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Tetrabenazine (Generic)
| Nitoman Tetrabenazine | ||||||
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| Xenazine Tetrabenazine | ||||||
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Shipped from Canada | ||||||
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General Medication Fact Sheet for Tetrabenazine
| Field | Information |
|---|---|
| Generic Name | Tetrabenazine |
| Brand Name Versions | Xenazine |
| Boxed/Label Warning | Increased risk of depression and suicidal thoughts in patients with Huntington’s disease. Monitor patients for worsening depression, suicidal thoughts, or unusual changes in behavior. Avoid use in patients who are actively suicidal or have untreated depression. |
| Purpose | Treats chorea (involuntary movements) associated with Huntington’s disease. |
| Mechanism of Action | Depletes monoamines (dopamine, serotonin, norepinephrine) from nerve terminals. Primarily reduces dopamine, which helps control movement. |
| Dosage Forms | Oral tablets |
| Available Strengths | 12.5 mg, 25 mg |
| Dosage Frequency | Typically administered two or three times daily, depending on individual needs and tolerability. |
| Common Side Effects | Drowsiness, insomnia, depression, anxiety, nausea, akathisia (restlessness), fatigue. |
| Serious Side Effects | Neuroleptic Malignant Syndrome (NMS), QT prolongation, parkinsonism, dysphagia (difficulty swallowing). |
| Drug Interactions | MAO inhibitors, reserpine, dopamine antagonists (e.g., antipsychotics), alcohol, levodopa, CYP2D6 inhibitors. |
| Important Notes | Avoid alcohol. Use caution when driving or operating machinery. Report any changes in mood or suicidal thoughts immediately. Monitor for signs of NMS. |
| Storage | Store at room temperature away from moisture and light. |
| Missed Dose | If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time. |
| Alternatives | Deutetrabenazine (Austedo), Amantadine, Antipsychotics (for symptom management) |
Tetrabenazine Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Deutetrabenazine (Austedo) | VMAT2 inhibitor (similar to tetrabenazine but with a modified chemical structure) | May have a longer half-life and potentially fewer dosing requirements compared to tetrabenazine. |
| Amantadine | Dopamine agonist and NMDA receptor antagonist | Used off-label for chorea; may be less effective than VMAT2 inhibitors. |
| Antipsychotics (e.g., Haloperidol, Risperidone) | Dopamine receptor antagonists | Can suppress chorea but carry a risk of tardive dyskinesia and other extrapyramidal side effects. Used cautiously. |
Tetrabenazine Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Drowsiness | Neuroleptic Malignant Syndrome (NMS) |
| Insomnia | QT prolongation |
| Depression | Parkinsonism |
| Anxiety | Dysphagia (difficulty swallowing) |
| Nausea | Suicidal thoughts/behavior |
| Akathisia (restlessness) | Hypotension |
| Fatigue | Arrhythmias |
Tetrabenazine Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Chorea associated with Huntington’s Disease | 12.5 mg once daily | Individualized; titrate slowly based on response and tolerability, typically up to a maximum of 100 mg/day in divided doses. | Administer with food. Dose adjustments should be made gradually. Consult a healthcare professional for appropriate titration. |
