Deutetrabenazine

Deutetrabenazine is a prescription medication used to treat chorea (uncontrolled movements) caused by Huntington's disease. Additionally, deutetrabenazine is used to treat tardive dyskinesia (involuntary, repetitive movements) in adults. Deutetrabenazine belongs to a group of drugs called VMAT2 inhibitors. These work in the brain to change how your nervous system and muscles function. 

This medication comes in tablet form and is typically taken 1 time per day initially for Huntington's disease and 2 times a day for tardive dyskinesia. Deutetrabenazine should be taken with food at the same time every day.

Do not chew, divide, or break deutetrabenazine tablets. Swallow deutetrabenazine tablets whole.

Common side effects of Huntington's disease patients taking deutetrabenazine include sleepiness, diarrhea, dry mouth, and fatigue. 

Common side effects of tardive dyskinesia patients taking deutetrabenazine include common cold and insomnia. 

Deutetrabenazine can also cause drowsiness. Do not drive or operate heavy machinery until you know how deutetrabenazine affects you.

Deutetrabenazine is a prescription medication used to treat chorea (uncontrolled movements) related to Huntington's disease. Huntington's disease is a genetic disorder that causes nerves in the brain to breakdown over time. 

Deutetrabenazine can also be used to treat tardive dyskinesia. Tardive dyskinesia is a disorder typically caused by long term use of antipsychotics. Tardive dyskinesia patients have involuntary and repetitive movements. 

Deutetrabenazine may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Deutetrabenazine may be found in some form under the following brand names:

• Austedo

Serious side effects have been reported with deutetrabenazine. See the “Deutetrabenazine Precautions” section.

Huntington's Patients: 

Common side effects include:

• sleepiness
• diarrhea
• dry mouth
• fatigue
• urinary track infections
• insomnia

Tardive Dyskinesia Patients:

Common side effects include:

• common cold 
• insomnia
• depression
• restlessness

This is not a complete list of deutetrabenazine side effects. Ask your doctor or pharmacist for more information. Tell your doctor if you have any side effects that bother you or that do not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

Medications that block the enzyme called CYP2D6 such as: 

•  quinidine (Qualaquin), fluoxetine (Prozac, Sarafem), amitriptyline (Elavil, Amitril, Amitid), and paroxetine (Paxil)

Medications that can cause an arrhythmia called Torsades des Point such as:

• certain anti-arrhythmia medications including
  • procainamide, sotalol (Betapace), quinidine, dofetilide (Tikosyn), amiodarone (Nexterone, Pacerone, Cordarone), ibutilide (Corvert)
• certain fluoroquinolone antibiotics including
  • levofloxacin (Levaquin), ciprofloxacin (Cipro), gatifloxacin (Zymar), moxifloxacin (Avelox)
• certain macrolide antibiotics including
  • clarithromycin (Biaxin), erythromycin (EES, others)
• certain azole antifungals including
  • ketoconazole (Nizoral), itraconazole (Sporanox, Onmel)
• certain antidepressants including
  • amitriptyline, desipramine (Norpramin), imipramine (Tofranil), doxepin (Silenor), fluoxetine (Prozac, Sarafem, Symbyax), sertraline (Zoloft), venlafaxine (Effexor XR)
• certain antipsychotics including
  • haloperidol (Haldol), droperidol (Inapsine), quetiapine (Seroquel XR), thioridazine, ziprasidone (Geodon)
• and other medications including
  • cisapride, sumatriptan (Treximet, Imitrex, Alsuma, Zecuity), zolmitriptan (Zomig, arsenic trioxide (Trisenox), dolasetron (Anzemet), and methadone (Methadone, Dolophine

Reserpine. This medication works similarly to Austedo, so taking them together could cause overdose symtoms and cause problems in the central nervous system. 

Medications that block an enzyme called monoamine oxidase such as:

• isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Emsam, Eldepryl, Zelapar), rasagiline (Azilect)

Antipsychotics medications such as:

• paliperidone (Invega), lurasidone (Latuda), olanzapine (Zyprexa), aripiprazole (Abilify), asenapine (Saphris), iloperidone (Fanapt), haloperidol (Haldol), prochlorperazine (Compazine), chlorpromazine (Thorazine), clozapine (Clozaril), risperidone (Risperdal), quetiapine (Seroquel), and ziprasidone (Geodon)

Alcohol and other sedating medications such as: 

• barbiturate medications including
  • butalbital, pentobarbital (Nembutal), phenobarbital (Luminal)
• benzodiazepine medications including
  • clonazepam (Klonopin), diazepam (Diastat), lorazepam (Ativan), midazolam (Versed), alprazolam (Xanax), temazepam (Restoril)
• hypnotic medications including
  • eszopiclone (Lunesta), zeleplon (Sonata), zolpidem (Ambien)
• first generation antihistamine medications including
  • diphenhydramine (Benedryl), doxylamine (Diclectin), promethazine (Phenergan), hydroxyzine (Vistaril), chlorpheniramine (Chlor-Trimeton)
• muscle relaxant medications including
  • baclofen (Lioresal), carisoprodol (Somadril), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), tizanidine (Zanaflex), gabapentin (Neurontin), pregabalin (Lyrica)
• opioid pain relieving medications including
  • tramadol (Ultram), morphine (MS Contin), hydromorphone (Dilaudid), oxymorphone (Opana), oxycodone (Oxycontin), hydrocodone (Vantrela), fentanyl (Duragesic), codeine, meperidine (Demerol)
• antidepressant medications including
  • amitriptyline (Elavil), trazodone (Oleptro), mirtazapine (Remeron), doxepin (Sinequan), nortriptyline (Pamelor), nefazodone (Serzone)
• antipsychotic medications including
  • olanzepine (Zyprexa), clozapine (Clozaril), haloperidol (Haldol), fluphenazine (Prolixin), quetiapine (Seroquel), prochlorperazine (Compazine)

Tetrabenazine or valbenazine. Deutetrabenazine is contraindicated if taking these medications. 

