Individualize Their Dose — There Is No Target Dose
Start low and go slow
Increase by 12.5 mg weekly until a patient experiences clinical effects or an intolerable AE occurs
- If an intolerable AE* occurs, titration should be stopped and the dose should be reduced
- If an AE does not resolve or lessen with reduced dose, consider discontinuation
Recommended Dosing Guide2
*Such as akathisia, restlessness, parkinsonism, agitation, depression, insomnia, fatigue, anxiety or sedation/somnolence.
Patients who appear to require doses greater than 50 mg/day should be genotyped for CYP2D62
Does your patient need to be genotyped for CYP2D6?
Learn about the Xenazine CYP2D6 Support Program. »
Dosing in the pivotal study
The dosage for patients taking Xenazine® (tetrabenazine) in the pivotal study at Week 12 ranged from 25 to 100 mg/day2,3
- In the pivotal study at Week 12, dosing ranged from 25 to 100 mg/day3
- 56% of patients required more than 50 mg/day
- Individual dosing is required
- Xenazine should be titrated up slowly for a dose that is appropriate for each patient
- Monitor patients for the emergence or worsening of depression, suicidality, or unusual changes in behavior. This is especially important when Xenazine is started and when the dose is changed
- Following treatment interruption of greater than five (5) days, Xenazine therapy should be re-titrated when resumed. For short-term treatment interruption of less than five (5) days, treatment can be resumed at the previous maintenance dose without titration.
- "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.
- Xenazine [package insert]. Deerfield, IL: Lundbeck; June 2015.
- Huntington Study Group. Tetrabenazine as antichorea therapy in Huntington disease: a randomized controlled trial. Neurology. 2006; 66(3):366-372.