XENAZINE/NITOMAN (Tetrabenazine)
XENAZINE/NITOMAN (Tetrabenazine)
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XENAZINE/NITOMAN (Tetrabenazine)

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What is this medication?

Tetrabenazine, Xenazine (US)/Nitoman (CDN)
Central Monoamine-Depleting AgentVesicular Monoamine Transporter 2 (VMAT2) Inhibitor

Brand Name US: Xenazine
Canadian Equivalent: Nitoman

Tetrabenazine, Nitoman/Xenazine is officially indicated for chorea associated with Huntington disease

How does this medication work?

Tetrabenazine, Nitoman/Xenazine is a reversible inhibitor of the human vesicular monamine transporter type 2 (VMAT-2).   It decreases the uptake of monoamines (dopamine, serotonin, norepinephrine, histamine) into synaptic vesicles and depletes the monoamine stores.

How should I take this medication?

Oral: 12.5 mg once daily in the morning, may increase to 12.5 mg twice daily after 1 week. Dosage may be increased by 12.5 mg daily at weekly intervals; daily doses >37.5 mg should be divided into 3 doses (maximum single dose: 25 mg).

Patients requiring doses >50 mg/day: Genotype for CYP2D6:

Extensive/intermediate metabolizers: Maximum: 100 mg/day; 37.5 mg/dose.

Poor metabolizers: Maximum: 50 mg/day; 25 mg/dose.

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, store at room temperature.  May administer without regard to meals.  If treatment is interrupted for >5 days, retitration is recommended. If treatment is interrupted for <5 days resume at previous maintenance dose.

You Need to Avoid:  Significant drug interactions exist, requiring dose/frequency adjustment or avoidance so avoid starting any new medications without consulting prescriber.

What should I watch for while using this medication?

Before starting Tetrabenazine, Nitoman/Xenazine make sure your physician is aware of any allergies or medications you currently take, if you have a prolactin dependent tumor, CYP2D6 poor metabolizers, if you have hepatic impairment, a depressive disorder, are pregnant, or breastfeeding. Tetrabenazine, Nitoman/Xenazine use has been associated with rare but serious adverse events such as akathisia, CNS depression, depression, suicidal ideation, esophageal dysmotility, aspiration, neuroleptic malignant syndrome, ophthalmic effects, orthostatic hypotension, parkinsonism, QT prolongation, and tardive dyskinesia.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Drowsiness, sedation, depression, extrapyramidal reaction, fatigue, insomnia, akathisia, anxiety, falling, nausea, upper respiratory tract infection, drug-induced Parkinson’s disease, equilibrium disturbance, irritability, abnormal gait, dizziness, dysarthria, headache, obsessive rumination, dysphagia, vomiting, decreased appetite, dysuria, bruise, bradykinesia, bronchitis, dyspnea

Note this is not a complete list of side effects, only the most common