This is not a complete list of deutetrabenazine drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with all deutetrabenazine uses and include the following:

QT prolongation. This is a condition when changes in the electrical activity of your heart occur, causing irregular heartbeats that can be life threatening. Talk to your healthcare provider about other medicines you are taking before you start taking deutetrabenazine. Tell your healthcare provider right away if you have any signs or symptoms of QT prolongation:

• feeling faint
• lightheadedness
• dizziness
• feeling like your heart is beating irregularly or quickly

Neuroleptic Malignant Syndrome (NMS). A condition affects your body movements and can be life threatening. Talk to your healthcare providor right away if you have any signs or symptoms of NMS:

• increased reflexes
• muscle stiffness
• changes in mental status
• irregular pulse or blood pressure

Agitiation/Restlessness. Austedo can make you feel like you need to constantly be moving. May include rocking, marching, or crossing and uncrossing legs. 

Sedation. Deutetrabenazine can make you feel more tired or dizzy. Do not operate a motor vehicle or machinery until you know how deutetrabenazine will affect you.

Hyperprolactinemia. Deutetrabenazine can cause an increase in a hormone called prolactin and could lead to low levels of estrogen or osteoporosis. Keep all appointments with your doctor so you can monitor prolactin levels. 

Eye problems. Deutetrabenazine can bind to tissue that contains melanin, typically found in the eyes, and cause toxic effects. You should continue periodic eye exams while taking deutetrabenazine. 

Huntington's Disease Patients Only:

Depression/Suicidal thoughts. Contact your provider right away if you see any of the following symptoms of depression or suicide:

• severe sadness
• suidcide thoughts
• changes in behavior

Worsening Huntington's symptoms. If you have an increase in Huntington's symptoms contact your doctor right away and discontinue deutetrabenazine: 

• worsening mood
• decrease in cognition (mental capacity)
• increased muscle rigidity 

Parkinson-like symptoms. Deutetrabenazine can cause a secondary parkinson's disease in Huntington's patients. Your doctor may decrease your dose or stop deutetrabenazine completely if parkinson's is confirmed. 

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of deutetrabenazine, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking deutetrabenazine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to deutetrabenazine or to any of its ingredients
• have emotional or mental problems (for example, depression, nervousness, anxiety, anger, agitation, psychosis, previous suicidal thoughts or suicide attempts)
• have liver disease
• have an irregular heartbeat
• have low levels of potassium or magnesium in your blood
• have or have had breast cancer
• are pregnant or plan to become pregnant
• are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

In animal studies, pregnant animals were given deutetrabenazine, and there was no clear effect on the baby. 

No well-controlled studies have been done in humans. Therefore, deutetrabenazine may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if deutetrabenazine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of deutetrabenazine. Your doctor and you will decide if the benefits outweigh the risk of using deutetrabenazine.

Take deutetrabenazine exactly as prescribed. 

Deutetrabenazine comes in tablet form and is taken differently depending on what is being treated. 

Deutetrabenazine is typically taken 1 time per day initially for Huntington's disease and 2 times a day for tardive dyskinesia. Deutetrabenazine should be taken with food at the same time every day.

Do not chew, divide, or break deutetrabenazine tablets. Swallow deutetrabenazine tablets whole.

If you miss a dose of deutetrabenazine, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the dose and take your dose at the regular time. Do not take two doses of deutetrabenazine at the same time. 

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. 

Huntington's Disease

The recommended starting dose of deutetrabenazine for the treatment of Huntington's disease is 6 mg (1 tablet) once per day. Your doctor might increase your dose by 6 mg every week depending on symtom control. The max dose of deutetrabenazine is 48 mg (8 tablets) per day. 

Tardive Dyskinsia

The recommended starting dose of deutetrabenazine for the treatment of Huntington's disease is 6 mg (1 tablet) 2 times per day. Your doctor might increase your dose by 6 mg every week depending on symptom control. The max dose of deutetrabenazine is 48 mg (8 tablets) per day. 

If you take too much deutetrabenazine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away. 

Store deutetrabenazine at room temperature, protect from light. Keep deutetrabenazine and all medicines out of the reach of children. 

Deutetrabenazine can increase the risk of depression and suicidal thoughts and behavior in patients with Huntington’s disease. Closely monitor for new or worsening depression, suicidality, or unusual changes in behavior. Patients, caregivers, and families should be informed of the risk of depression and suicidality and should report behaviors of concern promptly to the treating doctor. 

Particular caution should be exercised in treating patients with a history of depression or prior suicide attempts or ideation, which are increased in frequency in Huntington’s disease. Deutetrabenazine is contraindicated in patients who are suicidal, and in patients with untreated or inadequately treated depression.