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Deutetrabenazine Dosage

Medically reviewed on September 14, 2017.

Applies to the following strengths: 6 mg; 9 mg; 12 mg

Usual Adult Dose for Huntington Disease

-Initial Dose: 6 mg orally once a day
-Maintenance Dose: May increase dose in increments of 6 mg/day at weekly intervals.
-Maximum Dose: 48 mg/day

Comments:
-Determine the dose for each patient based on chorea reduction and tolerability.
-Administer total daily dosages of 12 mg or more in 2 divided doses.
-May discontinue this drug without tapering.
-Re-titrate dose when resuming this drug following treatment interruption of greater than 1 week; resume treatment at the previous maintenance dose without titration if treatment interruption is less than 1 week.

Use: Treatment of chorea associated with Huntington's disease.

Renal Dose Adjustments

Data not available.

Liver Dose Adjustments

Contraindicated.

Dose Adjustments

Patients Switching from Tetrabenazine to Deutetrabenazine: Discontinue tetrabenazine and initiate deutetrabenazine the following day; the initial dose for deutetrabenazine is based on the current tetrabenazine daily dose (TDD):
-If TDD 12.5 mg: Switch to deutetrabenazine 6 mg once a day.
-If TDD 25 mg: Switch to deutetrabenazine 6 mg twice a day.
-If TDD 37.5 mg: Switch to deutetrabenazine 9 mg twice a day.
-If TDD 50 mg: Switch to deutetrabenazine 12 mg twice a day.
-If TDD 62.5 mg: Switch to deutetrabenazine 15 mg twice a day.
-If TDD 75 mg: Switch to deutetrabenazine 18 mg twice a day.
-If TDD 87.5 mg: Switch to deutetrabenazine 21 mg twice a day.
-If TDD 100 mg: Switch to deutetrabenazine 24 mg twice a day.

CYP450 2D6 Poor Metabolizers OR Concomitant Use of Strong CYP450 2D6 Inhibitors:
-Maximum Single Dose: 18 mg
-Maximum Daily Dose: 36 mg

Precautions

US BOXED WARNING:
DEPRESSION AND SUICIDALITY: This drug can increase the risk of depression and suicidality (suicidal thoughts and behavior) in patients with Huntington's disease; thus, it is contraindicated in patients with untreated or inadequately treated depression and in those who are suicidal.
-Balance the risks of depression and suicidality with the clinical need for chorea treatment when considering the use of this drug.
-Inform patients, their caregivers, and their families of the risk of depression and suicidality; instruct them to promptly report behaviors of concern to the treating healthcare provider.
-Closely monitor patients for the emergence or worsening of depression, suicidality, or unusual behavior changes.
-Exercise particular caution in treating patients with a history of depression or prior suicide attempts or ideation, which are increased in frequency in Huntington's disease.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available.

Other Comments

Administration Advice:
-Administer with food.
-Swallow drug tablets whole; do not chew, crush, or break tablets.

Storage Requirements:
-Store at 25 degrees Celsius (77 degrees Fahrenheit); excursions permitted to 15 to 30 degrees Celsius (59 to 86 degrees Fahrenheit).
-Protect from light and moisture.

General:
-Overdosage: Provide supportive care and consider the possibility of multiple drug involvement in managing overdose.

Monitoring:
-General: Periodically re-evaluate the need for this drug by assessing the effect on chorea and possible adverse effects.
-Nervous System: Signs and symptoms of akathisia, restlessness, and agitation.
-Psychiatric: Signs and symptoms of new or worsening depression, suicidality, or unusual behavior changes.

Patient Advice:
-While taking this drug, avoid alcohol and potentially dangerous activities such as driving a car or operating machinery until you know how this drug affects you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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