Indications
Deutetrabenazine is a prescription medicine used to reduce involuntary, jerky or writhing movements. It is used for chorea (sudden, dance-like movements) in Huntington’s disease, and for tardive dyskinesia, which is repeated involuntary movement of the face, tongue or limbs caused by long-term use of some psychiatric or anti-sickness medicines.
How It Works
Deutetrabenazine blocks a transporter called VMAT2, which loads nerve chemicals such as dopamine into storage packets inside nerve cells. With less dopamine released, the over-active movement signals in the brain calm down. It is a modified form of Tetrabenazine that is broken down more slowly, so it can be taken less often and gives steadier levels.
Dosage and Administration
Take exactly as prescribed. The doctor starts with a low dose and increases it gradually, usually at weekly intervals, until movements are controlled and side effects are acceptable. Tablets are taken with food and swallowed whole without crushing or chewing. Do not change the dose or stop suddenly without speaking to your doctor.
Interactions
- Do not take with Tetrabenazine, Valbenazine or Reserpine.
- Do not take with MAO inhibitors such as Selegiline or Phenelzine, or within 14 days of stopping them.
- Strong CYP2D6 inhibitors such as Paroxetine, Fluoxetine, Bupropion or Quinidine raise its levels; the doctor will limit the dose.
- Medicines that prolong the QT interval on the ECG (for example some antipsychotics, antibiotics like Moxifloxacin, or Amiodarone) increase heart rhythm risk.
- Antipsychotics and other dopamine blockers may increase stiffness and restlessness; alcohol and sedatives increase sleepiness.
Contraindications
- Huntington’s disease with untreated or inadequately treated depression, or a person who is actively suicidal.
- Liver impairment.
- Taking Tetrabenazine, Valbenazine, Reserpine or an MAO inhibitor as above.
- Allergy to Deutetrabenazine.
Side Effects
Common side effects include sleepiness, tiredness, dry mouth, diarrhoea, constipation, trouble sleeping, restlessness and feeling low. Some people develop stiffness, slow movements or tremor resembling Parkinson’s disease.
Get urgent medical help if you have thoughts of suicide or self-harm, a marked worsening of mood, fainting or a racing or irregular heartbeat, or high fever with severe muscle stiffness and confusion (a rare reaction called neuroleptic malignant syndrome).
Pregnancy and Lactation
There is little information on use in pregnancy. Use only if your doctor decides the benefit outweighs the risk. It is not known if it passes into breast milk; discuss breastfeeding with your doctor.
Precautions and Warnings
- It can cause or worsen depression and suicidal thoughts in Huntington’s disease; patients and families should report mood changes right away.
- An ECG may be needed in people with heart rhythm problems or those taking medicines that affect the QT interval.
- It may cause sleepiness; avoid driving or operating machinery until you know how it affects you.
- Regular follow-up is needed to adjust the dose and check for side effects.
Overdose
Overdose may cause severe sleepiness, confusion, abnormal movements, low blood pressure, sweating, vomiting and hallucinations. Seek emergency medical help immediately.
Therapeutic Class
VMAT2 inhibitor (treatment for movement disorders)
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.