Tetraben
Generic Name
Tetrabenazine
Manufacturer
Generic Pharmaceuticals
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tetraben 25 mg tablet | ৳ 35.00 | ৳ 350.00 |
Description
Overview of the medicine
Tetrabenazine is a medication used to treat involuntary movements (chorea) associated with Huntington's disease and tardive dyskinesia. It works by reducing the amount of certain neurotransmitters in the brain.
Uses & Indications
Dosage
Adults
Initial: 12.5 mg once daily, titrated slowly, usually by 12.5 mg every 3-7 days. Max daily dose typically 100 mg (divided doses). Adjust based on response and tolerability.
Elderly
Start at lower dose and titrate slowly, monitor for side effects.
Renal_impairment
No specific dosage adjustment recommended, but use with caution due to unknown effects of metabolites.
How to Take
Orally, with or without food. Administer in divided doses daily.
Mechanism of Action
Tetrabenazine reversibly inhibits Vesicular Monoamine Transporter 2 (VMAT2), leading to decreased uptake of monoamines (dopamine, serotonin, norepinephrine, histamine) into synaptic vesicles and subsequent depletion of presynaptic monoamine stores. This reduces the amount of monoamines released into the synapse, modulating hyperkinetic movements.
Pharmacokinetics
Onset
Typically within days to weeks of titration.
Excretion
Primarily excreted in urine as metabolites.
Half life
Parent drug: 1.5-2 hours; Active metabolites (α-HTBZ, β-HTBZ): 3-7 hours.
Absorption
Rapidly absorbed, peak plasma concentration within 1-2 hours.
Metabolism
Extensively metabolized by CYP2D6 to active hydroxylated metabolites (α-HTBZ, β-HTBZ).
Side Effects
Contraindications
- Patients with Huntington's disease who are depressed, suicidal, or have suicidal ideation
- Hepatic impairment
- Untreated or inadequately treated depression
- Concomitant use with reserpine or MAO inhibitors
- Pheochromocytoma
- Prolonged QT interval (if clinically significant)
- History of neuroleptic malignant syndrome (NMS)
Drug Interactions
CNS Depressants
Increased sedation risk.
CYP2D6 Inhibitors
May increase tetrabenazine and metabolite exposure, requiring dose reduction.
QT-Prolonging Drugs
Use with caution due to potential for QT prolongation.
Reserpine and MAO Inhibitors
Contraindicated due to additive monoamine depletion.
Storage
Store at room temperature (20-25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms may include sedation, sweating, dizziness, hypotension, nausea, vomiting, diarrhea, tremors, and dystonia. Management is supportive, including gastric lavage, activated charcoal, and symptomatic treatment.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is unknown if tetrabenazine is excreted in human milk; generally not recommended during breastfeeding.
Side Effects
Contraindications
- Patients with Huntington's disease who are depressed, suicidal, or have suicidal ideation
- Hepatic impairment
- Untreated or inadequately treated depression
- Concomitant use with reserpine or MAO inhibitors
- Pheochromocytoma
- Prolonged QT interval (if clinically significant)
- History of neuroleptic malignant syndrome (NMS)
Drug Interactions
CNS Depressants
Increased sedation risk.
CYP2D6 Inhibitors
May increase tetrabenazine and metabolite exposure, requiring dose reduction.
QT-Prolonging Drugs
Use with caution due to potential for QT prolongation.
Reserpine and MAO Inhibitors
Contraindicated due to additive monoamine depletion.
Storage
Store at room temperature (20-25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms may include sedation, sweating, dizziness, hypotension, nausea, vomiting, diarrhea, tremors, and dystonia. Management is supportive, including gastric lavage, activated charcoal, and symptomatic treatment.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. It is unknown if tetrabenazine is excreted in human milk; generally not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months
Availability
Pharmacies, Hospitals
Approval Status
Approved (e.g., FDA, EMA)
Patent Status
Generic available
Clinical Trials
Numerous clinical trials have established the efficacy and safety of tetrabenazine for Huntington's disease chorea and tardive dyskinesia. Key trials include the TETRA-HD study.
Lab Monitoring
- No routine lab monitoring required.
- Consider ECG if patient has risk factors for QT prolongation.
- Monitor for signs of depression or suicidality.
Doctor Notes
- Careful titration required to find the optimal dose for each patient.
- Monitor closely for psychiatric adverse events, especially during dose changes.
- Consider drug interactions with CYP2D6 inhibitors.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Report any new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior immediately.
- Avoid alcohol while taking this medicine.
- Do not drive or operate heavy machinery until you know how this medicine affects you.
Missed Dose Advice
If a dose is missed, take it as soon as you remember unless it's almost time for your next dose. Do not double the dose.
Driving Precautions
Tetrabenazine can cause sedation and somnolence. Patients should be advised not to drive or operate hazardous machinery until they are reasonably certain that tetrabenazine does not adversely affect their ability to engage in such activities.
Lifestyle Advice
- Maintain a healthy diet and regular exercise routine as advised by your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Regular follow-up appointments with your doctor are important.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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