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Generic name: Tetrabenazine [TET-ra-BEN-a-zeen]
Dosage Form: Tablet (12.5mg, 25mg)
Drug class: VMAT2 inhibitors

What is Xenazine?

The drug Xenazine (tetrabenazine) is an approved FDA drug that treats involuntary movements (chorea) that are caused by Huntington's Disease. It is a rare genetic disease that causes nerve cells in the brain to break down and end up dying. Xenazine aids in controlling the involuntary body movements that are a sign of Huntington's disease; however, it does not treat mental and psychiatric (cognitive) symptoms. Furthermore, it cannot cure the disease.

Xenazine is believed to function by altering the amount of natural substances inside the brain that regulate the muscle's movement.

The drug Xenazine belongs to the category of drugs known as VMAT2 (VMAT2) inhibitors. Xenazine has its effects by blocking the VMAT2 protein, which reduces the amount of the messenger chemicals (dopamine, serotonin, and norepinephrine, as well as serotonin and histamine) in nerve cells. This is the way it is believed to aid in controlling bodily movements.


There is a chance that you will experience symptoms of depression or even thoughts of suicide while you take this medicine. Keep vigilant for any changes to your mental state or symptoms. Be sure to report any new or worsening symptoms you experience to your physician.

It is not recommended to use this medication if you suffer from serious or untreated depression, suicide thoughts, or if you have previously taken Reserpine within the last 20 days.

Avoid the Xenazine drug if you've used any MAO antagonist within the last 14 days. A risky drug interaction may occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, rasagiline, phenelzine, and tranylcypromine, among others.

Similar/related drugs

Ingrezza, Austedo, tetrabenazine, valbenazine, deutetrabenazine, Austedo XR

Before you take this drug

Do not take Xenazine if there is an allergy to the drug or one of its inactive ingredients, or if you are:

  • Depressive disorder that is untreated or severe;
  • Suicidal thoughts;
  • Liver disease liver disease
  • If you've taken reserpine during the past 20 days.

Avoid xenazine if you have taken an mao inhibitor in the last 14 interaction that could be dangerous that occurs with drugs could be dangerous. Mao inhibitors include isocarboxazid, linezolid, methylene blue injection, rasagiline, phenelzine, tranylcypromine, and many others.

To be sure xenazine is appropriate for you, consult your doctor if you suffer from:

  • Depression, emotional disorders, or mental illness
  • A history of suicidal ideas or behaviors;
  • Either in the past or at present;
  • The heart condition is also known as heart rhythm disorder.
  • A family or personal experience of the long qt syndrome
  • If you've had a cardiac attack.

The use of Xenazine can increase the risk of depression or thoughts of suicide. Your physician should monitor your progress regularly. Family members or other caregivers should be aware of changes in your symptoms or mood.


It's unclear whether the medicine could be harmful to babies who are still not due to be born. Inform your doctor if you are expecting or planning to be pregnant.


It isn't known if it is possible to introduce Xenazine into breast milk or if it can harm the nursing infant. Do not breastfeed when using this medication.

How to take Xenazine?

Follow the exact dosage of Xenazine as directed by your physician. Follow the directions on the prescription label. Your doctor may alter your dosage to ensure you are getting the best outcomes. Don't take Xenazine in greater or lesser quantities or for longer periods than suggested.

These tablets can be taken either with or without meals.

Consult your physician if your symptoms don't improve or if they become worse.

Do not stop using this medication suddenly, or you could experience a recurrence of symptoms. Discuss this with your doctor prior to stopping taking this medication.

Details on dosage

If prescribed for the first time, Xenazine is recommended to be gradually increased over a period of time to find the dose that lessens chorea and is well-tolerated.

Usual Adult Dose for Huntington's Disease:

Initial dose:
The first week, 12.5 mg is taken orally every day.
The second week: 12.5 mg oral, 2 times each day.
Maintenance dose:
The dose should be increased by 12.5 mg daily until the dose is comfortable and does not cause any chorea.
Doses ranging from 37.5mg up to 50 mg daily are recommended to be given in three divided doses.
The suggested maximum dosage for a single dose is 25 milligrams.

Assess the CYP450 2D6 status of the metabolizer in patients taking doses greater than 50 mg per day.

What happens if I miss a dose?

You should take the dose you missed as quickly as you remember. Do not take any missed doses if you are close to the time of the next dose. Don't take any extra medication to compensate for your missed dosage.

If you do not take dosages for more than 5 days consecutively, consult your physician prior to taking Xenazine for the second time.

What happens if I overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help line at 1-800-222-1222.

What should be avoided?

The medicine could affect your reactions or thinking. Be cautious if you drive or engage in activities that require you to remain alert.

Alcohol consumption with this medicine may cause unwanted side effects.

Side effects of Xenazine

Seek medical attention immediately. If you notice symptoms that indicate an allergy, such as hives, breathing difficulties, or swelling of your lips, face, or tongue,

If you notice any new or more severe symptoms, consult your physician for any new or worsening symptoms, such as changes in your behavior or mood, anxiety, panic attacks, trouble sleeping, or if you are feeling uncontrollably angry or aggressive. active, restless (mentally as well as physically), depressed, or contemplating suicide or harming yourself.

Xenazine may cause serious side effects. Consult your physician immediately in the event of:

  • Tremors, shaking, involuntary movements, balance issues;
  • Muscles that are not controlled in your facial muscles (chewing or lip-smacking mouth movement, frowning blinking, or eye movements);
  • Difficulty swallowing
  • Rapid heartbeats or fast beats;
  • An euphoric feeling, similar to feeling like you're about to pass out
  • Nervous system reactions that are severe, very rigid (rigid) muscles with extremely high fever, sweating, confusion, irregular, or rapid heartbeats

The most common negative side effects of xenazine could be:

  • Drowsiness, tiredness;
  • Depression;
  • Nausea;
  • Experiencing anxiety, anger, feeling anxious, agitated, or uneasy.

This isn't a complete list of all side effects, and other side effects could occur. Contact your physician for advice regarding medical adverse effects. You can report any side effects to the FDA at 1-800-FDA-1088.

Interaction with other drugs

Other medications can interfere with Xenazine. This includes medications that are prescribed and available over the counter, such as vitamins and herbal products. Be sure to inform your healthcare professionals about any medicines you take now as well as any medication you begin or stop taking.

It is essential to inform your doctor that you take:

  • Reserpine
  • Monoamine oxidase inhibitors (maois);
  • Alcohol or other sedative substances;
  • Drugs that trigger qtc prolongation, such as antipsychotic drugs (e.g., chlorpromazine, haloperidol, thioridazine, or ziprasidone) and antibiotics (e.g., moxifloxacin), Classes 1A (e.g., quinidine and procainamide), and Class III (e.g., amiodarone or sotalol),  antiarrhythmic medicines, or other medications that are known to extend your qtc interval;
  • Neuroleptic medications (e.g., chlorpromazine, haloperidol, olanzapine, and thioridazine);
  • Strong CYP2D6 inhibitors;
  • Deutetrabenazine oder valbenazine.




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