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At a glance

Tetrabenazine is a VMAT2 inhibitor used for the treatment of chorea associated with Huntington's disease. It reduces involuntary movements by depleting monoamine stores in synaptic vesicles.

Indications
  • Chorea associated with Huntington's disease
Pharmacology

Tetrabenazine reversibly inhibits VMAT2 in synaptic vesicles, reducing uptake of dopamine, serotonin, norepinephrine, and histamine, depleting monoamine stores from nerve terminals and controlling hyperkinetic movements.

Dosage

Adult Dose (Oral):

  • Start (Week 1): 12.5 mg/day
  • Week 2: 25 mg/day (12.5 mg twice daily)
  • Titrate by 12.5 mg weekly to tolerated dose
  • 37.5-50 mg/day: 3 divided doses (max single dose 25 mg)
  • >50 mg/day: CYP2D6 genotyping required; Poor metabolizers: max 50 mg/day (single 25 mg); Extensive/intermediate: max 100 mg/day (single 37.5 mg)
  • Elderly: Start 12.5 mg/day, increase gradually
Side effects

Common Side Effects (>10%):

  • Sedation/somnolence, fatigue
  • Insomnia, depression
  • Akathisia, anxiety
  • Nausea

Serious (Rare):

  • Neuroleptic malignant syndrome (fever, muscle rigidity, confusion)
  • Suicidal thoughts
  • Pneumonia
Use in pregnancy

Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.

Pregnancy Category: D — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Do not use in hepatic impairment
  • Do not use in actively suicidal or untreated/undertreated depression
  • May affect driving ability (somnolence, dizziness)
  • Do not stop abruptly (may worsen symptoms)
Overdose effects

Overdose may cause drowsiness, sweating, and hypothermia; provide symptomatic treatment.

Storage conditions

Store in a cool and dry place, protected from light and moisture; keep out of reach of children.

Tetrabenazine — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.