tetrabenazine
Brand names: Xenazine
Tetrabenazine is a medicine used to treat chorea (uncontrollable movements) caused by Huntington's disease. It helps to reduce these movements.
Drug Pricing (NADAC)
Generic Price
$1.97/unit
Generic Available
Yes (8 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Tetrabenazine is used to treat chorea, which are the involuntary, jerky movements that happen with Huntington's disease.
Common side effects
Feeling sleepy or drowsy, Feeling tired, Trouble sleeping
Key warnings
Tetrabenazine can increase the risk of depression and suicidal thoughts in people with Huntington's disease.
How It Works
Tetrabenazine works by affecting a substance in the brain that moves other chemicals. It lowers the amount of certain chemicals, like dopamine, in the brain. This helps to control the involuntary movements (chorea) caused by Huntington's disease.
How to Take It
You will start with a low dose of 12.5 mg each day. Your doctor may increase the dose slowly, by 12.5 mg each week. If you take 37.5 mg to 50 mg per day, divide the dose into three times a day. You can take this medicine with or without food.
Pregnancy & Breastfeeding
This medicine may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if this medicine passes into breast milk, so talk to your doctor if you are breastfeeding.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store the medicine at room temperature, away from heat and moisture.
Side Effects (from patient reports)
Based on 5,479 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 7,235 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
7,235
Death-Related Reports
1,527
Hospitalization Reports
1,469
Top Indication
Huntington^S Disease
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DEATH | 1,216 |
| 2 | OFF LABEL USE | 1,121 |
| 3 | DRUG INEFFECTIVE | 696 |
| 4 | DEPRESSION | 474 |
| 5 | SOMNOLENCE | 451 |
| 6 | FATIGUE | 360 |
| 7 | FALL | 314 |
| 8 | HOSPITALISATION | 296 |
| 9 | INSOMNIA | 276 |
| 10 | INTENTIONAL PRODUCT USE ISSUE | 274 |
| 11 | ANXIETY | 263 |
| 12 | DRUG ADMINISTRATION ERROR | 241 |
| 13 | CONDITION AGGRAVATED | 224 |
| 14 | DRUG DOSE OMISSION | 224 |
| 15 | DYSKINESIA | 223 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Tetrabenazine can increase the risk of depression and suicidal thoughts in people with Huntington's disease. If you have thoughts of harming yourself, tell your doctor right away. You should not take this medicine if you are actively suicidal or have untreated depression.
Known Drug Interactions
7.7 Concomitant Deutetrabenazine or Valbenazine Tetrabenazine is contraindicated in patients currently taking deutetrabenazine or valbenazine.
Mechanism: These two drugs are very similar and work in the same way to treat movement disorders. Taking them together can lead to an overdose of the same medicine type and cause severe side effects.
What to do: You must not take these two medications at the same time. Talk to your doctor about which single treatment is right for you.
7.7 Concomitant Deutetrabenazine or Valbenazine Tetrabenazine is contraindicated in patients currently taking deutetrabenazine or valbenazine.
Mechanism: These medications are designed to do the same thing in the brain to control body movements. Using both at once increases the risk of dangerous side effects because they have the same target.
What to do: Do not use these drugs together. Your healthcare provider should prescribe only one of these medicines to manage your condition.
7.6 Neuroleptic Drugs The risk for Parkinsonism, NMS, and akathisia may be increased by concomitant use of tetrabenazine and dopamine antagonists or antipsychotics (e.g., chlorpromazine, haloperidol, olanzapine, risperidone, thioridazine, ziprasidone) [see Warnings and Precautions ( 5.4 , 5.5 , 5.6 )] .
Mechanism: Both drugs lower dopamine activity in the brain, which can cause stiff muscles, tremors, or a dangerous fever.
What to do: Your doctor should watch you closely for any new movement problems or signs of a serious reaction.
7.6 Neuroleptic Drugs The risk for Parkinsonism, NMS, and akathisia may be increased by concomitant use of tetrabenazine and dopamine antagonists or antipsychotics (e.g., chlorpromazine, haloperidol, olanzapine, risperidone, thioridazine, ziprasidone) [see Warnings and Precautions ( 5.4 , 5.5 , 5.6 )] .
Mechanism: These medications both block dopamine, which can lead to movement disorders like tremors or a life-threatening reaction.
What to do: Tell your doctor immediately if you notice muscle stiffness, restlessness, or a high fever.
7.5 Drugs That Cause QTc Prolongation Tetrabenazine causes a small prolongation of QTc (about 8 msec), concomitant use with other drugs that are known to cause QTc prolongation should be avoided, these including antipsychotic medications (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone), antibiotics (e.g., moxifloxacin), Class 1A (e.g., quinidine, procainamide) and Class III (e.g., amiodarone, sotalol) antiarrhythmic medications or any other medications known to prolong the QTc interval. 7.6 Neuroleptic Drugs The risk for Parkinsonism, NMS, and akathisia may be increased by con...
Mechanism: Both drugs can cause a dangerous change in the heart's rhythm and increase the risk of serious movement problems.
What to do: You should avoid taking these drugs together to prevent heart rhythm issues and severe muscle side effects.
Common Questions
Can I stop taking this medicine suddenly?
Will this medicine cure my Huntington's disease?
Can I drink alcohol while taking this medicine?
What should I do if I feel worse after starting this medicine?
Can I drive while taking this medicine?
What if I take too much?
Are there foods I should avoid?
How long does it take for this medicine to work?
Can this medicine cause other movement problems?
Will this medicine interact with other medications I'm taking?
What are the common side effects of tetrabenazine?
Does tetrabenazine interact with other medications?
What drug class is tetrabenazine?
Is tetrabenazine safe during pregnancy?
Related Medications in VMAT2 Inhibitor
Other drugs grouped near tetrabenazine — same-class peers and common alternatives.
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alprazolam
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amitriptyline
Elavil
Amitriptyline is a medicine used to treat depression.
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amphetamine/dextroamphetamine
Adderall, Adderall XR
Adderall XR is a stimulant medicine.
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aripiprazole
Abilify
Aripiprazole (Abilify) is a medicine used to treat certain mental disorders and mood problems.
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What the FDA Data Shows for tetrabenazine
The FDA label for tetrabenazine (sold under brand names such as Xenazine) classifies it as a prescription-only medication in the VMAT2 Inhibitor class. Tetrabenazine is used to treat chorea, which are the involuntary, jerky movements that happen with Huntington's disease. Official labeling lists 7 commonly reported side effects, including Feeling sleepy or drowsy, Feeling tired, Trouble sleeping.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 5,479 voluntary reports. The database also lists 16 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $1.97.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: July 24, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages