medicines. Do not start or stop any medicines during treatment with brexpiprazole without first talking to your healthcare provider. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Storage

Store brexpiprazole tablets at room temperature between 68°F to 77°F (20°C to 25°C). Keep out of the reach of children.

Ingredients

Brexpiprazole is available as the brand Rexulti and as generic brexpiprazole.

Active ingredient: brexpiprazole

Inactive ingredients (Rexulti brand): lactose monohydrate, corn starch, microcrystalline cellulose, hydroxypropyl cellulose, low-substituted hydroxypropyl cellulose, magnesium stearate, hypromellose, and talc. For color: titanium dioxide, iron oxide, and ferrosoferric oxide.

Inactive ingredients (generic brexpiprazole [Ajanta Pharma USA Inc.]: lactose monohydrate, microcrystalline cellulose, hydroxypropyl cellulose unspecified, low-substituted hydroxypropyl cellulose unspecified, magnesium stearate, Hypromellose unspecified, talc, titanium dioxide, propylene glycol, ferric oxide red

Inactive ingredients (generic brexpiprazole [Amneal Pharmaceuticals NY LLC]: ferric oxide red, ferric oxide yellow, ferrosoferric oxide, hypromellose unspecified, lactose monohydrate, microcrystalline cellulose, magnesium stearate, corn starch,  talc, titanium dioxide.

Who makes brexpiprazole?

Rexulti (the brand of brexpiprazole) is manufactured through a partnership between two pharmaceutical companies:

• Otsuka Pharmaceutical (Tokyo, Japan)
  • Also makes Abilify, Samsca, and other medications
• Lundbeck (Copenhagen, Denmark)
  • Also makes Lexapro, Vyepti, and other medications.

These companies have a long-standing partnership in developing psychiatric medications, with Rexulti being one of their major joint products.

Generic brexpiprazole is packaged by Ajanta Pharma USA Inc. and Amneal Pharmaceuticals NY LLC.

Avonex is a disease-modifying therapy (DMT) used to treat relapsing multiple sclerosis (MS) in adults (including clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease). Avonex injection (interferon beta-1a injection) is given intramuscularly (into a muscle), usually once weekly at bedtime.

For people living with MS, Avonex helps manage the disease by resembling the mechanism of action of interferons, which are proteins naturally produced by our immune system that help regulate the body’s immune response and fight viral infections.

• Avonex contains interferon beta 1-a, which is a man-made form of interferon that works in the same way, binding to specific receptors on cell surfaces and decreasing the activity of immune cells that attack the myelin sheath, reducing inflammation in the central nervous system, and helping to suppress the autoimmune response that characterizes MS.
• Avonex belongs to the drug class called interferons. It may also be called an immunomodulator.

Important: Avonex injection will not cure MS; it will only decrease the frequency of relapse symptoms.

Avonex (interferon beta-1a) gained FDA approval on May 17, 1996. There is no Avonex generic (more correctly called a biosimilar).

• Another form of interferon beta-1a, called Rebif, also used for MS, is given 3 times a week by subcutaneous (under the skin) injection.

Avonex and MS

Multiple sclerosis (MS) is an autoimmune disease that occurs when the immune system attacks the myelin sheath protecting nerve fibers, disrupting brain-body communication and causing MS symptoms like vision problems, muscle weakness, and coordination difficulties.

Avonex for MS addresses this disease process by modulating the immune response. The interferon beta-1a reduces immune attacks on myelin, decreases central nervous system inflammation, and prevents new MS lesions. For MS patients, this means fewer relapses, reduced disease activity, and slower disability progression.

Warnings

Liver Damage: Avonex injection can harm your liver. Call your doctor if you have symptoms such as nausea, loss of appetite, tiredness, confusion, easy bruising or bleeding, dark urine, clay-colored stools, or yellowing of your skin or eyes.

Mental Health: Some MS patients using interferon beta-1a have thoughts about suicide. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before using Avonex injection, tell your doctor if you are allergic to any drugs, or if you have liver disease, a thyroid disorder, epilepsy or other seizure disorder, heart disease, chest pain (angina), congestive heart failure, a heart rhythm disorder, or a history of depression or suicidal behavior.

Before taking this medicine

Do not use Avonex injection if you are allergic to natural or recombinant interferon beta or albumin.

To make sure Avonex injection is safe for you, tell your doctor if you have:

• depression, mental illness, or suicidal thoughts or actions;
• liver disease;
• bleeding problems or a blood clot;
• low blood cell counts;
• heart disease;
• a thyroid disorder;
• a latex allergy;
• an autoimmune disorder such as rheumatoid arthritis, lupus, or psoriasis;
• a seizure; or
• if you drink alcohol.

