Tetrabenazine
About Tetrabenazine
Tetrabenazine is a prescription medication used to manage involuntary, jerky, and uncontrollable movements (known as chorea) in patients with Huntington’s disease. It helps calm the excessive nerve activity in the brain that causes these sudden, disruptive movements. By regulating these signals, it makes physical actions more controlled and predictable.
For the best results, you must take Tetrabenazine consistently every day, exactly as directed by your healthcare provider. This medication is usually taken multiple times a day and can be taken with or without food, though keeping a consistent routine helps maintain stable drug levels. Making simple changes, such as practicing stress-reduction techniques and pacing your physical activities, can further help manage movement symptoms.
Tetrabenazine can cause side effects, with the most common being sleepiness, fatigue, and mild trouble sleeping. However, you must contact your doctor immediately if you experience serious side effects, such as signs of depression, thoughts of self-harm, severe muscle stiffness, or extreme restlessness.
Talk to your doctor before starting Tetrabenazine if you have a history of depression, suicidal behaviour, or heart rhythm issues. Do not take this if you currently have active depression, untreated suicidal thoughts, or liver damage.
This medicine interacts with alcohol, which can cause dangerous drowsiness, and with certain antidepressants that can raise the drug levels in your body to unsafe limits. If you are pregnant, breastfeeding, an older adult, or considering this medicine for a child, you must consult your doctor to discuss whether it is appropriate. Tetrabenazine is not approved for use in children, and safety and effectiveness in paediatric patients have not been established.
Uses of Tetrabenazine
Medicinal Benefits
Tetrabenazine offers the following benefits when used as prescribed:
- Reduces involuntary movements: It helps decrease the severity and frequency of uncontrolled movements, improving overall motor control.
- Makes daily activities easier: Better movement control can help with routine tasks such as eating, drinking, writing, dressing, and personal care.
- Reduces physical fatigue: Controlling constant involuntary movements may lessen muscle strain, discomfort, and exhaustion throughout the day.
- Improves balance and coordination: Reduced abnormal movements may contribute to safer walking, better stability, and a lower risk of falls or injuries.
- Supports independence and quality of life: Improved movement control can enhance confidence, social participation, and the ability to perform everyday activities more comfortably.
- Provides targeted symptom management: By acting on specific brain pathways involved in movement control, Tetrabenazine helps reduce chorea and improve overall motor function.
Directions for Use
To ensure you get the full benefit of this medicine and take it safely, please follow these instructions:
- Swallow the tablet whole with a full glass of water. Do not chew, crush, or break the tablet.
- You can take this medication with or without food, but try to be consistent with how you take it each day.
- Your doctor will start you on a low dose and gradually increase the dose over several weeks to find what works best for you. Do not change your dose on your own.
- Always follow your doctor's exact instructions regarding how and when to take this medicine.
Storage
Side Effects of Tetrabenazine
Common Side Effects (Usually mild):
- Sleepiness, extreme tiredness, or daytime drowsiness
- Trouble sleeping at night (insomnia)
- Feeling restless, anxious, or an inability to sit still (akathisia)
- Mild nausea or an upset stomach
Serious Side Effects (Call a doctor right away):
- New or worsening depression, mood swings, or feelings of hopelessness
- Thoughts of hurting yourself or suicide
- Severe muscle stiffness, tremors, or shaking similar to Parkinson's disease
- Difficulty swallowing or speaking
- High fever accompanied by severe sweating, fast heartbeats, and confusion
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Drug Warnings
- Avoid Driving Until You Know Its Effects: Do not drive, operate heavy machinery, or perform dangerous activities until you know how this medicine affects your alertness, as it frequently causes severe sleepiness.
- Monitor for Mood and Behaviour Changes: Ask your family members or caregivers to watch you closely for any changes in your mood, behaviour, or signs of depression.
- Do Not Stop Treatment Abruptly: Do not stop taking Tetrabenazine suddenly; stopping abruptly can cause your involuntary movements to return quickly and worsen.
- Report Swallowing Difficulties Immediately: If you experience difficulty swallowing or find yourself choking on food, contact your doctor immediately as this medicine can affect throat muscles.
- Inform All Healthcare Providers: Alert all your healthcare providers that you are taking this medication, especially before starting any new prescription, over-the-counter medicine, or herbal supplement.
