Deutetrabenazine Disease Interactions

The use of deutetrabenazine is contraindicated in patients with Huntington's disease who are suicidal, or have untreated or uncontrolled depression. Deutetrabenazine can increase the risk of depression and suicidal thoughts and behavior in these patients. Particular caution should be exercised in treating patients with a history of depression or prior suicide attempts or ideation.

The use of deutetrabenazine is contraindicated in patients with hepatic impairment. The effect of hepatic impairment on the pharmacokinetics of deutetrabenazine and its primary metabolites has not been studied; however, in a clinical study conducted with a closely related VMAT2 inhibitor, there was a large increase in exposure to this drug and its active metabolites in patients with hepatic impairment.

The use of deutetrabenazine should be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias.

Neuroleptic Malignant Syndrome (NMS) has been reported in association with drugs that reduce dopaminergic transmission such as, deutetrabenazine. Deutetrabenazine should be used with caution in patients presenting similar signs and symptoms of NMS. Clinicians should be alerted to the signs and symptoms associated with NMS. Recurrence of NMS has been reported with resumption of drug therapy. If treatment with deutetrabenazine is needed after recovery from NMS, patients should be monitored for signs of recurrence.

The use of vesicular monoamine transporter 2 (VMAT2) inhibitor, such as valbenazine and deutetrabenazine may cause parkinsonism in patients with tardive dyskinesia. These agents should be used with caution in patients with parkinson disease or those presenting with parkinson-like symptoms such as, falls, gait disturbances, tremor, drooling and hypokinesia. It is recommended to reduce the dose or to discontinue treatment in patients who develop clinically significant parkinson-like signs or symptoms while on treatment with these agents.