Tetrabenazine (Nitoman/Xenazine)

Primer

Tetrabenazine (Trade name: Nitoman/Xenazine) is a vesicular monoamine transporter 2 (VMAT2) inhibitor used in the treatment of Huntington's Disease and tardive dyskinesia.

Pharmacokinetics

See also article: Introduction to Pharmacology

Pharmacokinetics of Tetrabenazine

Absorption
Distribution
Metabolism
Elimination
Half-life

See also article: Cytochrome (CYP) P450 Metabolism

Tetrabenazine: Cytochrome P450 Metabolism

Substrate of (Metabolized by)
Induces
Inhibits

Pharmacodynamics

Mechanism of Action

Toxicity

Indications

Dosing

Dosing for Tetrabenazine

Starting
Titration
Maximum
Taper

Formulations

Tetrabenazine comes in

Monitoring

Contraindications

Tetrabenazine should not be taken under the following circumstances:

Known hypersensitivity to tetrabenazine
In patients with currently untreated or inadequately treated episodes of clinical depression
If administered together with a monoamine oxidase inhibitor (MAOI)
- At least 14 days should elapse between the discontinuation of an MAOI and initiation of treatment with tetrabenazine, and vice versa (between the discontinuation of tetrabenazine and the initiation of treatment with an MAOI)
Impaired hepatic function
In patients taking reserpine

Absolute

Relative

Drug-Drug Interactions

Side Effects

Tetrabenazine can cause depression as it causes a depletion of amines, therefore, untreated depression is a contraindication.

Adverse Events

Clinical Pearls

Special Populations

Geriatric

See main article: Geriatric Pharmacology

Pediatric

See main article: Pediatric Pharmacology

Obstetric and Fetal

See main article: Obstetric and Fetal Pharmacology

Medically Ill

See main article: Psychotropic Dosing in the Medically Ill

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