Tetrabenzine 25mg 100’ct tablet
Tetrabenazine tablets are used to treat involuntary movements (chorea) caused by Huntington’s disease. The tablets come in two strengths: 12.5 mg and 25 mg. The medication is thought to work by blocking the protein VMAT2, which lowers the amount of messenger chemicals in the nerve cells, thereby helping to control involuntary body movements
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Description
Tetrabenazine tablets are used to treat involuntary movements (chorea) caused by Huntington’s disease. The tablets come in two strengths: 12.5 mg and 25 mg. The medication is thought to work by blocking the protein VMAT2, which lowers the amount of messenger chemicals in the nerve cells, thereby helping to control involuntary body movements
Dosage and Administration
- Adults with Huntington’s Chorea: The initial dose is 12.5 mg taken one to three times a day. The dose can be increased every three to four days by 12.5 mg until the optimal effect is observed or up to a maximum daily dose of 200 mg.
- Elderly Patients: No specific studies have been performed in the elderly, but the medication has been administered to elderly patients without apparent ill effect. However, Parkinson-like adverse reactions are common in these patients and could be dose-limiting.
- Paediatric Population: No adequate controlled studies have been performed in children, and the treatment is not recommended for children.
- Hepatic Impairment: Patients with mild and moderate hepatic impairment should receive half the initial dose and a slower up-titration of the dose. Patients with severe hepatic impairment have not been studied, and additional caution is advised.
- Renal Impairment: No studies have been performed in patients with renal impairment, and caution is advised in these patients
Indication
- Used to treat involuntary movements (chorea) caused by Huntington’s disease
Dosage
- Available in 12.5 mg and 25 mg strengths
- Take by mouth with or without food, as directed by your doctor
- Usually start with once daily dosing, then potentially increase to 2-3 times per day over several weeks
- Dosage is based on your condition, response to treatment, and other medications
Important Safety Information
- Can increase risk of depression and suicidal thoughts/attempts
- Discuss risks and benefits with your doctor, especially if you have a history of depression or suicidal thoughts
- Tell your doctor right away if you notice any new or worsening symptoms of depression, sadness, loss of interest, suicidal thoughts, or other mental/mood changes
Monitoring
- Let your doctor know if your uncontrolled movements do not improve or worsen with this medication
- Take regularly to get the most benefit
- If you stop taking it for several days, you may need to slowly increase the dose again when restarting
Key Benefits of Tetrabenazine 25mg Tablets
Treats Involuntary Movements (Chorea) in Huntington’s Disease
- Tetrabenazine is used to decrease the uncontrollable movements (chorea) caused by Huntington’s disease.
Potential Advantage Over Typical Antipsychotics
- Compared to typical antipsychotics, tetrabenazine offers the potential advantage of not inducing tardive dyskinesia, a movement disorder that can be a side effect of some antipsychotic medications.
Available in Two Strengths
- Tetrabenazine tablets come in both 12.5 mg and 25 mg strengths, allowing for dosage flexibility based on individual patient needs.                                                Active Ingredient
- TetrabenazineÂ
Inactive Ingredients
- Lactose monohydrateÂ
- Maize starch/Corn starchÂ
- TalcÂ
- Magnesium stearateÂ
- Sodium starch glycolateÂ
- Colloidal anhydrous silicaÂ
- Iron oxide yellow
TetrabenazineDrug for hyperkinetic movement disordersMoreTrade NamesXenazine, Nitoman, Xentra, othersOther NamesRo-1-9569UsesTreatment for chorea associated with Huntington’s disease, antipsychotic for schizophrenia
Mechanism of Action of Tetrabenazine
Tetrabenazine (TBZ) exerts its therapeutic effects through the following key mechanisms:Depletion of Monoamine Neurotransmitters
- TBZ acts as a selective, reversible inhibitor of the vesicular monoamine transporter type 2 (VMAT2)Â .
- This inhibition leads to depletion of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine from presynaptic storage vesicles .
Blockade of Dopamine Receptors
- In addition to depleting monoamines, TBZ also exhibits weak binding affinity and inhibition of postsynaptic dopamine D2 receptors .
- This dopamine receptor blockade contributes to the reduction of involuntary movements (chorea) associated with Huntington’s disease .
Mechanism in Huntington’s Disease
- The depletion of dopamine and other monoamines, as well as the dopamine receptor blockade, are the primary mechanisms by which TBZ improves the hyperkinetic movements (chorea) in Huntington’s disease .
- Dopamine is required for fine motor control, so reducing its transmission helps alleviate the uncontrolled movements characteristic of Huntington’s chorea .
Initial Dose
- 12.5 mg once daily, usually in the morning
- After 1 week, increase to 12.5 mg twice daily
Maintenance Dose
- Titrate up slowly by 12.5 mg at weekly intervals to determine lowest effective dose
- Maximum single dose is 25 mg
- Doses above 37.5 mg daily should be given in 3 divided doses
Patients Requiring Doses >50 mg/day
- Genotype for CYP2D6 to determine if poor (PM) or extensive (EM) metabolizer
- PMs: Max 50 mg/day in 2-3 divided doses, max single dose 25 mg
- EMs: Max 100 mg/day in 3 divided doses, max single dose 37.5 mg
Discontinuation
- Taper not needed, chorea may return 12-18 hours after last dose
- If interrupted >5 days, re-titrate; <5 days, resume previous maintenance dose
Storage
- Store at 25°C (77°F), excursions permitted between 15-30°C
- Protect from light
Reviews
- Tetrabenazine is an effective treatment for chorea associated with Huntington’s disease
- Careful titration is required to identify the lowest effective dose that reduces chorea and is well-tolerated
- Adverse effects like parkinsonism, depression, sedation may occur and require dose reduction or discontinuation
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