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tetrabenazine

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

What is tetrabenazine?

Tetrabenazine reduces the amount of certain chemicals in the body that are overly active in people with Huntington's disease.

Tetrabenazine is used to treat Huntington's chorea (uncontrolled muscle movements).

Tetrabenazine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about tetrabenazine?

You should not use this medication if you are allergic to tetrabenazine, or if you have severe or untreated depression, suicidal thoughts, liver disease, or past or present breast cancer.

Do not use tetrabenazine if you have taken reserpine within the past 20 days, or if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) within the past 14 days.

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Before you take tetrabenazine, tell your doctor if you have heart disease or a recent history of heart attack, a personal or family history of "Long QT syndrome," or a history of depression or suicidal thoughts or actions.

Tetrabenazine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

You may feel depressed or have thoughts about suicide when you first start taking this medication. Your doctor will need to check you at regular visits during treatment.

Stop taking tetrabenazine and call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, confusion, trouble swallowing, problems with balance, uncontrolled muscle movements, extreme drowsiness, or if you feel restless, agitated, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my health care provider before taking tetrabenazine?

You should not use this medication if you are allergic to tetrabenazine, or if you have:

  • severe or untreated depression;

  • suicidal thoughts;

  • liver disease; or

  • past or present breast cancer.

Do not use tetrabenazine if you have taken reserpine within the past 20 days, or if you have used an MAO inhibitor within the past 14 days. Examples of MAO inhibitors include furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate).

To make sure you can safely take tetrabenazine, tell your doctor if you have any of these other conditions:

  • heart disease or recent history of heart attack;

  • a personal or family history of "Long QT syndrome"; or

  • a history of depression or suicidal thoughts or actions.

You may feel depressed or have thoughts about suicide when you first start taking this medication. Tell your doctor if you have worsening depression or suicidal thoughts while taking tetrabenazine.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits while you are taking tetrabenazine.

FDA pregnancy category C. It is not known whether tetrabenazine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether tetrabenazine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are taking tetrabenazine.

How should I take tetrabenazine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Call your doctor if your chorea symptoms do not improve, or if they get worse while taking tetrabenazine.

You may need frequent eye exams while you are taking tetrabenazine. Follow your doctor's instructions.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include some of the serious side effects listed in this medication guide.

What should I avoid while taking tetrabenazine?

Tetrabenazine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of tetrabenazine.

Tetrabenazine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using tetrabenazine and call your doctor at once if you have a serious side effect such as:

  • extreme drowsiness;

  • mood or behavior changes, thoughts about suicide or hurting yourself;

  • feeling restless, agitated, or hyperactive (mentally or physically);

  • tremor (uncontrolled shaking), restless muscle movements in your eyes, tongue, jaw, or neck;

  • trouble swallowing;

  • problems with balance;

  • dizziness, fainting, fast or pounding heartbeat;

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, feeling like you might pass out;

  • muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine; or

  • urinating less than usual or not at all, swelling, weight gain, feeling short of breath.

Less serious side effects may include:

  • sleep problems (insomnia);

  • feeling anxious or irritable;

  • mild drowsiness, tired feeling;

  • mild nausea;

  • breast swelling or discharge; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Tetrabenazine dosing information

Usual Adult Dose for Huntington Disease:

Initial dose:
First week: 12.5 mg orally daily
Second week: 12.5 mg orally 2 times daily

Maintenance dose:
Titrate by 12.5 mg orally weekly to tolerated dose that reduces chorea

Maximum dose:
37.5 to 50 mg daily should be administered in 3 divided doses
Maximum recommended single dose: 25 mg

What other drugs will affect tetrabenazine?

Tell your doctor about all other medications you use, especially:

  • arsenic trioxide (Trisenox);

  • droperidol (Inapsine);

  • celecoxib (Celebrex);

  • cimetidine (Tagamet);

  • darifenacin (Enablex);

  • ropinirole (Requip);

  • terbinafine (Lamisil);

  • ADHD medications (Adderall, Ritalin, Strattera);

  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);

  • an antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin, Zyban), clomipramine (Anafranil), desipramine (Norpramin), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), imipramine (Tofranil), paroxetine (Paxil), sertraline (Zoloft);

  • anti-malaria medication;

  • cancer medications such as gefitinib (Iressa), imatinib (Gleevec), or nilotinib (Tasigna);

  • a heart rhythm medication;

  • HIV or AIDS medicine such as delavirdine (Rescriptor) or ritonavir (Norvir);

  • medicine to treat or prevent nausea and vomiting, such as dolasetron (Anzemet), metoclopramide (Reglan), ondansetron (Zofran), or promethazine (Phenergan, Promacot);

  • medicines to treat Parkinson's disease, restless leg syndrome, or pituitary gland tumor (prolactinoma);

  • medicine to treat psychiatric disorders, such as aripiprazole (Abilify), chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), olanzapine (Zyprexa), perphenazine (Trilafon), risperidone (Risperdal), thioridazine (Mellaril), ziprasidone (Geodon), and others;

  • migraine headache medicine such as sumatriptan (Imitrex) or zolmitriptan (Zomig); or

  • a narcotic such as levomethadyl (Orlaam), methadone (Methadose, Diskets, Dolophine) or propoxyphene (Darvon, Darvocet).

This list is not complete and other drugs may interact with tetrabenazine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about tetrabenazine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02. Revision Date: 2010-12-15, 5:01:39 PM.

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