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Austedo vs Ingrezza: How do they compare?

Medically reviewed by Melisa Puckey, BPharm. Last updated on Sep 23, 2021.

Official answer

by Drugs.com
  • 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?

There have been separate Austedo (deutetrabenazine) clinical trials and Ingrezza (valbenazine) clinical trials to see how well they worked.

  • 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?

Take Austedo

  • twice daily
  • with food.
  • should be swallowed whole, do not crush, chew or break tablets

Take Ingrezza

  • 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

Austedo Ingrezza
Boxed warning Depression and suicidality in patients with Huntington's Disease None
Indications
(Adults)
Chorea associated with Huntington’s disease
Tardive dyskinesia
Tardive dyskinesia
Medicine Group VMAT2 inhibitors VMAT2 inhibitors
Dose 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
Administration Taken twice daily, with food
Tablets should be swallowed whole, do not crush, chew or break tablets.
Taken once daily, with or without food
Contraindications If you have Huntington's disease and have depression that is not treated or inadequately treated, or if you are suicidal.
Liver impairment.
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.
Hypersensitivity
somnolence
QT prolongation
Parkinsonism
Treatment effectiveness:
(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:
Austedo 24mg by week 12 had a treatment effect of reducing AIMS score by -1.8 (-3.2 - -1.4= -1.8) This was not statistically significant.
Austedo 36mg by week 12 had a treatment effect of -1.9 (-3.3 - -1.4= -1.9) This was statistically significant.

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


Bottom Line:

  • 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.
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