Xenazine® (tetrabenazine) Side Effects
Before You Start Xenazine
Before you or a loved one starts taking Xenazine, tell your doctor about all of the prescription medications — as well as non-prescription medicines, vitamins, herbal products or other supplements — that you or your loved one are taking. Xenazine may interact with some of these medications. Make sure you tell your doctor before you start or stop any new medication or if you change the dose of any medication or supplements you are taking.
Xenazine can be taken along with an antidepressant, but your depression must be under control. Patients with depression were allowed into the Xenazine clinical trial only if their depression was under control and over half had a history of depression.2
Xenazine can increase the risk of depression and suicidal thoughts and behavior (suicidality) in patients with Huntington’s disease.2 You should tell your doctor if you are depressed before you start taking Xenazine. You should not start taking Xenazine if you are depressed or have suicidal thoughts.
Always read the Medication Guide before starting your treatment with Xenazine and every time your prescription is refilled, as the information may have changed. If you have any questions regarding Xenazine, be sure to talk with your doctor.
Can Side Effects Be Managed?
Individual results may vary. Xenazine may not be effective in reducing choreic movements in all HD patients. Please review the Important Safety Information, including Boxed Warning about the increased risk of depression and suicidality, below.
Sue and Jeff’s Story
Sue and Jeff share their experiences living with Huntington’s disease, from their initial reactions to her diagnosis to working with their doctor to find treatment for her HD chorea symptoms.
Chorea Symptoms in Huntington's Disease
Dr. Sung discusses how chorea can affect Huntington's disease patients.
Craig and Sara's Huntington's Disease Story
Watch Craig and Sara discuss their experiences with chorea associated with Huntington's disease and how it can affect the entire family.
Matt’s HD Chorea
See how Matt and his caregiver and wife, Karen, worked to find treatment options, including Xenazine, to help manage his HD chorea.
Medication Assistance Program: REACH
Learn about Lundbeck’s medication assistance program, REACH, which offers financial assistance for Xenazine patients who qualify.
HD Chorea Symptoms: Improvement Since Xenazine
Listen as these caregivers share their individual stories on how Xenazine helped with chorea symptoms associated with Huntington’s disease.
Side effects with Xenazine occur most often when the medication is first started or when the dose is increased. If you or your loved one begins taking Xenazine and starts to experience a side effect, you should tell your doctor right away. Your doctor may decide to:
- Lower your dose of Xenazine to see if the side effect lessens or goes away
- Prescribe a medication to reduce the side effect
- Discontinue Xenazine, if the side effect cannot be managed
The goal of Xenazine therapy is to reduce HD chorea while managing side effects. Your doctor has many options to help you manage side effects so that you will be able to get the most from your Xenazine therapy.
The need for therapy should be evaluated on an ongoing basis with your doctor. The dose of Xenazine should be adjusted slowly over several weeks for a dose that is appropriate for you. Tell your doctor if you stop taking Xenazine for more than 5 days. Do not take another dose until you talk to your doctor. If your doctor thinks you need to take more than 50 mg of Xenazine each day, you will need to have a blood test to see if a higher dose is right for you.
Some people should not take Xenazine. Xenazine can increase the chance of depression, suicidal thoughts or suicidal actions in some patients.
Do not take Xenazine if:
- You are sad (depressed) much of the time. You can become more depressed taking Xenazine.
- You take medicine for depression, but it is not well controlled.
- You think or talk about harming yourself or killing yourself (suicide). You may be more likely to think about ending your life while taking Xenazine.
- You have liver problems.
- You take a monoamine oxidase inhibitor (MAOI), reserpine or a medicine that contains reserpine. If your doctor plans to switch you from taking reserpine to Xenazine, you must wait at least 20 days after your last dose of reserpine before you start taking Xenazine. Ask your doctor or pharmacist if you are not sure.
When taking Xenazine, pay close attention to any changes in how you feel. Let your doctor know if you have sudden changes in your mood, behaviors or thoughts. These changes may occur when you start Xenazine and when your doctor changes your dose.
Possible Xenazine side effects
Xenazine can cause serious side effects, including:
- Depression, suicidal thoughts or actions. See: “What is the most important information I should know about Xenazine?”
- Neuroleptic malignant syndrome (NMS). Call your doctor right away and go to the nearest emergency room if you develop these signs and symptoms that do not have another obvious cause:
- High fever
- Stiff muscles
- Problems thinking
- Very fast or uneven heartbeat
- Increased sweating
- Parkinsonism. Symptoms of parkinsonism include: slight shaking, body stiffness, trouble moving or keeping your balance.
- Restlessness. You may get a condition where you feel a strong urge to move. This is called akathisia.
- Trouble swallowing. Xenazine may increase the chance that you will have trouble swallowing. Increased coughing may be the first sign that you are having trouble swallowing. Trouble swallowing increases your risk of pneumonia.
- Irregular heartbeat. Xenazine increases your chance of having certain changes in the electrical activity in your heart which can be seen on an electrocardiogram (EKG). These changes can lead to a dangerous abnormal heartbeat. Taking Xenazine with certain medicines may increase this chance.
- Dizziness due to blood pressure changes when you change position (orthostatic hypotension). Change positions slowly from lying down to sitting up and from sitting up to standing when taking Xenazine. Tell your doctor right away if you get dizzy or faint while taking Xenazine. Your doctor may need to watch your blood pressure closely.
- Tardive dyskinesia (TD). TD is a condition where there is repeated facial grimacing that cannot be controlled, sticking out of the tongue, smacking of the lips, puckering and pursing of the lips, and rapid eye blinking. Xenazine works like other drugs that can cause TD. If you get TD with Xenazine, it is possible that the TD will not go away.
Common side effects
Common side effects with Xenazine include:
- Sleepiness (sedation)
- Trouble sleeping