Ingrezza Disease Interactions

Valbenazine is extensively metabolized after oral administration by the liver. Dosage adjustment of valbenazine 40 mg once daily is recommended for patients with moderate or severe hepatic impairment (Child-Pugh score 7 to 15). Close monitoring of hepatic function is recommended.

Valbenazine may prolong the QT interval, although the degree of QT prolongation is not clinically significant at concentrations expected with recommended dosing. The use of valbenazine should be avoided in patients with congenital long QT syndrome or with arrhythmias associated with a prolonged QT interval. For patients at increased risk of a prolonged QT interval, it is recommended to assess the QT interval before increasing the dosage.

The use of valbenazine is not recommended in patients with severe renal impairment (creatinine clearance <30 mL/min). Dosage adjustment is not necessary for patients with mild to moderate renal impairment (creatinine clearance 30 to 90 mL/min).

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.