Last update Feb. 9, 2026

C25H27N3O2S

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

It is an atypical or second generation antipsychotic indicated in the treatment of schizophrenia and major depressive disorder. Oral administration once daily.

Its pharmacokinetic data (large volume of distribution, moderately high molecular weight, and very high percentage of plasma protein binding) explain the negligible transfer to breast milk observed. (Konishi 2024), and no clinical problems have been observed in three infants whose mothers took it. (Fukuda 2026)

Plasma levels in an infant whose mother was taking Brexpiprazole were below the detection limit. (Konishi 2024)

Brexpiprazole produces a minimal increase in prolactin levels. (Clayton 2020, Ivkovic 2019, Ishigooka 2018)

There are concerns about the possibility of decreased milk production and other unspecified breastfeeding disturbances attributed to brexpiprazole. (Fukuda 2026, Jiang 2024, Naughton 2023, Berlin 2020)

Until there is further published data on this drug in relation to breastfeeding, known safer alternatives are preferable (Wichniak 2021), especially during the neonatal period and in cases of prematurity.


See below the information of these related products:

Alternatives

  • Olanzapine (Safe product and/or breastfeeding is the best option.)
  • Paliperidone (Safe product and/or breastfeeding is the best option.)
  • Quetiapine Fumarate (Safe product and/or breastfeeding is the best option.)
  • Risperidone (Safe product and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.
DONATE NOW

Other names

C25H27N3O2S is Brexpiprazole in Molecular formula.

Is written in other languages:

Groups

C25H27N3O2S belongs to these groups or families:

Tradenames

Main tradenames from several countries containing C25H27N3O2S in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 95 %
Molecular weight 434 daltons
Protein Binding > 99 %
VD 1.56 l/Kg
pKa 13.56 -
Tmax 4 hours
T½ 91 - 96 hours
Theoretical Dose 0.00035 mg/Kg/d
Relative Dose 0.7 - 1.05 %

References

  1. Fukuda A, Oyanagi G, Kikuchi S, Iwasaki C, Okubo M, Noda A, Morishita K, Okabe N, Iwabuchi R, Sato Y, Kimura E, Kobayashi N, Tomita H, Sato S, Iwama N, Hanita T, Saito M, Tomita H, Obara T, Mano N. Evaluation of the Safety of Taking Brexpiprazole During the Lactation Period. Breastfeed Med. 2026 Feb 6:15568253251408037. Abstract
  2. Konishi T, Kitahiro Y, Fujiwara N, Yamamoto K, Hashimoto M, Ito T, Itohara K, Fujioka K, Imafuku H, Otsuka I, Omura T, Yano I. Pharmacokinetics of Brexpiprazole, Quetiapine, Risperidone, and Its Active Metabolite Paliperidone in a Postpartum Woman and Her Baby. Ther Drug Monit. 2024 Oct 1;46(5):687-691. Abstract
  3. Jiang Y, Zhou L, Shen Y, Zhou Q, Ji Y, Zhu H. Safety assessment of Brexpiprazole: Real-world adverse event analysis from the FAERS database. J Affect Disord. 2024 Feb 1;346:223-229. Abstract
  4. Naughton S, O'Hara K, Nelson J, Keightley P. Aripiprazole, brexpiprazole, and cariprazine can affect milk supply: Advice to breastfeeding mothers. Australas Psychiatry. 2023 Apr;31(2):201-204. Abstract
  5. Wichniak A, Siwek M, Rymaszewska J, Janas-Kozik M, Wolańczyk T, Bieńkowski P, Dudek D, Heitzman J, Szulc A, Samochowiec J. The position statement of the Working Group of the Polish Psychiatric Association on the use of D2/D3 dopamine receptor partial agonists in special populations. Psychiatr Pol. 2021 Oct 31;55(5):967-987. Abstract Full text (link to original source) Full text (in our servers)
  6. Berlin S, Bodnar K. Low breast milk production associated with brexipiprazole (Rexulti). The Academy of Breastfeeding Medicine 25th Annual International Meeting. Breastfeed Med 2020;15:A-3. Poster-Abstract #4. Abstract Full text (link to original source)
  7. Clayton AH, Ivkovic J, Chen D, George V, Hobart M. Effect of Brexpiprazole on Prolactin and Sexual Functioning: An Analysis of Short- and Long-Term Study Data in Major Depressive Disorder. J Clin Psychopharmacol. 2020 Nov/Dec;40(6):560-567. Abstract Full text (link to original source)
  8. Ivkovic J, Lindsten A, George V, Eriksson H, Hobart M. Effect of Brexpiprazole on Prolactin: An Analysis of Short- and Long-Term Studies in Schizophrenia. J Clin Psychopharmacol. 2019 Jan/Feb;39(1):13-19. Abstract Full text (link to original source)
  9. Ishigooka J, Iwashita S, Higashi K, Liew EL, Tadori Y. Pharmacokinetics and Safety of Brexpiprazole Following Multiple-Dose Administration to Japanese Patients With Schizophrenia. J Clin Pharmacol. 2018 Jan;58(1):74-80. Abstract Full text (link to original source)

Total visits

1,350

Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at elactancia.org@gmail.com

e-lactancia is a resource recommended by AELAMA of Spain

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM