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tetrabenazine
generic
Black Box Warnings .
Depression and Suicidality
incr. risk of depression and suicidality in pts w/ Huntington dz, esp. if depression hx or prior suicide attempts or ideation; weigh risk vs. benefit; observe all pts for new or worsening depression, suicidality, or unusual behavior changes; inform pts and caregivers of depression and suicidality risk and instruct to report any concerning behaviors; contraindicated if actively suicidal or if untreated/inadequately treated depression
Adult Dosing .
Dosage forms: TAB: 12.5 mg, 25 mg
chorea, Huntington dz-associated
- [CYP2D6 genotype unknown]
- Dose: individualize dose PO bid-tid; Start: 12.5 mg PO qam x1wk, then 12.5 mg PO bid x1wk, then may incr. by 12.5 mg/day qwk; Max: 25 mg/dose up to 50 mg/day; Info: perform CYP2D6 genotyping if dose >50 mg/day; divide dose tid if >37.5 mg/day; retitrate if tx interrupted >5 days
- [CYP2D6 poor metabolizer]
- Dose: individualize dose PO bid-tid; Start: 12.5 mg PO qam x1wk, then 12.5 mg PO bid x1wk, then may incr. by 12.5 mg/day qwk; Max: 25 mg/dose up to 50 mg/day; Info: divide dose tid if >37.5 mg/day; retitrate if tx interrupted >5 days
- [CYP2D6 intermediate metabolizer]
- Dose: individualize dose PO bid-tid; Start: 12.5 mg PO qam x1wk, then 12.5 mg PO bid x1wk, then may incr. by 12.5 mg/day qwk; Max: 37.5 mg/dose up to 100 mg/day; Info: divide dose tid if >37.5 mg/day; retitrate if tx interrupted >5 days
- [CYP2D6 extensive metabolizer]
- Dose: individualize dose PO bid-tid; Start: 12.5 mg PO qam x1wk, then 12.5 mg PO bid x1wk, then may incr. by 12.5 mg/day qwk; Max: 37.5 mg/dose up to 100 mg/day; Info: divide dose tid if >37.5 mg/day; retitrate if tx interrupted >5 days
tardive dyskinesia (off-label)
- [25-75 mg/day PO divided bid-tid]
- Start: 12.5 mg PO bid-tid, may incr. by 12.5 mg/day qwk; Max: 200 mg/day; Info: perform CYP2D6 genotyping if dose >50 mg/day; max 50 mg/day in CYP2D6 poor metabolizers; divide dose tid if >37.5 mg/day; retitrate if tx interrupted >5 days
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: contraindicated
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.