Tetrabenazine

The recommended starting dose of tetrabenazine for adults is 12.5 mg (1/2 a tablet) two to three times daily. If this is tolerated, the dose may be gradually increased to 25 mg taken three times a day.

Usually improvement is seen after a week at the maximum dose that side effects are not a problem. If this is not the case, Tetrabenazine may not be appropriate for you.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Tetrabenazine exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Tetrabenazine at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause unusual tiredness; it may cause either drowsiness or excitability - use caution until you know how you will react; it may cause nervousness or anxiety; it may cause excessive salivation. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Each yellow, flat, round tablet with a breaking score on one side, contains tetrabenazine 25 mg. Nonmedicinal ingredients: maize starch, lactose monohydrate, talc, magnesium stearate, and ferric oxide yellow.

Do not take tetrabenazine if you:

• are allergic to tetrabenazine or any ingredients of the medication
• have untreated or poorly treated signs of Depression (e.g. poor concentration, changes in sleep, decreased interest in activities)
• have had depression or are currently being treated for depression, unless you are under the care of a psychiatrist experienced with your condition and the medication tetrabenazine
• have taken a monoamine oxidase inhibitor (MAOI) within the last 14 days
• plan to start taking a MAOI in the next 14 days
• have reduced liver function
• are taking a medication for high blood pressure called reserpine

There may be an interaction between tetrabenazine and any of the following:

• alcohol
• Alfuzosin
• amantadine
• Amiodarone
• antihistamines (e.g., cetirizine, Diphenhydramine, Hydroxyzine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, olanzepine, Quetiapine, Risperidone)
• aripirazole
• azelastine
• "azole" antifungals (e.g., fluconazole, itraconazole, Voriconazole)
• Baclofen
• barbiturates (butabarbital, Phenobarbital)
• benzodiazepines (e.g., clobazem, Diazepam, Lorazepam)beta-2 agonists (e.g., salmeterol, formoterol)
• Buprenorphine
• Bupropion
• Buspirone
• Capecitabine
• Carbamazepine
• chloral hydrate
• chloroquine
• Cimetidine
• Clonidine
• Cobicistat
• cocaine
• cyproheptadine
• Darifenacin
• delavirdine
• Disopyramide
• Domperidone
• Dronedarone
• efavirenz
• Famotidine
• Fingolimod
• Flecainide
• Gabapentin
• Galantamine
• Granisetron
• HIV protease inhibitors (e.g., atazanavir, lopinavir, ritonavir, saquinavir)
• Indapamide
• isoniazid
• Lamotrigine
• Levetiracetam
• levodopa
• Linezolid
• lithium
• Loperamide
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• magnesium sulfate
• Mefloquine
• methylene blue
• methocarbamol
• Metoclopramide
• Metronidazole
• mifepristone
• Mirabegron
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• Nabilone
• Octreotide
• Ondansetron
• opioids (e.g., Codeine, hydroxycodone, Methadone, Morphine)
• orphenadrine
• Oxaliplatin
• peginterferon alfa-2b
• pentamidine
• Pramipexole
• Primaquine
• procainamide
• Propafenone
• protein kinase inhibitors (e.g., Crizotinib, Dasatinib, imatinib, Nilotinib)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin, Ofloxacin)
• reserpine
• Romidepsin
• Ropinirole
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• Solifenacin
• Sotalol
• sulfamethoxazole
• Tacrolimus
• Tamoxifen
• terbinafine
• tipranavir
• Tizanidine
• Topiramate
• Tramadol
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Nortriptyline)
• Trimethoprim
• Vardenafil
• Venlafaxine
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Tetrabenazine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Tetrabenazine.

Abnormal heart rhythms: Tetrabenazine may cause a heart rhythm problem called QT prolongation. If you have a history of QT prolongation, slow or irregular heartbeat, irregular heart rhythm, heart failure, Heart Attack, heart disease, taking other medications known to cause QT prolongation, or a family history of sudden cardiac death at less than 50 years of age, discuss with your doctor how Tetrabenazine may affect your medical condition, or how your medical condition may affect the dosing and effectiveness of Tetrabenazine. Your doctor will perform tests at regular intervals to monitor for any changes in your heart rhythm.

Depression: Tetrabenazine may cause depression. If you have depression or a history of depression, discuss with your doctor how Tetrabenazine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Tetrabenazine, and whether any special monitoring is needed. The symptoms of depression may be as severe as thinking about hurting yourself of others. If you experience these side effects or notice them in a family member who is taking Tetrabenazine, contact your doctor immediately.

If you experience symptoms of depression such as poor concentration, changes in weight, changes in sleep, decreased interest in activities, or notice them in a family member who is taking Tetrabenazine contact your doctor as soon as possible.

Drowsiness/reduced alertness: Tetrabenazine may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how Tetrabenazine affects you.

Low blood pressure: Tetrabenazine may cause a decrease in blood pressure causing dizziness and fainting, especially when getting up from a sitting or lying position. Get up slowly from a sitting or lying position to avoid dizziness, fainting, or falling.

Neuroleptic malignant syndrome (NMS): Like other medications that affect chemical messengers in the brain, tetrabenazine can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Parkinsonism: Tetrabenazine works to reduce uncontrolled movement. Some people taking tetrabenazine have experienced tremor or stiff muscles with difficulty starting movement, a condition that mimics Parkinson's Disease. If you experience these signs, contact your doctor as soon as possible.

Pregnancy: Tetrabenazine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Tetrabenazine, contact your doctor immediately.

Breast-feeding: Tetrabenazine may pass into breast milk. If you are a breast-feeding mother and are taking tetrabenazine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Tetrabenazine have not been established for children.

This medication is typically used 3 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.