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Tetrabenazine

Generic Name: tetrabenazine (TET-ra-BEN-a-zine)
Brand Name: Xenazine

Tetrabenazine may increase the risk of depression and suicidal thoughts or actions in patients with Huntington disease. Tell your doctor if you have a history of depression or suicidal thoughts or attempts. Do not take tetrabenazine if you have untreated depression, if your treatment for depression is not working well, or if you feel suicidal.

Family and caregivers must closely observe patients who take tetrabenazine for signs of new or worsening depression, suicidal thoughts, or unusual changes in behavior. Tell the patient's doctor right away if these effects occur.

Be sure that the benefits of using tetrabenazine outweigh the risks. Talk with your doctor for more information.


Tetrabenazine is used for:

Treating involuntary movements (chorea) in patients with Huntington disease.

Tetrabenazine is a monoamine depleter. It works by reducing the amount of certain chemicals in the brain (eg, dopamine, norepinephrine, serotonin). How it works to reduce involuntary muscle movements is not fully known.

Do NOT use tetrabenazine if:

  • you are allergic to any ingredient in tetrabenazine
  • you have suicidal thoughts, untreated depression, or if you are being treated for depression and your treatment is not working well
  • you have decreased liver function, a certain heart problem (long QT syndrome), or a history of irregular heartbeat
  • you take certain medicines that may affect your heartbeat, including certain antibiotics (eg, moxifloxacin), certain medicines for irregular heartbeat (eg, amiodarone, sotalol, quinidine, procainamide), or certain medicines for mood or mental problems (eg, chlorpromazine, thioridazine, ziprasidone)
  • you take a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), reserpine, or if you have taken reserpine within the past 20 days

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Before using tetrabenazine:

Some medical conditions may interact with tetrabenazine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you or a family member has a history of depression, suicidal thoughts or attempts, or other mental or mood problems
  • if you have breast cancer or a history of breast cancer
  • if you have a history of heart problems, heart failure, or recent heart attack; fast or slow heartbeat; or electrolyte problems (eg, low blood potassium or magnesium levels)
  • if you are a CYP2D6 poor metabolizer

Some MEDICINES MAY INTERACT with tetrabenazine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Medicines that may affect your heartbeat including certain antibiotics (eg, moxifloxacin), certain medicines for irregular heartbeat (eg, amiodarone, sotalol, quinidine, procainamide), or certain medicines for mood or mental problems (eg, chlorpromazine, thioridazine, ziprasidone) because the risk of severe irregular heartbeat (QT prolongation) may be increased
  • Duloxetine, fluoxetine, neuroleptic medicines (eg, haloperidol, risperidone, olanzapine), paroxetine, reserpine, sertraline, or terbinafine because they may increase the risk of tetrabenazines side effects
  • MAOIs (eg, phenelzine) because they may decrease tetrabenazines effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if tetrabenazine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use tetrabenazine:

Use tetrabenazine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Tetrabenazine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get tetrabenazine refilled.
  • Take tetrabenazine by mouth with or without food.
  • If you miss a dose of tetrabenazine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use tetrabenazine.

Important safety information:

  • Tetrabenazine may cause drowsiness or dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use tetrabenazine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using tetrabenazine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Tetrabenazine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by tetrabenazine. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; or sweating. Contact your doctor at once if you have any of these symptoms.
  • Some patients who take tetrabenazine may develop muscle movements that they cannot control (tardive dyskinesia). The chance that this will happen or that it will become permanent may be greater in those who take tetrabenazine in higher doses or for a long time. Tell your doctor at once if you have muscle problems with your arms or legs, or with your tongue, face, mouth, or jaw (eg, fast eye blinking, lip smacking, mouth puckering or chewing movements, puffing of cheeks, sticking out of the tongue) while taking tetrabenazine.
  • Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.
  • Tetrabenazine may increase the amount of a certain hormone (prolactin) in your blood. Symptoms may include enlarged breasts, missed menstrual period, decreased sexual ability, or nipple discharge. Contact your doctor right away if you experience any of these problems.
  • Do not stop tetrabenazine without first talking with your doctor. Your symptoms (eg, involuntary movements) may return within 12 to 18 hours after your last dose.
  • If you stop taking tetrabenazine for more than 5 days, contact your doctor right away. Do not take another dose until you talk to your doctor. Your doctor may need to adjust your dose.
  • Lab tests, including liver and heart function, may be performed while you use tetrabenazine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Tetrabenazine should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using tetrabenazine while you are pregnant. It is not known if tetrabenazine is found in breast milk. Do not breast-feed while taking tetrabenazine.

Possible side effects of tetrabenazine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Decreased appetite; dizziness; drowsiness; nausea; tiredness; trouble sleeping; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fainting; fast or irregular heartbeat; fever; increased sweating; increased or unusual coughing; new or worsening muscle problems (eg, body stiffness, tremor or shaking, trouble moving or keeping your balance, unsteadiness); new or unusual involuntary muscle movements of the face, mouth, jaws, or tongue (eg, fast eye blinking, lip smacking, mouth puckering or chewing movements, puffing of cheeks, sticking out of the tongue); new or worsening mental or mood problems (eg, agitation or aggressiveness, anxiety, confusion, depression or sadness, panic attack, restlessness, or unusual behavior changes); persistent trouble sleeping; severe nausea or vomiting; severe or persistent dizziness; shortness of breath; suicidal thoughts or actions; trouble speaking or swallowing; trouble urinating; unusual bruising or bleeding; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include abnormal muscle movements; confusion; diarrhea; eye spasms; hallucinations; redness of the skin; severe drowsiness or dizziness; unusual sweating; tremor.

Proper storage of tetrabenazine:

Store tetrabenazine at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep tetrabenazine out of the reach of children and away from pets.

General information:

  • If you have any questions about tetrabenazine, please talk with your doctor, pharmacist, or other health care provider.
  • Tetrabenazine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take tetrabenazine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about tetrabenazine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to tetrabenazine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using tetrabenazine.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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