Austedo vs Ingrezza: How do they compare?
- Austedo and Ingrezza are both used to treat the movement disorder tardive dyskinesia.
- Austedo also treats the movement disorder chorea which is associated with Huntington’s Disease.
- They are both medicines from a group that are usually called VMAT2 inhibitors (inhibits vesicular monoamine transporter type 2).
How well does each medication work?
- Ingrezza 80mg dose had statistically significant improvement in tardive dyskinesia symptoms in 6 weeks.
- Austedo 36 mg had statistically significant improvement in tardive dyskinesia symptoms in 12 weeks.
- In the Ingrezza 40mg trial and the Austedo 24mg trial there was an improvement in scores but they were not clinically significant.
- In a clinical trial using Austedo for treatment of chorea there was a statistically significant improvement in chorea by 12 weeks, using a dose range 6mg to 48mg.
- Improvement in tardive dyskinesia is measured by the Abnormal Involuntary Movement Scale (AIMS) score. A negative score or decreasing score shows an improvement in tardive dyskinesia symptoms.
- Improvement in chorea movements is measured by the Total Maximal Chorea Score. A decreasing score or a negative score shows an improvement in chorea symptoms.
How easy are they to take?
- twice daily
- with food.
- should be swallowed whole, do not crush, chew or break tablets
- once a day
- with or without food
How safe are they?
Austedo has a Boxed Warning, specifically warning people that taking Austedo can increase the risk of developing depression, suicidal thoughts and behavior (suicidality) in patients with Huntington’s disease.
Ingrezza does not have a boxed warning.
Who should not take these medications?
Some people should not take some medications if they have been or are on specific medications or have a particular health condition, these are called contraindications.
You should not take Austedo if you:
- If you have huntington's disease and you have depression that is not being treated or is being treated but you are still depressed, or if you are suicidal.
- have liver impairment.
- if you have been taking reserpine in the last 20 days.
- if you have been taking a medicine called a monoamine oxidase inhibitors (MAOI) in the last 14 days.
- if you are taking the medicine tetrabenazine (Xenazine) or vabenazine.
You should not take Ingrezza if you:
- Allergic or hypersensitive to Ingrezza or any of the ingredients in Ingrezza.
What serious side effects does each medicine have?
Austedo: Depression and suicidality in patients with Huntington’s disease, QTc prolongation, neuroleptic malignant syndrome (NMS), akathisia, agitation, restlessness, parkinsonism, sedation, somnolence, hyperprolactinemia and binding to melanin-containing tissues.
Ingrezza: Hypersensitivity, somnolence, QT Prolongation and parkinsonism.
Table Comparing Austedo and Ingrezza
|Boxed warning||Depression and suicidality in patients with Huntington's Disease||None|
Chorea associated with Huntington’s disease
|Medicine Group||VMAT2 inhibitors||VMAT2 inhibitors|
Chorea: Starting at 6mg once daily and may increase if necessary up to 48mg daily (divided into 2 doses per day).
Tardive dyskinesia: 6mg twice daily and dose maybe increase up to 48mg daily (divided into 2 doses per day).
|Tardive dyskinesia: Starting dose is 40mg and maybe increased up to 80mg daily depending on dose and tolerability|
Taken twice daily, with food
Tablets should be swallowed whole, do not crush, chew or break tablets.
|Taken once daily, with or without food|
If you have Huntington's disease and have depression that is not treated or inadequately treated, or if you are suicidal.
If you have been taking reserpine in the last 20 days.
If you have been taking MAOI in the last 14 days.
If you are taking tetrabenazine(Xenazine) or vabenazine.
|If you are hypersensitive to valbenazine or any ingredient of Ingrezza|
|Serious side effects||
Depression and suicidality in patients with Huntington’s disease, QTc prolongation, neuroleptic malignant syndrome (NMS), akathisia, agitation, restlessness
Parkinsonism, sedation, somnolence
hyperprolactinemia, binding to melanin-containing tissues.
(Drug effect - placebo effect = treatment effect)
Chorea effectiveness: Austedo (dose 6mg to 48 mg) up to 12 weeks had a treatment effect of reducing Total Maximal Chorea Score by -2.5 (-4.4- -1.9 = -2.5)
Tardive Dyskinesia Effectiveness:
Tardive Dyskinesia Effectiveness:
Ingrezza 40mg by week 6 had a treatment effect of reducing AIMS score by -1.8 (-1.9 - -0.1 = -1.8) This was not statistically significant.
Ingrezza 80mg by week 6 had a treatment effect of reducing AIMS score by -3.1 (-3.2 - -0.1= -3.1) which was statistically significant
- Both Austedo 36mg and Ingrezza 80mg provide statistically significant reduction in dyskinesia symptoms.
- Austedo (6mg-48mg) induces a statistically significant improvement in chorea.
- Individual patients' contraindications, other medications and medical conditions will determine which medication will suit them best.
- Austedo Professional Medications Information [Accessed September 23, 2021] https://www.drugs.com/pro/austedo.html
- Ingrezza Professional Medication Information [Accessed September 23, 2021] https://www.drugs.com/pro/ingrezza.html
- Valbenazine and Deutetrabenazine for Tardive Dyskinesia. [Accessed September 23, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040721/
- Treatment of tardive dyskinesia with VMAT-2 inhibitors: a systematic review and meta-analysis of randomized controlled trials. [Accessed September 23, 2021] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958944/
Related medical questions
- How much does Ingrezza cost?
- Ingrezza mechanism of action: How does it work?
- What condition is Ingrezza used to treat?
- Which pharmacies can dispense Ingrezza?
- How long does it take for Ingrezza to work?
- Does Ingrezza cause weight gain?
- How effective is Ingrezza?
- Can Ingrezza capsules be opened?
- How long does it take for Austedo to work?
- What condition is Austedo used to treat?
- What drugs cause tardive dyskinesia?