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Xenazine (Tetrabenazine)
| Tetrabenazine (Generic) Tetrabenazine | ||||||
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Shipped from Canada | ||||||
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| Tetrabenazine (Generic) Tetrabenazine | ||||||
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Shipped from Mauritius | ||||||
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General Medication Fact Sheet for Xenazine
| Field | Information |
|---|---|
| Medication Name | Xenazine |
| Generic Name | Tetrabenazine |
| Boxed/Label Warning | Increased risk of depression and suicidality in patients with Huntington’s disease. |
| Purpose | Treatment of chorea associated with Huntington’s disease. |
| Mechanism of Action | Reversibly depletes monoamines (dopamine, serotonin, norepinephrine, and histamine) from nerve terminals by inhibiting the vesicular monoamine transporter type 2 (VMAT2). |
| Dosage Forms | Oral tablets |
| Available Strengths | 12.5 mg, 25 mg |
| Dosage Frequency | Typically administered twice or three times daily. |
| Common Side Effects | Somnolence, insomnia, depression, anxiety, nausea, akathisia (restlessness), parkinsonism. |
| Serious Side Effects | Worsening of depression/suicidality, neuroleptic malignant syndrome (NMS), QT prolongation, parkinsonism, akathisia. |
| Drug Interactions | MAO inhibitors, reserpine, dopamine antagonists (e.g., antipsychotics), alcohol, levodopa, CYP2D6 inhibitors. |
| Important Notes | Monitor for depression and suicidality. Avoid use with MAO inhibitors. Use caution in patients with a history of depression, suicidal thoughts, or other psychiatric conditions. ECG monitoring may be required. |
| Storage | Store at room temperature away from moisture and light. |
| Missed Dose | Take as soon as you remember unless it is almost time for your next dose. Do not double the dose. |
| Alternatives | Austedo (deutetrabenazine), Ingrezza (valbenazine), symptomatic treatment for chorea. |
Xenazine Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Austedo (deutetrabenazine) | VMAT2 inhibitor | Another option for treating chorea associated with Huntington’s disease; may have a different side effect profile. |
| Ingrezza (valbenazine) | VMAT2 inhibitor | Used for tardive dyskinesia; may be used off-label in some instances for chorea management. |
| Amantadine | Dopamine modulator | Sometimes used off-label to manage chorea; its effectiveness varies. |
Xenazine Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Somnolence (drowsiness) | Worsening of depression/suicidality |
| Insomnia | Neuroleptic Malignant Syndrome (NMS) |
| Depression | QT Prolongation |
| Anxiety | Parkinsonism (tremor, rigidity, slow movement) |
| Nausea | Akathisia (restlessness) |
| Akathisia (restlessness) | Falls |
Xenazine Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Chorea associated with Huntington’s Disease | 12.5 mg once daily | Increase gradually in 12.5 mg increments weekly to control chorea while managing side effects (Max 100mg/day or 200mg/day if CYP2D6 poor metabolizer). | Administer with food to reduce nausea. Dosage adjustment based on individual response and tolerability. |