- Take Extra Precautions Against Falls: Drowsiness, dizziness, balance problems, and falls may occur more frequently in older adults, so extra caution is advised when standing, walking, or performing daily activities.
Drug Interactions
Drug-Drug Interactions
The following medications may affect how Tetrabenazine works or increase the risk of side effects:
- Monoamine Oxidase Inhibitors (MAOIs): Do not take this medicine with MAOIs, or within 14 days of stopping them, as combining them can cause a dangerous, life-threatening rise in blood pressure.
- Antidepressants (such as fluoxetine or paroxetine): These medications can significantly increase the levels of Tetrabenazine in your body, increasing the risk of severe side effects. Your doctor may need to lower your dose.
- Central Nervous System Depressants: Taking this medicine with sleep aids, muscle relaxants, or strong prescription pain relievers can cause extreme drowsiness and slowed breathing.
- Antipsychotic medications: Combining these can increase the risk of severe muscle stiffness, tremors, and a life-threatening reaction that affects body temperature and muscles.
- Reserpine: Do not take Tetrabenazine together with reserpine. Both medicines reduce dopamine activity, and using them together can significantly increase the risk of severe side effects. Tetrabenazine should not be started until at least 20 days after stopping reserpine.
Drug-Food Interactions
Certain foods and beverages may affect the safety or effectiveness of Tetrabenazine, including:
Alcohol: Avoid consuming alcohol while taking this medicine. Alcohol significantly worsens sleepiness, dizziness, and coordination issues.
Drug-Disease Interactions
Some medical conditions may affect the safety or effectiveness of Tetrabenazine, including:
- Depression or Suicidal Thoughts: This medicine can worsen or trigger severe depression and suicidal behavior. It must not be used if you have active or untreated depression.
- Liver Damage: Your body processes this medicine through the liver. If you have liver damage, the medicine can build up to toxic levels in your system.
- Parkinson's Disease: This medicine can make stiffness, tremors, and slow movements worse if you already have Parkinson's disease.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeIt causes excessive sleepiness if you consume alcohol while taking this Tetrabenazine.
Pregnancy
consult your doctorIf you are pregnant or trying to get pregnant, speak to your doctor before taking the Tetrabenazine. It may harm the unborn baby.
Breast Feeding
consult your doctorDo not take Tetrabenazine or stop using it immediately if you are breastfeeding.
Driving
unsafeIt causes drowsiness and impairs your ability to drive carefully.
Liver
cautionIf you have a history of liver disease/conditions, Tetrabenazine should be taken with caution. However, dose adjustments will be made by the doctor accordingly.
Kidney
cautionIf you have a history of kidney diseases, Tetrabenazine should be taken with caution. However, dose adjustments will be made by the doctor accordingly.
Children
unsafeIt is not recommended for treatment in children.
Habit Forming
Diet & Lifestyle Advise
- Create a fall-proof home: Because uncontrolled movements and medication-induced drowsiness can affect your balance, secure loose rugs, install grab bars in the bathroom, and keep walking paths clear to prevent falls.
- Strictly avoid alcohol: Drinking alcohol while on this medication can dangerously increase drowsiness, dizziness, and coordination problems, significantly raising your risk of accidents.
- Prioritise regular sleep schedules: Fatigue can make movement symptoms worse and increase the risk of mood changes. Aim for a consistent sleep routine every night.
- Keep a daily mood diary: Track your feelings and behaviours daily. Share this journal with close family members or caregivers so they can help spot early signs of depression, anxiety, or irritability.
- Eat easy-to-manage foods: If involuntary movements make eating difficult or raise swallowing risks, opt for softer foods and use weighted utensils or cups with lids to prevent spills.
Patients Concern
Disease/Condition Glossary
Huntington's disease is a condition in which bodily movements cannot be controlled. People with this disease have excess stores of certain natural substances secreted by the brain, causing uncontrollable body movements. Tetrabenazine acts by depleting the availability of these extra chemicals that affect the activity of muscles and nerves. These movements may be sudden, irregular, shaky, and jerky. You can experience dizziness, lightheadedness, decreased appetite, difficulty speaking, and trouble swallowing. This disease occurs when the genes from the ancestors or immediate family members are passed to the next generations. It is an inherited disease, and not everyone gets it.
FAQs
Tetrabenazine is used to treat Huntington's disease. Huntington's disease (HD) is an inherited disease that causes certain nerve cells in the brain to waste away. People are born with defective genes.
