Deutetrabenazine Brand Name– Austedo
What is Deutetrabenazine
Deutetrabenazine is an oral, vesicular monoamine transporter 2 (VMAT 2) inhibitor indicated for the treatment of tardive dyskinesia and chorea associated with Huntington’s disease.
Deutetrabenazine is a deuterated formulation of tetrabenazine. Adverse reactions associated with peak plasma concentrations of tetrabenazine (e.g., somnolence, depression) sometimes limit treatment.
The chemical alteration present in deutetrabenazine slows drug metabolism and prolongs therapeutic effect, which decreases dosing requirements and thereby produces lower peak plasma concentrations.
During a placebo-controlled trial of 222 adult patients with tardive dyskinesia, deutetrabenazine dosages of 24 mg/day and 36 mg/day significantly reduced abnormal involuntary movements compared to placebo as measured by the Abnormal Involuntary Movement Scale (AIMS); AIMS total scores improved from baseline to 12 weeks by 1.4, 3.2, and 3.3 units for placebo, deutetrabenazine 24 mg/day, and deutetrabenazine 36 mg/day, respectively.
A reduction in abnormal involuntary movements by AIMS was noted as early as 2 weeks into deutetrabenazine therapy.
An additional placebo-controlled trial in adults with tardive dyskinesia (n = 113) demonstrated a statistically significant AIMS change with deutetrabenazine compared to placebo (-3 vs. -1.6) from baseline to 12 weeks.
The mean deutetrabenazine dosage was 38.3 mg/day. In a 12-week, randomized, double-blind, placebo-controlled trial of 90 patients with chorea associated with Huntington’s disease, deutetrabenazine significantly improved motor function as measured by the change from baseline in Total Maximal Chorea Score (-4.4 vs. -1.9; p less than 0.0001).
The mean deutetrabenazine dosage after titration was 40 mg/day.
Deutetrabenazine use may increase the risk for suicidality in patients with Huntington’s disease, and is therefore contraindicated in patients who are suicidal or who have untreated or inadequately treated depression.
Indications
- Huntington’s Disease (Huntington’s Chorea)
- tardive dyskinesia
For the treatment of chorea associated with Huntington’s Disease (Huntington’s Chorea)
Side Effects
- agitation
- akathisia
- anxiety
- constipation
- cystitis
- depression
- diarrhea
- dizziness
- drowsiness
- fatigue
- hyperprolactinemia
- insomnia
- neuroleptic malignant syndrome
- pharyngitis
- pseudoparkinsonism
- QT prolongation
- restlessness
- suicidal ideation
- tremor
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- alcoholism
- bradycardia
- breast cancer
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- coronary artery disease
- depression
- diabetes mellitus
- driving or operating machinery
- females
- geriatric
- heart failure
- hepatic disease
- hyperprolactinemia
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- long QT syndrome
- malnutrition
- MAOI therapy
- myocardial infarction
- pregnancy
- QT prolongation
- suicidal ideation
- thyroid disease
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Tramadol
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfentanil
- Alfuzosin
- Alprazolam
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Apomorphine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atomoxetine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine
- Azelastine; Fluticasone
- Azithromycin
- Baclofen
- Barbiturates
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Brexpiprazole
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Butabarbital
- Butorphanol
- Cabergoline
- Cannabidiol
- Capsaicin; Metaxalone
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carisoprodol
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chloral Hydrate
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clemastine
- Clobazam
- Clofazimine
- Clomipramine
- Clonazepam
- Clonidine
- Clorazepate
- Clozapine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Cyclobenzaprine
- Cyproheptadine
- Dacomitinib
- Dantrolene
- Dasatinib
- Degarelix
- Desflurane
- Desipramine
- Dexmedetomidine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Doxylamine
- Doxylamine; Pyridoxine
- Dronedarone
- Droperidol
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Entacapone
- Entrectinib
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esketamine
- Estazolam
- Eszopiclone
- Ethanol
- Ezogabine
- Fentanyl
- Fingolimod
- Flecainide
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Gabapentin
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen; Oxycodone
- Ibutilide
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Inotuzumab Ozogamicin
- Isocarboxazid
- Isoflurane
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lasmiditan
- Lefamulin
- Lemborexant
- Lenvatinib
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levocetirizine
- Levofloxacin
- Levorphanol
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorazepam
- Loxapine
- Lumateperone
- Lurasidone
- Macimorelin
- Maprotiline
- Meclizine
- Mefloquine
- Melatonin
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Meprobamate
- Metaproterenol
- Metaxalone
- Methadone
- Methocarbamol
- Methohexital
- Methyldopa
- Metoclopramide
- Metronidazole
- Midazolam
- Midostaurin
- Mifepristone
- Mirtazapine
- Molindone
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nalbuphine
- Nefazodone
- Nilotinib
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Orphenadrine
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxazepam
- Oxycodone
- Oxymorphone
- Ozanimod
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenobarbital
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pirbuterol
- Pitolisant
- Posaconazole
- Pramipexole
- Pregabalin
- Primaquine
- Primidone
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Propantheline
- Protriptyline
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Rasagiline
- Remifentanil
- Reserpine
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Romidepsin
- Ropinirole
- Rotigotine
- Rufinamide
- Safinamide
- Salmeterol
- Saquinavir
- Scopolamine
- Secobarbital
- Selegiline
- Selpercatinib
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Siponimod
- Sodium Oxybate
- Solifenacin
- Sorafenib
- Sotalol
- Sufentanil
- Sunitinib
- Suvorexant
- Tacrolimus
- Tamoxifen
- Tapentadol
- Tasimelteon
- Telavancin
- Telithromycin
- Temazepam
- Terbutaline
- Tetrabenazine
- Thalidomide
- Thiopental
- Thioridazine
- Thiothixene
- Tiotropium; Olodaterol
- Tipranavir
- Tizanidine
- Tolcapone
- Tolterodine
- Toremifene
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Umeclidinium; Vilanterol
- Valbenazine
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Vigabatrin
- Voriconazole
- Vorinostat
- Zaleplon
- Ziprasidone
- Zolpidem
