What is Tetrabenazine?
Tetrabenazine is used in movement disorder such as dystonia and chorea. It works by inhibiting the reuptake of certain chemicals (dopamine and serotonin) in the brain.
When is tetrabenazine prescribed?
- Dystonia
- Chorea associated with Huntington disease
- Tardive dyskinesia (off-label)
- Tourette’s syndrome (Tics): off-label
How is tetrabenazine available in the Indian market?
Only as oral tabletsHow tetrabenazine helps in managing my condition?
Tetrabenazine belongs to a group of medications known as vesicular monoamine transporter 2 (VMAT2) inhibitors. Tetrabenazine works by temporarily blocking a protein in the brain (VMAT-2) that helps store certain chemicals like dopamine, serotonin, norepinephrine, and histamine. This reduces the amount of these chemicals in the brain that effect nerves and muscles.
What health factors should be discussed about before starting?
- Any medicine you are already taking or if you are allergic to any medicines
- If you are on either of these drugs: Deutetrabenazine or valbenazine.
When is the ideal time to administer tetrabenazine?
Your doctor may prescribe tetrabenazine up to 3 times a day.
Take this medication with or without food, and at the same time every day.
If you experience a stomach upset after taking tetrabenazine on an empty stomach, it is better to take it with food.
Never discontinue even if you start feeling well.
Does tetrabenazine starts working immediately?
Tetrabenazine does not show its effects immediately. only after 1 to 2 weeks you will have improvement in your symptoms.
Is there any harm in drinking alcohol if I take tetrabenazine?
Drowsiness caused by tetrabenazine could be worsened by alcohol. It’s best to avoid drinking alcohol while taking tetrabenazine.
What precautions should be taken while taking tetrabenazine?
- This medication might make you feel sleepy or dizzy. Don’t drive, use machines, or do anything that needs focus until you know how it affects you
- See your doctor or healthcare provider regularly to monitor your progress. It may take several weeks to experience the full effects of this medication.
Who should avoid tetrabenazine?
- Do not give this medicine to a child without a doctor’s approval.
- Inform your doctor if you have history of liver disease
- Patients with irregular heart beat or any heart disease
- Breast cancer patients
Can I stop taking tetrabenazine once I start feeling better?
Never stop the medicine if your condition gets better or your symptoms might come back.
If you start feeling confused, seeing things that aren’t there, have stiff muscles, or get a fever, you might be developing a condition called Neuroleptic Malignant Syndrome (NMS). This can happen if you suddenly stop taking tetrabenazine.
Consult your doctor before stopping tetrabenazine.
What action should you take if you forget a dose?
- Consume the missed dose after remembering it. If remembered when it is time for next dose, skip the previous missed dose and continue with the usual dosage pattern as advised by the doctor.
- Always ensure that you do not take more than recommended dose
- If you frequently forget doses, setting an alarm may help remind you take medicine
- If you miss two or more doses, contact your doctor for guidance on what to do.
What are the side effects of tetrabenazine? (Lexicomp)
Every drug has their own side effects. But some may experience, and some do not have any side effects.
Taking tetrabenazine could result in certain side effects. Reach out to your doctor immediately if any of these symptoms are getting worsened and do not subside.
- Vomiting, Drowsiness or fatigue
- Upper respiratory tract infection: common illness that affects the parts of your body that help you breathe, like your nose, throat, and sinuses.
- Headache
- Insomnia: feeling difficult to sleep
- Akathisia: restlessness and difficult to sit calm
Rare side effects include:
- Dysuria – pain or discomfort while passing urine
- Decreased appetite
- Balance impairment
- Suicidal tendencies
- Skin Bruises
What medications should I avoid while taking tetrabenazine?
Medicines to be avoided with tetrabenazine-
- Reserpine
- Amiodarone
- Linezolid
- Metoclopramide (drug to prevent vomiting)
- Medicines for sleep
- Medicines for psychotic problems
- Medicines for depression
- Mono amine oxidase inhibitors (selegiline)
Do not take any OTC/ herbal medications without informing to the doctor.
Is it safe to take tetrabenazine during pregnancy?
We have limited information, hence avoid unless benefits outweigh any possible risks.
How should tetrabenazine tablets be stored?
- Store this medicine in normal temperature.
- Ideally, Tightly sealed container should be used to keep this medicine
- Keep it away from children
- Keep this medicine away from moisture.
- Throw away unused tablets after it expires.
Can I stop reserpine and start tetrabenazine if there is no improvement?
These medications reduce monoamines in the central nervous system (CNS) and helps in treating hyperkinetic disorders.
A minimum gap of 20 days is needed after stopping reserpine and starting with tetrabenazine.
INFORM YOUR DOCTOR IF YOU WERE PREVIOUSLY TAKING RESERPINE
Author:
- Dr. Likitha B S, Pharm.D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr Praveen Kumar, B.Pharm, Pharm D(PB), Head Clinical Pharmacologist, Aster Hospitals, Bengaluru
- Dr C P Ravi Kumar, Consultant Paediatric Neurologist, Aster CMI Hospital