Plasma-derived products: Some brands of interferon beta-1a contain donated human plasma and may contain viruses or other infectious agents. Donated plasma is tested and treated to reduce the risk of contamination, but there is still a small possibility it could transmit disease. Ask your doctor about any possible risks.

Tell your doctor if you are pregnant or plan to become pregnant, or if you are breastfeeding.

Interferon beta-1a is not approved for use by anyone younger than 18 years old.

How to Give an Avonex Injection

Use Avonex exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Avonex Injection Guidelines:

• Frequency: Once weekly at bedtime, on the same day each week (such as every Monday)
• Method: Intramuscular injection into a muscle
• Injection devices: Available as a prefilled syringe or a prefilled autoinjector pen
• Site rotation: Use a different place each time you give an injection.

Avonex Injection Site Safety:

• Injection site reactions can occur with Avonex injections, including injection site necrosis
• About 2 hours after the Avonex injection, check for skin redness, swelling, or pain
• Report immediately: Any break in skin with blue-black discoloration, swelling, or drainage
• Call your doctor if the injection site reaction doesn’t go away within a few days.

Storage Instructions:

• Store in refrigerator, protect from light, do not freeze
• Prefilled syringe/autoinjector: Remove 30 minutes before injection to reach room temperature
• Do not leave the prefilled syringe/autoinjector out of the refrigerator for longer than 7 days.

Avonex Side Effects

Get emergency medical help if you have signs of an allergic reaction to Avonex (hives, itching, anxiety, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Life-threatening blood clots: Interferon beta-1a can cause life-threatening blood clots in the small blood vessels inside your organs, such as your brain or kidneys. Seek medical help right away if you have symptoms of this condition, such as a fever, tiredness, decreased urination, bruising, or nosebleeds.

Call your doctor at once if you have:

• pain, swelling, bruising, redness, oozing, or skin changes where the injection was given;
• a light-headed feeling, like you might pass out;
• unusual changes in mood or behavior (feeling hopeless, anxious, nervous, irritable, or depressed);
• thoughts about suicide or hurting yourself;
• easy bruising, unusual bleeding;
• a seizure;
• heart problems – swelling, rapid weight gain, feeling short of breath, rapid heartbeats, chest pain spreading to your jaw or shoulder, nausea, sweating;
• liver problems – nausea, loss of appetite, tiredness, confusion, easy bruising or bleeding, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes);
• signs of infection – fever, chills, cough with mucus, bloody diarrhea, pain or burning when you urinate; or
• thyroid problems – mood swings, trouble sleeping, tiredness, hunger, diarrhea, pounding heartbeats, muscle weakness, sweating, dry skin, thinning hair, menstrual changes, weight changes, puffiness in your face, feeling more sensitive to hot or cold temperatures
• breathing difficulties. Pulmonary arterial hypertension can occur with interferon beta products,
  including Avonex. Symptoms may include new or increasing fatigue or shortness of breath.

Common Avonex side effects may include:

• low blood cell counts;
• skin changes where the injection was given;
• depression;
• abnormal liver function tests;
• stomach pain; or
• flu symptoms – headache, fever, chills, chest pain, back pain, tiredness, weakness, muscle aches.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects.

Dosing Information

Usual Adult Maintenance Dose of Avonex for MS

• 30 mcg intramuscularly once a week.

Titrate the dose as follows to reduce the incidence and severity of influenza-like symptoms:

• Week 1: 7.5 mcg intramuscularly once weekly
• Week 2: 15 mcg intramuscularly once weekly
• Week 3: 22.5 mcg intramuscularly once weekly
• Week 4+: 30 mcg intramuscularly once weekly.

Available forms: Avonex injection is available as a single-dose prefilled syringe and single-dose prefilled autoinjector.

Missed Dose

Use the medicine as soon as you can, but do not inject Avonex two days in a row. Do not use two doses at one time.

Overdose

Seek emergency medical attention or call the Poison Help line .

What other drugs will affect Avonex?

Other drugs may interact with interferon beta-1a, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Avonex Injection Ingredients

Active ingredient: interferon beta-1a
Inactive ingredients: Avonex Single-Dose Prefilled Syringe: arginine hydrochloride, glacial acetic acid, polysorbate 20, sodium acetate trihydrate in water for injection.

Inactive ingredients: Avonex Single-Dose Prefilled Autoinjector Pen: arginine hydrochloride, glacial acetic acid, polysorbate 20, sodium acetate trihydrate in water for injection. 

Who makes Avonex?

Biogen Inc. makes Avonex.

Frequently Asked Questions

How long does it take for Avonex to work?