Tetrabenazine contains tetrabenazine, which works by depleting the stores of certain chemical messengers in the brain that help in controlling body movements.
No, if you forget to take one dose, never make up for the missing dose by doubling it at the next time. Instead, please continue with the next dose when it is due.
No, if taken more than the recommended dose, you may develop drowsiness, sweating, low blood pressure, and extremely low body temperature. Contact your doctor right away in this case.
No, do not take Tetrabenazine; instead, reach out to your doctor if you are intolerant to sugars because these tablets contain lactose.
No, do not stop taking Tetrabenazine on your own unless instructed by your doctor. Abruptly stopping may lead to the recurrence of disease conditions.
If necessary, Tetrabenazine may be broken in half, but they should not be crushed or chewed.
Tetrabenazine contains Tetrabenazine is formerly used as an antipsychotic but now used primarily in the symptomatic treatment of various hyperkinetic disorders.
Tetrabenazine is a medication used to manage chorea, a movement disorder often associated with Huntington's disease. It works by reducing the levels of certain neurotransmitters in the brain. While it can be effective in controlling involuntary movements, it's important to be aware of potential side effects like depression, sleepiness, and dizziness. If you're considering tetrabenazine or have questions about its use, consult with a healthcare professional for personalized advice.
Avoid alcohol and use caution when driving, operating machinery, or performing activities requiring alertness, as Tetrabenazine may cause drowsiness or dizziness. Consult your doctor before taking other medicines, and inform them if you are pregnant or breastfeeding.
No. Do not stop taking Tetrabenazine without consulting your doctor, even if your symptoms improve. Stopping the medicine suddenly may cause your involuntary movements (chorea) to return or worsen. If treatment needs to be discontinued, your doctor will advise you on the safest way to do so.
No. You should avoid alcohol while taking Tetrabenazine. Alcohol can increase side effects such as drowsiness, dizziness, impaired coordination, and loss of balance, increasing the risk of falls and accidents.
Tetrabenazine can influence blood pressure. Some individuals may experience low blood pressure (hypotension) as a side effect of taking this medication. This is more likely to occur if you have a history of low blood pressure or if you're taking other medications that can lower your blood pressure. If you notice symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, it's crucial to inform your doctor. They may adjust your dosage or recommend additional monitoring to manage this side effect effectively.
The common side-effects of Tetrabenazine are nausea, insomnia (difficulty sleeping), anxiety, fatigue, sleepiness, akathisia (inability to stay still), and depression. Most of these side effects fade away gradually over time without the need for medical intervention. However, consult your doctor if you experience these side effects frequently.
No, Tetrabenazine does not cure Huntington's disease, nor does it slow down the progression of the disease. It is prescribed solely to help manage and reduce the involuntary, jerky movements (chorea) caused by the condition. Talk to your doctor if you have questions about managing other symptoms of Huntington's disease.
If you, your family, or your caregiver notice any signs of depression, severe sadness, anxiety, or thoughts of hurting yourself, contact your doctor immediately or seek emergency medical help. This is a serious side effect that requires immediate medical evaluation. Talk to your doctor about alternative treatment options if needed.
You may begin to notice some reduction in your involuntary movements within the first few weeks of starting the treatment. Because your doctor will start you on a low dose and gradually increase the dose, it may take several weeks to find the dose that provides the best control for your symptoms. Talk to your doctor about your progress.
Yes, daytime sleepiness and fatigue are very common side effects of this medicine. Because of this, you should avoid driving, riding a bicycle, or operating tools or machinery until you know exactly how the medicine affects you. Talk to your doctor if the sleepiness interferes with your daily activities.
You should not take this medication if you have liver damage, as your liver is responsible for breaking down the medicine. If your liver is not working properly, the drug can build up to unsafe levels in your body. Talk to your doctor about alternative options that are safer for your liver.
If you miss taking your medication for more than a few days, do not simply restart taking your regular dose. You must contact your doctor or pharmacist first, as you may need to restart the medicine at a lower dose and gradually increase it again to avoid severe side effects. Talk to your doctor or pharmacist for specific guidance.
Tetrabenazine is not approved for use in children, and there is limited information regarding its safety and effectiveness in paediatric patients. It should only be used if specifically recommended and closely supervised by a specialist. Talk to your doctor for guidance on appropriate treatment options.
