Tetrabenazine: Uses, Dosage, and Side Effects Overview

Key Points About Tetrabenazine

Tetrabenazine is a prescription medication commonly used to manage movement disorders such as Huntington’s disease, tardive dyskinesia, and other conditions that cause involuntary movements. It works by decreasing specific brain chemicals that influence movement control. While Tetrabenazine can help alleviate symptoms, it is important to note that it does not cure the underlying condition. Always consult your healthcare provider before starting or adjusting your dosage to ensure safe and effective use tailored to your needs.

Medication Names and Brand Information

US Brand Name: Xenazine (Tetrabenazine)

The term “generic name” refers to the active ingredient in a medication, which remains the same regardless of the brand. In this case, the generic name is Tetrabenazine.

Pharmacologic Category of Tetrabenazine

Tetrabenazine belongs to a class of medications known as vesicular monoamine transporter 2 (VMAT2) inhibitors. This classification describes how the drug works: by altering neurotransmitter activity in the brain, it helps reduce involuntary movements associated with certain neurological conditions.

Tetrabenazine Dosage Guidelines

Tetrabenazine is prescribed for a variety of conditions that involve involuntary movements. Below are the recommended dosages for each condition. It is essential to follow your doctor’s instructions carefully and consult them before making any changes to your treatment plan. If you have questions or need additional guidance, consider reaching out to a telemedicine provider for support.

Tetrabenazine for Huntington’s Disease

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Tardive Dyskinesia

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Chorea

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Wilson’s Disease

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Tourette Syndrome

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Dyskinesia

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Essential Tremor

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Akathisia

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Restless Legs Syndrome

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Tetrabenazine for Parkinson’s Disease

Initial Dose: 12.5 mg once daily during the first week.

Maintenance Dose: The dose may be increased by 12.5 mg each week, up to a maximum of 50 mg per day, divided into two or three doses.

Dosage Forms and Strengths

Tetrabenazine is available in the following dosage forms:

1. Tablets: 12.5 mg
2. Tablets: 25 mg

How to Take Tetrabenazine Safely

Tetrabenazine is taken orally and can be consumed with or without food. It is essential to follow your healthcare provider’s instructions closely to ensure the medication is both safe and effective. If you miss a dose, take it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Avoid taking two doses at the same time. For personalized advice on how to take Tetrabenazine safely, consult one of our telemedicine providers.

Tetrabenazine Side Effects and Adverse Reactions

Like all medications, Tetrabenazine may cause side effects, which can range from mild to severe. Contact your healthcare provider immediately if you experience any concerning symptoms.

Common Side Effects:

1. Drowsiness
2. Fatigue
3. Nausea
4. Insomnia

These side effects are typically mild and may improve as your body adjusts to the medication.

Less Common Side Effects:

1. Depression
2. Anxiety
3. Restlessness

If you notice any changes in your mood or mental health, notify your healthcare provider promptly.

Serious Side Effects:

1. Suicidal thoughts
2. Severe depression
3. Difficulty breathing

Although rare, these side effects require immediate medical attention. Do not delay in seeking help if you experience any of these symptoms.

Contraindications for Tetrabenazine

There are certain conditions and circumstances where Tetrabenazine may not be safe to use. It is important to discuss the following contraindications with your healthcare provider before starting treatment:

Depression or Suicidal Thoughts: Tetrabenazine can increase the risk of depression and suicidal thoughts, particularly in individuals with a history of these conditions. Because the medication affects brain chemicals that regulate mood, it may worsen symptoms in those already at risk.

Liver Disease: Tetrabenazine is processed by the liver. If liver function is impaired, the medication can build up in the body, potentially leading to serious side effects.

Uncontrolled or Untreated Depression: Individuals with untreated or poorly managed depression should not take Tetrabenazine, as it can exacerbate these conditions.

Allergy to Tetrabenazine: If you have experienced an allergic reaction to Tetrabenazine, such as rash, itching, swelling, or difficulty breathing, you should avoid using this medication.

Taking Monoamine Oxidase Inhibitors (MAOIs): MAOIs, such as phenelzine or tranylcypromine, can interact dangerously with Tetrabenazine, leading to severe side effects like high blood pressure or serotonin syndrome.

Drug-to-Drug Interactions with Tetrabenazine

Tetrabenazine may interact with other medications, which can increase the risk of side effects or reduce the effectiveness of the treatment. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and dietary supplements.

Antidepressants: Medications such as fluoxetine (Prozac) and paroxetine (Paxil) can raise Tetrabenazine levels in the body, increasing the likelihood of side effects.

Antipsychotics: Drugs like haloperidol (Haldol) or chlorpromazine (Thorazine) may heighten the risk of side effects such as drowsiness, confusion, or movement disorders when taken with Tetrabenazine.

