Drug & supplement interaction

Sulbutiamine + Brexpiprazole

Brexpiprazole brand name: Rexulti.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Sulbutiamine and Brexpiprazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Sulbutiamine and Brexpiprazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Brexpiprazole and Sulbutiamine in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Sulbutiamine at all — not against Brexpiprazole, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Sulbutiamine safety at a glance

Sulbutiamine overall Use caution Generally well tolerated short-term, but long-term safety and quality of evidence are limited.
Pregnancy Avoid Not enough safety data; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety data; avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Brexpiprazole and Sulbutiamine? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Sulbutiamine and Brexpiprazole May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Tremor or shakiness / Drowsiness / Trouble sleeping / Headache reported in 4.0% of FDA reports for Brexpiprazole Additional detail

    Sulbutiamine

    “Cases of headache, insomnia, tremor, and drowsiness were each reported in one patient (0.06% of patients) using a combination of anti-infective medication and sulbutiamine.”

    Sulbutiamine · Natural Medicines adverse-effect record, reported in cluster headache.

    1 source cited
    1. 24374. Shah S. Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia. J Assoc Physicians India. 2003;51:891-5.

    Brexpiprazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Brexpiprazole, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

  • Nausea Additional detail

    Sulbutiamine

    “Five cases of nausea have been reported for patients using a combination of anti-infective medication and sulbutiamine.”

    Sulbutiamine · Natural Medicines adverse-effect record, reported in nausea and vomiting.

    1 source cited
    1. 24374. Shah S. Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia. J Assoc Physicians India. 2003;51:891-5.

    Brexpiprazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Brexpiprazole. Read the label on DailyMed ›

Effects for Brexpiprazole come from the ADVERSE REACTIONS section of its FDA label; effects for Sulbutiamine come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 16,505 voluntary FDA FAERS reports for Brexpiprazole that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Everything else you take

See Every Supplement That Interacts With Brexpiprazole

This page covers Sulbutiamine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Brexpiprazole page lists 177 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Indian Snakeroot (major), Lithium (major) and Rauvolfia Vomitoria (major).

By severity: 6 major · 130 moderate · 41 minor.

From our pharmacist’s overview on the Brexpiprazole page

“Brexpiprazole (Rexulti) treats schizophrenia and is added to antidepressants for depression, and its supplement list warrants real care before you add anything to it. The bulk of the 177 entries change how your liver clears the drug, so grapefruit can push levels up while St.”

Reviewed by 2 · Jul 18, 2026

Open the Brexpiprazole interaction page

One more smart check

Taking Sulbutiamine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 64 real supplement products containing Sulbutiamine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sulbutiamine. Even though Sulbutiamine itself has no known interaction with Brexpiprazole, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Sulbutiamine and Brexpiprazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Sulbutiamine
Top half

#598 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Brexpiprazole
Steady interest

#1,968 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Sulbutiamine reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Sulbutiamine and Brexpiprazole records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Sulbutiamine

What is Sulbutiamine?

  • Fatigue and low energy
  • Memory and focus
  • Mental clarity
  • Mood support
  • Vitamin B1 deficiency support

Sulbutiamine is a man-made, fat-soluble form of vitamin B1 (thiamine) developed in Japan, often taken for fatigue and to support mental energy and focus. Human evidence is limited and mostly older or small, so its real benefits are uncertain. It is generally well tolerated short-term, but you should talk with a pharmacist or doctor before using it, especially if you have a health condition.

Synthetic compound (not from a plant) · Tablets, capsules

An interaction check asks whether these two react with each other — it does not ask whether Sulbutiamine is a good idea for someone in your situation. Here is what our Sulbutiamine record says about it on its own.

Sulbutiamine: dosing

There is no firmly established standard dose for sulbutiamine as a supplement. Amounts used in older studies and on product labels vary, and there is not enough strong evidence to recommend one clear dose.The safest approach is to follow the directions on the product label and not take more than suggested.

From our Sulbutiamine monograph — the full record covers uses, side effects and every documented interaction.

Read the full Sulbutiamine monograph & all interactions
Medication

About Brexpiprazole

What Is Brexpiprazole Used For?

Brand name: Rexulti

Brexpiprazole tablets are approved for two uses in adults: as an add-on (adjunctive) treatment alongside antidepressants for major depressive disorder (MDD), and as a treatment for schizophrenia. These uses apply to both the generic brexpiprazole tablets and Rexulti.

Rexulti has one additional approved use: treating agitation associated with dementia due to Alzheimer's disease in adults. Rexulti is also approved for schizophrenia in adolescents ages 13 and older. Note that Rexulti is not approved for dementia-related psychosis without agitation from Alzheimer's disease, and it is not meant to be used on an as-needed basis for Alzheimer's-related agitation.

Most-Reported Side Effects for Brexpiprazole

From FAERS, the FDA’s public side-effect reporting system (16,505 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Weight increased 1,702 reports
Akathisia 869 reports
Tremor 654 reports
Anxiety 612 reports
Tardive dyskinesia 599 reports
See full Brexpiprazole drug information
Keep checking

Other Drugs & Sulbutiamine

Browse every other medication we’ve checked against Sulbutiamine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Sulbutiamine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Sulbutiamine list.

See the full Sulbutiamine interactions page
See every supplement checked against Brexpiprazole, ranked by severity
Evidence & sources

Sulbutiamine References

The 4 references that drive our Sulbutiamine monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Shah S. Adjuvant role of vitamin B analogue (sulbutiamine) with anti-infective treatment in infection associated asthenia. J Assoc Physicians India. 2003;51:891-5.
  2. Loo H, Poirier M, Ollat H, et al. [Effects of subutiamine (Arcalion 200) on psycho-behavioral inhibition in major depressive episodes]. Encephale. 2000;26(2):70-5.
  3. Kiew K, Wan Mohamad W, Ridzuan A, et al. Effects of sulbutiamine on diabetic polyneuropathy: an open randomized controlled study in type 2 diabetics. Malays J Med Sci. 2002;9(1):21-7.
  4. Sevim S, Kaleagasi H, Tasdelen B. Sulbutiamine shows promising results in reducing fatigue in patients with multiple sclerosis. Mult Scler Relat Disord. 2017;16:40-43. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Sulbutiamine and Brexpiprazole Together: Common Questions

Is it safe to take Sulbutiamine with Brexpiprazole?
We do not list a known interaction between Sulbutiamine and Brexpiprazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Sulbutiamine and Brexpiprazole have any of the same side effects?
Yes — our sources link each of them separately to 5 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Does Brexpiprazole interact with any supplements?
Yes. Brexpiprazole has documented interactions with 177 supplements in our database — Sulbutiamine is not one of them. The Brexpiprazole interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Sulbutiamine monograph Uses, safety profile, and every drug interaction in one place Brexpiprazole drug information The full plain-English guide to this medication Brexpiprazole supplement interactions Every supplement checked against Brexpiprazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 4 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Brexpiprazole and Sulbutiamine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.