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Xenazine

Generic name: tetrabenazineTET-ra-BEN-a-zeen ]
Dosage form: tablet (12.5mg, 25mg)
Drug class: VMAT2 inhibitors

Medically reviewed by Melisa Puckey, BPharm. Last updated on May 3, 2023.

What is Xenazine? 

Xenazine (tetrabenazine) is an FDA-approved medicine used to treat involuntary movements (chorea) caused by Huntington's disease, which is a rare, inherited disease that causes nerve cells in the brain to breakdown and die. Xenazine helps control involuntary body movement of Huntington’s disease, but does not help the psychiatric and thinking (cognitive) symptoms, and it does not cure the disease.

Xenazine is thought to work by changing the level of natural substances in the brain that control muscle movement.

Xenazine is from the class of medications called vesicular monoamine transporter 2 (VMAT2) inhibitors. Xenazine has its effect by blocking the protein VMAT2 which lowers the amount of messenger chemicals (dopamine, serotonin, norepinephrine, and histamine) in the nerve cells, which is how it is thought to help control involuntary body movements.

Warnings

You may have depression or thoughts about suicide while taking this medicine. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

You should not use this medicine if you have severe or untreated depression, suicidal thoughts, liver disease, or if you have taken reserpine in the past 20 days.

Do not use Xenazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Before taking Xenazine

You should not use Xenazine if you are allergic to it or any of the inactive ingredients or if you have:

Do not use Xenazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure Xenazine is safe for you, tell your doctor if you have:

Taking Xenazine may increase your risk of depression or thoughts about suicide. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Pregnancy 

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Breastfeeding

It is not known whether Xenazine passes into breast milk or if it could harm a nursing baby. You should not breastfeed while using this medicine.

Related/similar drugs

Austedo, deutetrabenazine, Xenazine

How should I take Xenazine?

Take Xenazine exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use Xenazine in larger or smaller amounts or for longer than recommended.

You may take these tablets with or without food.

Call your doctor if your symptoms do not improve or if they get worse.

You should not stop using this medicine suddenly, or your symptoms may return. Talk to your doctor before you stop taking this medicine.

Xenazine Dosing Information

When first prescribed, Xenazine should be increased slowly over several weeks to identify a dose that reduces chorea and is tolerated.

Usual Adult Dose for Huntington's Disease:

Initial dose:
First week: 12.5 mg orally daily
Second week: 12.5 mg orally 2 times daily

Maintenance dose:
Increase by 12.5 mg orally weekly to a dose that is tolerated and that reduces chorea.
Doses of 37.5mg to 50 mg daily should be administered in 3 divided doses.
Maximum recommended single dose: 25 mg

Comments:
Determine CYP450 2D6 metabolizer status in patients who require doses of greater than 50 mg per day.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for the missed dose.

If you miss your doses for more than 5 days in a row, ask your doctor before you start taking Xenazine again.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Xenazine?

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol with this medicine can cause side effects.

Xenazine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Xenazine may cause serious side effects. Call your doctor at once if you have:

Common side effects of Xenazine may include:

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Xenazine?

Other drugs may interact with Xenazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your healthcare providers about all medicines you use now and any medicine you start or stop using.

It is important to tell your doctor if you take: 

For more information on interactions with Xenazine click on the link below.

Ingredients 

Active ingredient: tetrabenazine

Inactive Ingredients: 

Storage

Store at 25°C (77°F) excursions permitted to 15° to 30°C (59° to 86°F).

Manufacturer

Manufactured by:
Recipharm Fontaine SAS
Rue des Prés Potets
21121 Fontaine-lés-Dijon, France.

Manufactured for:
Lundbeck
Deerfield, IL 60015 USA.

Xenazine is a trademark of Bausch Health Companies Inc. or its affiliates.

Popular FAQ

The main differences between deutetrabenazine (Austedo, Austedo XR) and tetrabenazine (Xenazine) are in their chemical structure and pharmacokinetics. The addition of deuterium to the Austedo compound lengthens the duration of action and may reduce certain side effects compared to Xenazine. Overall, the drugs are fairly similar with regards to drug class, warnings, side effects and potential drug interactions, but differ in their FDA-approved uses. Continue reading

It may take 2 to 3 weeks for you to notice an improvement in your chorea symptoms after you start taking tetrabenazine (Xenazine). Continue to take your medicine as directed by your doctor, even if you do not see improvements right away. In one study, Xenazine showed a significant effect within three weeks on the Total Chorea Score when compared to a placebo (inactive) treatment (an average reduction of 4 vs. 2 units, respectively). Continue reading

Xenazine is thought to help control involuntary body movements in Huntington’s disease by lowering levels of brain chemical messengers (neurotransmitters) that control muscle movement. Continue reading

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Xenazine only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.