Tetrabenazine Side Effects

Medically reviewed by Drugs.com. Last updated on May 25, 2023.

Applies to tetrabenazine: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Tetrabenazine can increase the risk of depression and suicidal thoughts and behavior (suicidality).

This risk must be balanced with the clinical need.

Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior.

Families and caregivers should be advised of the need for close observation and communication with the prescriber.

Particular caution should be exercised in treating patients with a history of depression or prior suicide attempts or ideation.

Tetrabenazine is contraindicated in patients who are actively suicidal, and in patients with untreated or inadequately treated depression.

Precautions

It is very important that your doctor check your progress at regular visits to see if the medicine is working properly and to allow for changes in the dose.

Tetrabenazine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies, or to become more depressed. If you or your caregiver notice any of these side effects, tell your doctor right away.

Do not take this medicine if you are also taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan®), phenelzine (Nardil®), selegiline (Eldepryl®), or tranylcypromine (Parnate®). If you have questions, check with your doctor.

Do not take this medicine if you are also taking reserpine (Harmonyl®). Wait at least 20 days after stopping reserpine before starting tetrabenazine. If you have questions, check with your doctor.

Check with your doctor right away if you have more than one of these symptoms while taking this medicine: convulsions (seizures), difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

This medicine may cause drowsiness, trouble with thinking, or trouble with controlling movements. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to think well.

Make sure your doctor knows if you are using chlorpromazine (Thorazine®), thioridazine (Mellaril®), ziprasidone (Geodon®), moxifloxacin (Avelox®), quinidine, procainamide (Pronestyl®), amiodarone (Cordarone®), or sotalol (Betapase®). Using any of these medicines together with tetrabenazine may cause serious side effects.

This medicine may cause tardive dyskinesia (a movement disorder). This may not go away after you stop using the medicine. Check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates (used for seizures); muscle relaxants; or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you Stop taking tetrabenazine. Check with your doctor before taking any of the above while you are using this medicine.

Serious side effects of tetrabenazine

Along with its needed effects, tetrabenazine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking tetrabenazine:

More common side effects

• body aches or pain
• chills
• cough
• difficulty in breathing
• difficulty with swallowing
• discouragement
• drowsiness
• ear congestion
• fear or nervousness
• feeling sad or empty
• fever
• headache
• inability to sit still
• irritability
• lack of appetite
• loss of balance control
• loss of interest or pleasure
• loss of voice
• mask-like face
• nasal congestion
• need to keep moving
• relaxed and calm
• restlessness
• runny nose
• shuffling walk
• sleepiness or unusual drowsiness
• sleeplessness
• slow movement or reflexes
• slurred speech
• sneezing
• sore throat
• stiffness of arms and legs
• tic-like (jerky) movements of the head, face, mouth, and neck
• tiredness
• trembling and shaking of fingers and hands
• trouble concentrating
• trouble sleeping
• trouble with balance
• unable to sleep
• unusual tiredness or weakness

Less common side effects

• burning while urinating
• changes in patterns and rhythms of speech
• cough producing mucus
• difficult or painful urination
• dizziness
• shortness of breath
• tightness in chest
• trouble in speaking
• trouble in walking
• wheezing

Get emergency help immediately if any of the following symptoms of overdose occur while taking tetrabenazine:

Symptoms of overdose

• blurred vision
• diarrhea
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• fixed position of the eye
• inability to move eyes
• increased blinking or spasms of the eyelid
• mood or mental changes
• nausea and vomiting
• seeing, hearing, or feeling things that are not there
• shakiness in legs, arms, hands, or feet
• sticking out of tongue
• sweating
• trembling or shaking of hands or feet
• uncontrolled twisting movements of neck, trunk, arms, or legs
• unusual facial expressions

Other side effects of tetrabenazine

Some side effects of tetrabenazine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• bruising
• large, flat, blue, or purplish patches in the skin

Less common side effects

• decreased appetite

For healthcare professionals

Applies to tetrabenazine: oral tablet.

Nervous system adverse events

• Very common (10% or more): Any extrapyramidal event (33%), sedation/somnolence (31%), akathisia/hyperkinesia/restlessness (19%), parkinsonism (12%)
• Common (1% to 10%): Balance difficulty, dizziness, dysarthria, unsteady gait, headache
• Uncommon (0.1% to 1%): Altered levels of consciousness
• Rare (less than 0.1%): Neuroleptic malignant syndrome
• Frequency not reported: Ataxia, dyskinetic seizure, dystonia, memory impairment, amnesia
• Postmarketing reports: Tremor^[Ref]

Other

• Very common (10% or more): Fatigue (22%), fall (15%)
• Common (1% to 10%): Head laceration
• Uncommon (0.1% to 1%): Hyperthermia
• Frequency not reported: Lassitude, hypothermia, weakness, lactation, irregular menstrual cycle^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (22%), depression (19%), anxiety/aggravated anxiety (15%)
• Common (1% to 10%): Irritability, obsessive reaction, agitation, confusion
• Frequency not reported: Disorientation, feelings of unreality, nervousness, sleep disorders
• Postmarketing reports: Worsening aggression^[Ref]

Gastrointestinal

• Very common (10% or more): Nausea (13%)
• Common (1% to 10%): Vomiting, dysphagia/choking attacks, constipation, diarrhea
• Frequency not reported: Dry mouth, epigastric pain, sialorrhea^[Ref]

Respiratory

• Very common (10% or more): Upper respiratory tract infection (11%)
• Common (1% to 10%): Shortness of breath, bronchitis
• Frequency not reported: Bronchopneumonia
• Postmarketing reports: Pneumonia^[Ref]

Cardiovascular

• Common (1% to 10%): Hypotension
• Frequency not reported: Hypertensive crisis, bradycardia^[Ref]

Dermatologic

• Common (1% to 10%): Ecchymosis
• Frequency not reported: Sweating
• Postmarketing reports: Hyperhidrosis, skin rash^[Ref]

Genitourinary

• Common (1% to 10%): Dysuria^[Ref]

Metabolic

• Common (1% to 10%): Decreased appetite
• Frequency not reported: Anorexia, weight gain^[Ref]

Musculoskeletal

• Uncommon (0.1% to 1%): Severe extrapyramidal symptoms (e.g., muscular rigidity, autonomic dysfunction)
• Very rare (less than 0.01%): Skeletal muscle damage^[Ref]

Hematologic

• Frequency not reported: Leukopenia^[Ref]

Ocular

• Frequency not reported: Oculogyric crisis, photophobia^[Ref]

See also:

Frequently asked questions

• Austedo (deutetrabenazine) vs Xenazine (tetrabenazine): How do they compare?
• What's the MOA for Xenazine (tetrabenazine)?
• How long does it take for Xenazine (tetrabenazine) to work?

Further information

Tetrabenazine side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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