Valbenazine
Generic name: Valbenazine
Brand name: Ingrezza
Dosage form: oral capsule
Drug class: VMAT2 inhibitors
What is valbenazine?
Valbenazine is a drug used to treat a side effect of antipsychotic or neuroleptic medications called tardive dyskinesia.
Tardive dyskinesia is a movement disorder that causes uncontrollable abnormal movements of the jaw, lips and tongue. It is a rare side effect that may occur after long-term use of certain medications that block dopamine receptors, leading to too much dopamine signaling in the brain. These medications are used to treat schizophrenia and other conditions.
Dopamine is a chemical messenger called a monoamine neurotransmitter. It communicates information between nerve cells and and is involved in many bodily functions including movement and mood.
Valbenazine is a type of drug called a VMAT2 (vesicular monoamine transporter 2) inhibitor. It is thought to work by preventing the release of dopamine from small structures (vesicles) within dopamine-producing nerve cells, which reduces extra dopamine signaling in the brain.
Valbenazine is used to treat the symptoms of tardive dyskinesia, but it does not cure the condition. It was approved by the US Food and Drug Administration in 2017.
What is valbenazine used for?
Valbenazine is a prescription medicine used to treat adults with movements in the face, tongue, or other body parts that cannot be controlled (tardive dyskinesia).
It is not known if valbenazine is safe and effective in children.
Who should not take valbenazine?
Do not take valbenazine if you:
- are allergic to valbenazine, or any of the ingredients in valbenazine. See below for a complete list of ingredients in valbenazine.
What should I tell my doctor before taking valbenazine?
Before taking valbenazine, tell your healthcare provider about all of your medical conditions including if you:
- have liver problems
- have heart disease that is not stable, have heart failure or recently had a heart attack
- have an irregular heart rhythm or heartbeat (QT prolongation, heart arrhythmia)
How should I take valbenazine?
- Take valbenazine exactly as your healthcare provider tells you to. Your healthcare provider will tell you how much valbenazine to take and when to take it.
- Do not stop taking valbenazine without talking to your healthcare provider first.
- Valbenazine can be taken with or without food.
What happens if I overdose?
If you take too much valbenazine, call your poison control center at 1-800-222-1222.
Dosing information
- The initial dosage of valbenazine is 40 mg once daily. After one week, the recommended dosage of valbenazine is 80 mg once daily.
- Valbenazine can be taken with or without food.
- The recommended dosage for patients with moderate or severe hepatic impairment is 40 mg once daily.
- The recommended dosage for known CYP2D6 poor metabolizers is 40 mg once daily.
- See the full prescribing information for further information about valbenazine dosing.
What are the side effects of valbenazine?
Valbenazine may cause serious side effects, including:
- Sleepiness (somnolence). Do not drive, operate heavy machinery, or do other dangerous activities until you know how valbenazine affects you.
- Heart rhythm problems (QT prolongation). Valbenazine may cause a heart problem known as QT prolongation. Symptoms of QT prolongation may include:
- fast, slow, or irregular heartbeat
- shortness of breath
- dizziness or fainting
Tell your healthcare provider right away if you have a change in your heartbeat (a fast or irregular heartbeat), or if you faint.
- Parkinson-like symptoms. Symptoms include: shaking, body stiffness, trouble moving or walking, or keeping your balance
The most common side effect of valbenazine is sleepiness (somnolence).
Other common side effects include:
- changes in balance (balance problems, dizziness) or an increased risk of falls
- headache
- feelings of restlessness
- dry mouth
- constipation
- blurred vision
These are not all of the possible side effects of valbenazine. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Interactions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
Using valbenazine at the same time as a monoamine oxide inhibitor (MAOI) should be avoided. Examples of MAOIs include:
- Isocarboxazid
- Phenelzine
- Selegiline
Taking valbenazine with certain other medicines may cause serious side effects. Do not start any new medicines while taking valbenazine without talking to your healthcare provider first.
Pregnancy and breastfeeding
Tell your healthcare provider is you are pregnant or plan to become pregnant. Valbenazine may harm your unborn baby.
Tell your healthcare provider if you are breastfeeding or plan to breastfeed. It is not known if valbenazine passes into your breast milk. Do not breastfeed during treatment with valbenazine and for 5 days after the final dose. Talk to your healthcare provider about the best way to feed your baby during treatment with valbenazine.
Storage
- Store valbenazine at room temperature between 68°F to 77°F (20°C to 25°C).
Keep valbenazine and all medicines out of the reach of children.
What are the ingredients in valbenazine?
Active ingredient: valbenazine
Inactive ingredients:
40 mg capsule, 60 mg capsule, 80 mg capsule: hypromellose, isomalt, magnesium stearate, pregelatinized starch, and silicified microcrystalline cellulose.
The capsule shells contain candurin silver fine, FD&C Blue#1, FD&C Red#40, and gelatin.
Valbenazine is distributed under the brand name Ingrezza by Neurocrine Biosciences, Inc., San Diego, CA 92130, U.S.A.
Popular FAQ
A specialty pharmacy will dispense your Ingrezza and will mail it directly to you via overnight mail. Your doctor will send your prescription to the appropriate pharmacy, and they will contact you to verify the information. Continue reading
Weight gain has been reported in a 6-week clinical study with Ingrezza, but it is not a common side effect. In this study with 151 patients taking either the 40 mg/day or 80 mg/day dose, 3 patients had weight gain (2%) compared to zero patients (0%) in the placebo (inactive treatment) group. Continue reading
Ask your doctor before you open the Ingrezza capsule and take it any other way than swallowing it whole. Do not open, cut, crush or split the capsule without your doctor’s advice. Contact your doctor right away if you are having trouble swallowing your capsule. Continue reading
Ingrezza takes approximately 6 to 8 weeks to start working, although some improvements in symptoms of tardive dyskinesia (TD) and chorea associated with Huntington's disease (HD) may be noticed within two weeks. Maximal effects of Ingrezza may take up to 32 weeks to develop for TD and up to 12 weeks for chorea associated with HD. Continue reading
The effectiveness of Ingrezza improves with time, with maximal effectiveness reported at around 32 weeks for Tardive dyskinesia (TD) and up to 12 weeks for chorea associated with Huntington's disease (HD).
Trials consistently report over 61% of participants as “much improved” or “very much improved” after 4 to 6 weeks treatment with Ingrezza 50mg to 80mg according to their CGI-TD score. Changes in baseline with AIMS range from -2.4 to -5.8. Trials for chorea associated with HD reported a 4.6-point improvement in chorea severity score with Ingrezza compared with a 1.4-point improvement with placebo by the end of 12 weeks (mean difference –3.2, 95% CI, –4.4 to –2.0; P < 0.0001).
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