Tetrabenazine

Generic name: Tetrabenazine (tet Ra Ben' A Zeen)
Brand names: Xenazine
Dosage form: tablet (12.5mg, 25mg)
Drug class: VMAT2 inhibitors

Usage of Tetrabenazine

Tetrabenazine tablets are used to treat involuntary movements (chorea) caused by Huntington's disease, which is a rare, inherited disease that causes nerve cells in the brain to breakdown and die. Tetrabenazine helps control involuntary body movement of Huntington’s disease, but does not help the psyChiatric and thinking (cognitive) symptoms, and it does not cure the disease.

Tetrabenazine is thought to work by changing the level of natural substances in the brain that control muscle movement.

Tetrabenazine (Brand name: Xenazine) is from the class of medications called vesicular monoamine transporter 2 (VMAT2) inhibitors. Tetrabenazine has its effect by blocking the protein VMAT2 which lowers the amount of messenger chemicals (dopamine, serotonin, norepinephrine, and histamine) in the nerve cells, which is how it is thought to help control involuntary body movements.

Tetrabenazine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Tetrabenazine may cause serious side effects. Call your doctor at once if you have:

tremors, shaking, restless movement, problems with balance;

uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

trouble swallowing;

fast or pounding heartbeats;

a light-headed feeling, like you might pass out; or

severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats.

Common side effects of tetrabenazine may include:

drowsiness, tiredness;

depressed mood;

nausea; or

feeling anxious, agitated, or restless.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Tetrabenazine

You should not use tetrabenazine if you are allergic to it or any of the inactive ingredients, or if you have:

severe or untreated depression;

suicidal thoughts;

liver disease; or

if you have taken reserpine in the past 20 days.

Do not use tetrabenazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

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

depression, an emotional disorder, or mental illness;

a history of suicidal thoughts or actions;

past or present breast cancer;

heart disease or heart rhythm disorder;

a personal or family history of long QT syndrome; or

if you recently had a heart attack.

Taking tetrabenazine may increase your risk of depression or thoughts about suicide. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Pregnancy

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Breastfeeding

It is not known whether tetrabenazine passes into breast milk or if it could harm a nursing baby. You should not breastfeed while using this medicine.

Relate drugs

How to use Tetrabenazine

When first prescribed tetrabenazine should be increased slowly over several weeks to identify a dose that reduces chorea and is tolerated.

Usual Tetrabenazine Adult Dose for Huntington Disease:

Initial dose: First week: 12.5 mg orally daily Second week: 12.5 mg orally 2 times daily Maintenance dose: Increase by 12.5 mg orally weekly to tolerated dose that reduces chorea. Doses of 37.5mg to 50 mg daily should be administered in 3 divided doses. Maximum recommended single dose: 25 mg

Comments: Determine CYP450 2D6 metabolizer status in patients who require doses of greater than 50 mg per day.

Warnings

You may have depression or thoughts about suicide while taking tetrabenazine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

You should not use tetrabenazine if you have severe or untreated depression, suicidal thoughts, liver disease, or if you have taken reserpine in the past 20 days.

What other drugs will affect Tetrabenazine

Other drugs may interact with tetrabenazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

It is important to tell your doctor if you take:

reserpine

monoamine oxidase inhibitors (MAOIs);

alcohol or other sedating drugs;

Drugs that cause QTc prolongation including antipsychotic medications (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone), antibiotics (e.g., moxifloxacin), Class 1A (e.g., quinidine, procainamide) and Class III (e.g., amiodarone, sotalol) antiarrhythmic medications or any other medications known to prolong the QTc interval;

neuroleptic drugs (e.g., chlorpromazine, haloperidol, olanzapine, risperidone, thioridazine, ziprasidone);

strong CYP2D6 inhibitors;

Deutetrabenazine or valbenazine.

For more information on interactions with tetrabenazine click on the link below.

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