Tardivex

Indications

Valbenazine is used in adults to treat tardive dyskinesia, a movement disorder with repeated, uncontrolled movements of the face, tongue, lips or limbs that can develop after long-term use of antipsychotic or some anti-sickness medicines. It is also used to reduce chorea (jerky, involuntary movements) caused by Huntington's disease.

How It Works

Valbenazine blocks a carrier protein called VMAT2 (vesicular monoamine transporter 2) inside nerve cells. This lowers the amount of dopamine that nerve cells release in the parts of the brain that control movement, which calms the abnormal, uncontrolled movements.

Dosage and Administration

Take as prescribed by your doctor. Treatment is usually started at a low dose once daily and increased after about a week, depending on response and tolerance; the dose may be lower if you have liver problems or take certain other medicines. Take the capsule once a day, with or without food. Do not stop or change the dose without speaking to your doctor.

Interactions

• Do not take with monoamine oxidase inhibitors (MAOIs) such as Selegiline or Linezolid.
• Strong enzyme inhibitors such as Ketoconazole, Clarithromycin, Fluoxetine, Paroxetine or Quinidine can raise valbenazine levels; a lower dose may be needed.
• Strong enzyme inducers such as Rifampicin, Carbamazepine, Phenytoin or St John's Wort lower its effect and should be avoided.
• Medicines that prolong the QT interval of the heart, and Digoxin, need extra care.
• Alcohol and other sedating medicines can increase sleepiness.

Contraindications

Do not use valbenazine if you are allergic to it or to any ingredient of the capsule.

Side Effects

• Sleepiness or tiredness (the most common effect)
• Dizziness, balance problems, falls
• Dry mouth, constipation, blurred vision
• Restlessness, drooling, tremor or stiffness (parkinsonism-like symptoms)
• Changes in the heart rhythm (QT prolongation)

In people with Huntington's disease it may worsen depression or cause suicidal thoughts.

Get urgent medical help if you have a fast or irregular heartbeat or fainting, swelling of the face, lips or throat, severe stiffness with fever, or thoughts of harming yourself.

Pregnancy and Lactation

There is limited information on use in pregnancy, and animal studies suggest possible risk. Use only if your doctor decides the benefit outweighs the risk. Breastfeeding is not recommended during treatment and for 5 days after the last dose.

Precautions and Warnings

Tell your doctor if you have heart rhythm problems, long QT syndrome, liver disease, depression or a history of suicidal thoughts. Do not drive or operate machines until you know how the medicine affects you. Family members should watch for mood changes, especially in Huntington's disease.

Overdose

Too much may cause severe sleepiness, sweating, low blood pressure, slow heartbeat or uncontrolled movements. Get medical help straight away.

Therapeutic Class

VMAT2 (vesicular monoamine transporter 2) inhibitor; drug for movement disorders.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.