tetrabenazine at a glance
Medicine class
VMAT2 inhibitor and central monoamine-depleting agent
Main licensed uses
Huntington’s chorea, hemiballismus, senile chorea and selected moderate-to-severe tardive dyskinesia
Administration
Oral tablet that may be taken with or without food
Important practical effect
Drowsiness, dizziness and impaired balance can affect driving, machinery use and falls risk
What is tetrabenazine used for?
Licensed uses include specified involuntary movement disorders.
Movement disorders associated with organic central nervous system conditions, including Huntington’s chorea, hemiballismus and senile chorea.
Moderate-to-severe tardive dyskinesia that is disabling or socially distressing and persists despite appropriate changes to antipsychotic treatment.
The NHS lists tetrabenazine among medicines that may reduce tics, but tics are not a licensed indication for the selected product.
How does tetrabenazine work?
Tetrabenazine reversibly inhibits vesicular monoamine transporter 2 (VMAT2). This reduces the storage and release of monoamines, particularly dopamine, from nerve terminals and can lessen excessive involuntary movements.
tetrabenazine preparations and strengths
Tablet
Route: Oral
Strengths: 25 mg
How to take tetrabenazine
Food does not materially affect absorption.
Swallow with water or another non-alcoholic drink.
The scored tablet can be divided into equal halves when instructed.
Avoid alcohol because it can increase drowsiness.
tetrabenazine side effects
Common or expected effects
- Drowsiness or sedation
- Restlessness, anxiety or confusion
- Insomnia
- Depression or low mood
- Nausea
- Tiredness
- Akathisia or parkinsonism
- Dizziness or impaired balance
- Reduced appetite
- Diarrhoea, vomiting or constipation
Get urgent medical advice
- Suicidal thoughts, self-harm or suicide attempt
- Possible neuroleptic malignant syndrome: high temperature, severe muscle rigidity, altered mental state or unstable pulse or blood pressure
- Severe restlessness or inability to remain still
- New or worsening parkinsonism
- Difficulty swallowing, choking or symptoms of aspiration pneumonia
- Fainting or a severe rise in blood pressure
- Serious hypersensitivity reaction
tetrabenazine in pregnancy
Human pregnancy data are inadequate, and animal studies found reproductive toxicity. Tetrabenazine is not recommended during pregnancy or for someone who could become pregnant and is not using contraception. Discuss pregnancy or pregnancy planning with the specialist prescriber.
tetrabenazine while breastfeeding
Tetrabenazine is contraindicated while breastfeeding. It is unknown whether tetrabenazine or its metabolites enter human milk, and a risk to the child cannot be excluded.
tetrabenazine interactions
Check all prescribed, over-the-counter and recreational substances. Important interactions include:
Monoamine oxidase inhibitors
The combination is contraindicated because it may cause a hypertensive crisis.
Levodopa
Tetrabenazine can oppose and reduce levodopa’s effect.
Dopamine antagonists, including antipsychotics and metoclopramide
They can increase parkinsonism, other extrapyramidal effects, QT prolongation and neuroleptic malignant syndrome risk.
Common questions about tetrabenazine
Answers are fully visible for fast scanning and source review.
What is tetrabenazine used for?
It is licensed for specified involuntary movement disorders, including Huntington’s chorea, hemiballismus, senile chorea and selected persistent, disabling moderate-to-severe tardive dyskinesia.
Is tetrabenazine used for tics?
The NHS lists it as an option that may reduce tics, but tics are not a licensed indication for the selected Xenazine product.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.