Avonex typically takes 3-6 months to show its full effect in reducing MS relapses. Some patients may notice improvements in fatigue and overall well-being within the first few weeks, but the medication’s primary benefit of reducing relapse frequency and slowing disability progression becomes more apparent over time. It’s important to continue treatment even if you don’t immediately notice changes, as the medication works to prevent future MS activity.

Can I travel with Avonex injections?

Yes, you can travel with Avonex, but it requires careful planning. Keep medication in its original packaging with prescription labels. For air travel, pack Avonex in carry-on luggage with a cooling pack (but not frozen). Bring a doctor’s letter explaining your medical need for the injection.

For international travel, research medication regulations in your destination country. Consider bringing extra supplies in case of delays. Avonex can be stored at room temperature for up to 7 days (prefilled syringe) or 30 days (vial) if refrigeration isn’t available.

What’s the difference between Avonex and Rebif?

Both Avonex and Rebif contain interferon beta-1a, but they differ in dosing and administration. Avonex is given once weekly by intramuscular injection (into the muscle), while Rebif is given three times weekly by subcutaneous injection (under the skin). Rebif typically has a higher cumulative weekly dose.

Both medications have similar effectiveness for MS treatment, but some patients may prefer the less frequent Avonex injections, while others may tolerate the smaller, more frequent Rebif doses better. Your neurologist can help determine which is best for your situation.

How can I manage flu-like symptoms from Avonex?

Flu-like symptoms are common, especially when starting Avonex, but usually improve over time. To minimize symptoms: take Avonex at bedtime so you sleep through the worst effects, pre-treat with over-the-counter pain relievers like acetaminophen or ibuprofen 30 minutes before injection and continue for 24 hours after, stay well-hydrated, use a heating pad for muscle aches, and ensure adequate rest.

The dose titration schedule (starting with lower doses) also helps reduce these symptoms. Most patients find flu-like effects diminish significantly after 2-3 months of treatment.

Can I drink alcohol while taking Avonex?

While there’s no absolute prohibition on alcohol with Avonex, you should use caution. Both Avonex and alcohol can affect liver function, so combining them may increase the risk of liver problems. Additionally, alcohol can worsen some MS symptoms like fatigue, balance problems, and depression. If you choose to drink, do so in moderation and discuss your alcohol consumption with your healthcare provider, especially if you have any liver function abnormalities or are taking other medications.

How to administer the Avonex injection?

Avonex is given by intramuscular injection, typically in the thigh (vastus lateralis muscle) or upper arm (deltoid muscle). Rotate between different sites to prevent tissue damage and injection site reactions.

For thigh injections, alternate between left and right thighs, and vary the exact location within each thigh. If using the upper arm, you may need assistance from someone else for proper injection technique.

Keep a record of injection sites to ensure proper rotation. Never inject into areas that are red, bruised, infected, or have scar tissue.

What blood tests do I need while taking Avonex?

Regular monitoring is essential while taking Avonex. Typical tests include: complete blood count (CBC) to check for low white blood cells, red blood cells, or platelets; liver function tests to monitor for hepatotoxicity; and thyroid function tests since Avonex can affect thyroid function. Initially, these tests may be done monthly for the first few months, then every 3-6 months once you’re stable. Your neurologist will determine the appropriate testing schedule based on your individual situation and any side effects you experience.

Can I get pregnant while taking Avonex?

If you’re planning to become pregnant or become pregnant while taking Avonex, discuss this immediately with your healthcare provider. Avonex is pregnancy category C, meaning effects on pregnancy aren’t fully known. Some studies suggest interferons may increase risk of miscarriage.

Your neurologist will weigh the benefits of continued MS treatment against potential risks to pregnancy. There are alternative MS treatments that may be safer during pregnancy. Don’t stop Avonex abruptly without medical supervision, as this could lead to MS relapses.

Is there financial assistance available for Avonex?

Yes, several options exist to help with Avonex costs. Biogen, the manufacturer, offers the Avonex Patient Support Program which may provide co-pay assistance for eligible patients with commercial insurance. The program may cover up to a certain amount per prescription.

Additionally, patient assistance programs are available for uninsured or underinsured patients who meet income requirements. The National MS Society also provides information about financial assistance programs. Contact Biogen’s patient support services or speak with your healthcare provider’s financial counselor to explore available options.

What should I do if I experience injection site reactions?

Mild injection site reactions (redness, swelling, pain) are common and usually resolve within a few days. Apply ice before injection and heat afterward to minimize discomfort. However, watch for signs of serious reactions: persistent pain, increasing redness or swelling after 2-3 days, skin breakdown or ulceration, blue-black discoloration, or drainage from the injection site. These could indicate injection site necrosis, which requires immediate medical attention.

Always rotate injection sites and never inject into irritated or damaged skin. If reactions persist or worsen, contact your healthcare provider.