MAO Inhibitors: Medications like phenelzine (Nardil) and tranylcypromine (Parnate) should not be combined with Tetrabenazine due to the risk of severe interactions, including serotonin syndrome.

Levodopa: Levodopa (Sinemet), a common treatment for Parkinson’s disease, may interact with Tetrabenazine, potentially worsening movement-related symptoms.

Is Tetrabenazine Safe During Pregnancy?

There is limited information about the safety of Tetrabenazine during pregnancy. While animal studies suggest potential risks, no well-controlled studies have been conducted in pregnant women. If you are pregnant or planning to become pregnant, it is important to discuss the potential risks and benefits of Tetrabenazine with your healthcare provider. They will help you determine whether the benefits of treatment outweigh the possible risks to your baby.

Tetrabenazine While Breastfeeding

Is it safe to take Tetrabenazine while breastfeeding?

The safety of Tetrabenazine during breastfeeding remains uncertain, as it is unclear whether the medication passes into breast milk. Due to the potential risk of serious side effects in nursing infants, breastfeeding while taking Tetrabenazine is generally not advised. If you are currently breastfeeding or planning to do so, it is essential to consult your healthcare provider. They can help you explore alternative treatments or determine whether it is safe to continue breastfeeding while on Tetrabenazine.

Estimated Cost of Tetrabenazine Medication

The cost of Tetrabenazine can vary depending on your location and the pharmacy you use. Without insurance, a 30-day supply typically costs between $1,500 and $2,000 when using a GoodRx coupon. To get the most accurate pricing, check with your local pharmacy and consider exploring financial assistance programs if needed. Your healthcare provider or pharmacist can also provide advice on ways to reduce the cost of your Tetrabenazine treatment.

Possible Alternatives to Tetrabenazine

If Tetrabenazine is not the right option for you, there are alternative treatments and lifestyle adjustments that may help manage your symptoms. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to assist you in exploring these options.

Huntington’s Disease

For Huntington’s disease, alternative treatments include antipsychotic medications such as risperidone (Risperdal) or olanzapine (Zyprexa), which may help control movement disorders. Physical therapy and lifestyle modifications, like regular exercise, can also play a significant role in improving symptoms.

Tardive Dyskinesia

FDA-approved alternatives for tardive dyskinesia include valbenazine (Ingrezza) and deutetrabenazine (Austedo). In some cases, reducing or discontinuing the antipsychotic medications that contribute to tardive dyskinesia may help alleviate symptoms. Always consult your healthcare provider before making any medication changes.

Chorea

In addition to Tetrabenazine, medications such as clonazepam (Klonopin) or valproic acid (Depakote) may help manage the involuntary movements associated with chorea.

Wilson’s Disease

Treatment for Wilson’s disease often involves chelating agents like penicillamine (Cuprimine) or zinc acetate (Galzin), which help reduce copper levels in the body.

Tourette Syndrome

For Tourette syndrome, behavioral therapy and medications such as clonidine (Catapres) or guanfacine (Intuniv) are commonly used to manage tics. In some cases, antipsychotic medications may also be included in the treatment plan.

Dyskinesia

Amantadine (Gocovri) is frequently prescribed to reduce dyskinesia in Parkinson’s disease. Adjusting the dosage of levodopa may also help control symptoms.

Essential Tremor

Beta-blockers like propranolol (Inderal) or anticonvulsants such as primidone (Mysoline) are common treatment options for essential tremor. Additionally, lifestyle changes, such as reducing caffeine intake, may provide symptom relief.

Akathisia

For akathisia, symptom relief may involve reducing or discontinuing the medication causing the condition. Beta-blockers or benzodiazepines are also potential treatment options.

Restless Legs Syndrome

Dopamine agonists like pramipexole (Mirapex) or ropinirole (Requip) are commonly prescribed for restless legs syndrome. If iron deficiency is a contributing factor, iron supplements may also be beneficial.

Parkinson’s Disease

In addition to Tetrabenazine, medications such as levodopa (Sinemet) or dopamine agonists can help manage Parkinson’s disease symptoms. Physical therapy and regular exercise are also crucial for maintaining mobility and enhancing quality of life.

Recent Updates on Tetrabenazine Research

Recent studies on Tetrabenazine aim to improve its safety profile and reduce side effects such as depression and sedation. Researchers are exploring the use of lower doses or combining Tetrabenazine with other medications to minimize risks. Additionally, ongoing research is examining the long-term effects of Tetrabenazine in individuals with Huntington’s disease and other movement disorders. If you are interested in learning more about the latest research or participating in a clinical trial, speak with your healthcare provider for guidance.

James Kingsley

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