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Xenazine Side Effects

Generic name: tetrabenazine

Medically reviewed by Last updated on May 25, 2023.

Note: This document contains side effect information about tetrabenazine. Some dosage forms listed on this page may not apply to the brand name Xenazine.

Applies to tetrabenazine: oral tablet.


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.

Serious side effects of Xenazine

Along with its needed effects, tetrabenazine (the active ingredient contained in Xenazine) 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

  • 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

  • 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 Xenazine

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

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

Less common

  • Decreased appetite

For Healthcare Professionals

Applies to tetrabenazine: oral tablet.

Nervous system

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]


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]


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]


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]


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]


Common (1% to 10%): Hypotension

Frequency not reported: Hypertensive crisis, bradycardia[Ref]


Common (1% to 10%): Ecchymosis

Frequency not reported: Sweating

Postmarketing reports: Hyperhidrosis, skin rash[Ref]


Common (1% to 10%): Dysuria[Ref]


Common (1% to 10%): Decreased appetite

Frequency not reported: Anorexia, weight gain[Ref]


Uncommon (0.1% to 1%): Severe extrapyramidal symptoms (e.g., muscular rigidity, autonomic dysfunction)

Very rare (less than 0.01%): Skeletal muscle damage[Ref]


Frequency not reported: Leukopenia[Ref]


Frequency not reported: Oculogyric crisis, photophobia[Ref]

Frequently asked questions


1. Product Information. Xenazine (tetrabenazine). Prestwick Pharmaceuticals Inc. 2008.

Further information

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

Some side effects may not be reported. You may report them to the FDA.