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Drug Interactions between Austedo XR and tetrabenazine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

tetrabenazine deutetrabenazine

Applies to: tetrabenazine and Austedo XR (deutetrabenazine)

CONTRAINDICATED: Tetrabenazine and deutetrabenazine and their active metabolites are reversible depletors of monoamine neurotransmitters and may have additive effects during coadministration. Both medications are reversible inhibitors of the human vesicular monoamine transporter type 2 (VMAT2), which is responsible for the monoamine transport from cellular cytosol into the synaptic vesicles. Severe monoamine depletion in the central nervous system may occur if these medications are given together. Presynaptic dopamine over-depletion could theoretically lead to supersensitivity to dopamine and increase the risk of tardive dyskinesia, which is a potentially irreversible syndrome of involuntary dyskinetic movements. The risk of other movement and motility disorders such as parkinsonism, dysphagia, akathisia, and other extrapyramidal symptoms may also be increased. Over-depletion of serotonin and norepinephrine may increase the risk of depression and suicidality.

MANAGEMENT: Concomitant use of tetrabenazine and deutetrabenazine is considered contraindicated. Treatment with deutetrabenazine may be started the day following discontinuation of tetrabenazine. The manufacturer's product labeling should be consulted for dosing guidelines when switching from tetrabenazine to deutetrabenazine.

References (1)
  1. (2017) "Product Information. Austedo (deutetrabenazine)." Teva Pharmaceuticals USA

Drug and food interactions

Moderate

tetrabenazine food

Applies to: tetrabenazine

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication

Vmat2 inhibitors

Therapeutic duplication

The recommended maximum number of medicines in the 'VMAT2 inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'VMAT2 inhibitors' category:

  • Austedo XR (deutetrabenazine)
  • tetrabenazine

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

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

Medical Disclaimer