tetraben
Generic Name
Tetrabenazine
Manufacturer
XYZ Pharmaceuticals
Country
USA
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tetraben 125 mg tablet | ৳ 20.00 | ৳ 200.00 |
Description
Overview of the medicine
Tetrabenazine is a vesicular monoamine transporter 2 (VMAT2) inhibitor used to treat chorea associated with Huntington's disease and tardive dyskinesia.
Uses & Indications
Dosage
Adults
Initial dose typically 12.5 mg/day, gradually titrated up to 100 mg/day in divided doses. Max 100 mg/day.
Elderly
Start with lower doses and titrate slowly due to potential for increased sensitivity.
Renal_impairment
No specific dose adjustment recommended, but use with caution.
How to Take
Oral. Take with food.
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 depletion of monoamine stores from nerve terminals.
Pharmacokinetics
Onset
Within days to weeks.
Excretion
Primarily in urine (via metabolites).
Half life
Approximately 4-7 hours (active metabolites).
Absorption
Rapidly absorbed, extensively metabolized.
Metabolism
Extensively metabolized by CYP2D6 to active metabolites (alpha-dihydrotetrabenazine and beta-dihydrotetrabenazine).
Side Effects
Contraindications
- Patients with Huntington's disease who are depressed, suicidal, or have suicidal ideation
- Hepatic impairment
- Concomitant use with MAOIs (within 14 days)
- Concomitant use with reserpine
- History of QT prolongation or congenital long QT syndrome
Drug Interactions
MAOIs
Contraindicated due to risk of hypertensive crisis.
Reserpine
Contraindicated due to additive VMAT2 inhibition.
Dopamine antagonists
May worsen parkinsonism-like symptoms.
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
May increase tetrabenazine exposure; reduce tetrabenazine dose.
Storage
Store at room temperature (20-25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms include sedation, diaphoresis, hypotonia, and hypotension. Treatment is supportive, including monitoring vital signs and cardiac rhythm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding.
Side Effects
Contraindications
- Patients with Huntington's disease who are depressed, suicidal, or have suicidal ideation
- Hepatic impairment
- Concomitant use with MAOIs (within 14 days)
- Concomitant use with reserpine
- History of QT prolongation or congenital long QT syndrome
Drug Interactions
MAOIs
Contraindicated due to risk of hypertensive crisis.
Reserpine
Contraindicated due to additive VMAT2 inhibition.
Dopamine antagonists
May worsen parkinsonism-like symptoms.
CYP2D6 inhibitors (e.g., fluoxetine, paroxetine)
May increase tetrabenazine exposure; reduce tetrabenazine dose.
Storage
Store at room temperature (20-25°C), away from moisture and light. Keep out of reach of children.
Overdose
Symptoms include sedation, diaphoresis, hypotonia, and hypotension. Treatment is supportive, including monitoring vital signs and cardiac rhythm.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Not recommended during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA
Patent Status
Generic versions available
Clinical Trials
Extensive clinical trials have demonstrated efficacy in reducing chorea in Huntington's disease and tardive dyskinesia. Post-marketing studies continue to monitor long-term safety.
Lab Monitoring
- Liver function tests (baseline and periodically)
- ECG (before and during treatment for QT prolongation)
Doctor Notes
- Careful titration is crucial to optimize efficacy and minimize side effects.
- Monitor for signs of depression, suicidality, and parkinsonism throughout treatment.
- Assess patient's CYP2D6 metabolizer status if dose adjustments are challenging.
Patient Guidelines
- Do not stop taking this medicine without consulting your doctor.
- Avoid alcohol.
- Report any signs of depression or suicidal thoughts immediately.
Missed Dose Advice
If a dose is missed, take the next dose at the regularly scheduled time. Do not double the dose.
Driving Precautions
May cause drowsiness or dizziness. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Maintain regular sleep patterns.
- Avoid activities requiring mental alertness until you know how this medicine affects you.
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