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Home | Already Prescribed | Finding The Right Dose

Finding the Right Dose of Xenazine® (tetrabenazine)

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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.

Hear from Sue and Jeff »


Chorea Symptoms in Huntington's Disease

Dr. Sung discusses how chorea can affect Huntington's disease patients.

Learn about HD symptoms »

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.

Watch Matt’s Story »

Medication Assistance Program: REACH

Learn about Lundbeck’s medication assistance program, REACH, which offers financial assistance for Xenazine patients who qualify.

Discover what REACH might do for you »

Depending on you or your loved one’s condition and previous history with taking Xenazine, your doctor will have started slowly and increased the strength and number of tablets (dose) over the course of several weeks up to a few months. This process is known as titration.

While taking Xenazine, it is important to remain patient since it may take a while for your physician to find the right dose that reduces chorea associated with Huntington’s disease (HD). Finding the right dose with titration is a very important part of your Xenazine treatment plan. The dose of Xenazine may be different for every person. Your dose will depend on factors such as:

  • How your body breaks down and responds to the medicine
  • Whether side effects are a problem for you

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 of Xenazine is right for you.

Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings or worsening depression. This is especially important when Xenazine is started or when the dose is changed.

Experiencing a side effect while taking Xenazine

During this time, you may experience some side effects, so be sure to talk with your doctor about how you are feeling. Side effects may be dose-dependent. Your doctor may adjust your dose to see if that lessens or stops the side effect.

Learn more about how Xenazine works »

Tell your doctor if you have any side effects. Do not stop taking Xenazine without talking to your doctor first. Call your doctor for medical advice about side effects. You may report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088.

If you miss a dose of Xenazine

Before starting Xenazine, you should talk to your healthcare provider about what to do if you miss a dose. If you miss a dose and it is time for your next dose, do not double the dose.

If you stop taking Xenazine for more than 5 days, do not take another dose until you talk to your doctor.

Your doctor may give you a Xenazine dosing schedule to help you keep track of when and how much Xenazine to take.

Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings or worsening depression. This is especially important when Xenazine is started or when the dose is changed.

If you have questions, be sure to check the Xenazine frequently asked questions list and talk to your healthcare provider.

XENAZINE® (tetrabenazine) Tablets

Indications and Usage:

XENAZINE is a medicine that is used to treat the involuntary movements (chorea) of Huntington's disease. XENAZINE does not cure the cause of the involuntary movements, and it does not treat other symptoms of Huntington's disease, such as problems with thinking or emotions.

It is not known whether XENAZINE is safe and effective in children.

Important Safety Information:

  • XENAZINE can cause serious side effects, including:
    • depression
    • suicidal thoughts
    • suicidal actions
  • You should not start taking XENAZINE if you are depressed (have untreated depression or depression that is not well controlled by medicine) or have suicidal thoughts.
  • Pay close attention to any changes, especially sudden changes, in mood, behaviors, thoughts or feelings, or worsening depression. This is especially important when XENAZINE is started and when the dose is changed.
  • Do not take XENAZINE if you have liver problems or are taking monoamine oxidase inhibitors (MAOIs) or reserpine. Ask your doctor or pharmacist if you are not sure. At least 20 days should pass after stopping reserpine before starting XENAZINE.
  • Tell your doctor if you are pregnant or plan to become pregnant, breast-feeding, have breast cancer or a history of breast cancer, or have heart disease or an irregular heartbeat.
  • Tell your doctor about all the medicines you take. Do not start any new medicines while taking XENAZINE without talking to your doctor first.
  • Take XENAZINE exactly as prescribed by your doctor. 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.
  • Neuroleptic Malignant Syndrome (NMS) is a potentially fatal side effect reported with XENAZINE. 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, or increased sweating. XENAZINE should be stopped immediately if NMS is diagnosed.
  • XENAZINE can also cause other serious side effects, including: parkinsonism (slight shaking, body stiffness, trouble moving, or keeping your balance), restlessness (akathisia), trouble swallowing, irregular heartbeat, and dizziness due to blood pressure changes when you change position (orthostatic hypotension). Trouble swallowing may increase the risk of pneumonia. Uncontrolled movements called tardive dyskinesia (TD) may also develop in patients treated with XENAZINE. It is possible that the TD will not go away.
  • The risk of side effects, such as irregular heartbeat, parkinsonism, NMS, and restlessness (akathisia), may be increased when using XENAZINE with other drugs (e.g., dopamine antagonists or antipsychotics).
  • Sleepiness is a common side effect of XENAZINE; do not drive a car or operate dangerous machinery until you know how XENAZINE affects you. Alcohol and other drugs may increase sleepiness caused by XENAZINE.
  • Some side effects, such as depression, tiredness, trouble sleeping, sleepiness, parkinsonism, agitation, and restlessness (akathisia), may be dose-dependent. If the side effects don’t stop or lessen, your doctor should consider lowering the dose or stopping your XENAZINE. The most commonly reported side effects in studies with XENAZINE were sleepiness, trouble sleeping, depression, tiredness, anxiety, restlessness, agitation, and nausea.

For more information, please see the full Prescribing Information, including Boxed Warning, the Medication Guide or go to www.XenazineUSA.com.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Sources:

  1. "FDA Approves First Drug for Treatment of Chorea in Huntington's Disease", FDA News Release, August 15, 2008: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116936.htm. Updated April 15, 2013. Accessed August 17, 2015.