Can I receive vaccines while taking Avonex?

Generally, inactivated (killed) vaccines are safe while taking Avonex, but live vaccines should typically be avoided as they may pose risks for people on immunomodulatory therapy. Common safe vaccines include the flu shot (inactivated), the pneumonia vaccine, and the hepatitis B vaccine.

However, timing and specific recommendations can vary. Always inform healthcare providers that you’re taking Avonex before receiving any vaccine. Your neurologist and primary care provider should coordinate your vaccination schedule to ensure optimal protection while maintaining MS treatment safety.

Avonex Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There are 2 for Avonex.Avonex (interferon beta-1a) – Biogen Inc.

Auvelity is a combination antidepressant medicine used to treat major depressive disorder (MDD) in adults. Auvelity contains dextromethorphan, an NMDA receptor antagonist, and bupropion, a norepinephrine-dopamine reuptake inhibitor (NDRI). 

Auvelity works by targeting multiple brain pathways involved in depression. Dextromethorphan works by blocking NMDA receptors, increasing the levels of glutamate, a chemical messenger (neurotransmitter),  to improve mood and brain connectivity. While bupropion helps dextromethorphan last longer in the body and increases dopamine and norepinephrine levels to improve depression symptoms.

Auvelity’s usual dose is 1 tablet taken once daily for 3 days, followed by 1 tablet twice daily, separated by at least 8 hours.  Tablets should be swallowed whole and not crushed or chewed.

Auvelity is a rapid-acting antidepressant that started working as early as 1 week, and patients’ depression symptoms continued to improve over time when compared to placebo in a 6-week clinical study for MDD (Study 1, NCT04019704).

Auvelity became an FDA-approved medicine on August 18, 2022, for adults with major depressive disorder (MDD).

How does Auvelity work?

Auvelity’s active ingredient, dextromethorphan, works as a N-methyl D-aspartate (NMDA) receptor antagonist and is also an agonist at the sigma-1 receptors. This helps to improve depressive symptoms by increasing glutamate levels, changing glutamate signalling, and regulating other neurotransmitters.

The second active ingredient, bupropion, helps dextromethorphan work more effectively by slowing how quickly it’s broken down in the body. It does this by blocking an enzyme called CYP2D6, allowing dextromethorphan to stay active longer. As a norepinephrine-dopamine reuptake inhibitor, bupropion also helps improve mood by increasing levels of dopamine and norepinephrine in the brain.

What is the cost of Auvelity?

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our price guide page for more information about the cost of Auvelity.

You may also be eligible for an Auvelity savings card or an Auvelity coupon. Ask your doctor or pharmacist if you qualify.

Auvelity side effects

Common Auvelity side effects

The most common Auvelity side effects include:

• dizziness
• diarrhea
• dry mouth
• excessive sweating
• headache
• feeling sleepy
• sexual function problems

Serious Auvelity side effects

Also, see Warnings.

Auvelity may cause serious side effects, including:

Seizures. There is a risk of seizures during treatment with this medicine. The risk is higher in people who:

• take higher doses of this medicine
• have certain medical problems
• take it with certain other medicines

Do not take Auvelity with other medicines unless your healthcare provider tells you to.
If you have a seizure during treatment, stop taking this medicine and call your healthcare provider right away. Do not take this medicine again if you have a seizure.

Increases in blood pressure (hypertension). Some people may get high blood pressure during treatment. Your healthcare provider should check your blood pressure before you start taking and during treatment.

Manic episodes. Manic episodes may happen in people with bipolar disorder who take Auvelity. Symptoms may include:

• greatly increased energy
• racing thoughts
• unusually grand ideas
• talking more or faster than usual
• severe trouble sleeping
• reckless behavior
• excessive happiness or irritability

Unusual thoughts or behaviors. One of the ingredients in Auvelity (bupropion), can cause unusual thoughts or behaviors, including delusions (believing you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.

Eye problems (angle-closure glaucoma). Auvelity may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your healthcare provider if you have eye pain, changes in your vision, or swelling or redness in or around the eye.

Dizziness. this medicine may cause dizziness, increasing your fall risk.

Serotonin syndrome. A potentially life-threatening problem called serotonin syndrome can happen when you take Auvelity with certain other medicines. Call your healthcare provider or go to the nearest hospital emergency room right away if you have any of the following signs and symptoms of serotonin syndrome:

• agitation
• seeing or hearing things that are not there (hallucinations)
• confusion
• coma
• fast heartbeat
• changes in blood pressure
• dizziness
• sweating
• flushing
• high body temperature (hyperthermia)
• shaking (tremors), stiff muscles, or muscle twitching
• loss of coordination
• seizures
• nausea, vomiting, diarrhea