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Xenazine Side Effects

Generic Name: tetrabenazine

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

In Summary

Common side effects of Xenazine include: drowsiness, sedation, bradykinesia, hypertonia, muscle rigidity, depression, exacerbation of depression, akathisia, and restlessness. Other side effects include: dysphagia, anxiety, and dizziness. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to tetrabenazine: oral tablet

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

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]


1. "Product Information. Xenazine (tetrabenazine)." Prestwick Pharmaceuticals Inc, Washington DC, VA.

Some side effects of Xenazine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.