• Administration:
  • Deutetrabenazine should be taken exactly as prescribed by a healthcare provider.
  • It is typically taken orally, with or without food.
  • Swallow the tablet whole, do not crush or chew it.
  • The dose may be split into two smaller doses taken at different times of the day (morning and evening).
  • If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular schedule. Never double the dose to make up for a missed dose.
• Storage:
  • Store Deutetrabenazine at room temperature (between 68°F to 77°F or 20°C to 25°C), away from excessive heat, moisture, or light.
  • Keep the medication out of the reach of children.

Deutetrabenazine works by inhibiting the vesicular monoamine transporter 2 (VMAT2), a protein that helps store and release certain neurotransmitters, including dopamine, in the brain. Dopamine is involved in regulating mood, movement, and motor control. By blocking VMAT2, Deutetrabenazine reduces the release of dopamine in the brain, which in turn calms abnormal movements associated with chorea (in Huntington’s disease) and Tardive Dyskinesia.

The deuterated formulation of Deutetrabenazine helps to prolong its action and decrease side effects. The changes in the molecule’s structure allow it to remain in the body for a longer period, leading to more stable blood levels and a reduced risk of fluctuations in symptoms, which can improve the patient’s overall treatment experience.

• Common Side Effects:
  • Drowsiness or fatigue: Some people may feel tired or sleepy, especially when starting treatment.
  • Dry mouth: Deutetrabenazine can cause dry mouth in some patients, which may be alleviated by drinking water or using saliva substitutes.
  • Insomnia: Difficulty sleeping can also occur, especially at higher doses.
  • Nausea: Some patients experience mild nausea when taking this medication.
  • Headache: Headaches are a common side effect, though they tend to subside with time.
• Serious Side Effects:
  • Parkinsonism: Although rare, some patients may develop Parkinsonism (symptoms similar to Parkinson’s disease), including tremors, muscle rigidity, and slowed movements.
  • Depression or mood changes: Deutetrabenazine can potentially worsen mood or lead to feelings of depression or suicidal thoughts, particularly in individuals with pre-existing mood disorders.
  • Tardive Dyskinesia: Paradoxically, Deutetrabenazine may sometimes worsen symptoms of Tardive Dyskinesia in certain patients, requiring dose adjustments or discontinuation.

• Parkinsonism: Deutetrabenazine may increase the risk of Parkinson-like symptoms. It is important to monitor for these signs, especially at higher doses.
• Mental Health Issues: Patients with a history of depression, suicidal thoughts, or other mental health issues should be closely monitored while using Deutetrabenazine. The medication may worsen mood and increase the risk of suicidal behavior.
• Liver Function: Deutetrabenazine should be used with caution in individuals with liver diseases. Routine monitoring of liver function is recommended during treatment.
• Pregnancy and Breastfeeding: The safety of Deutetrabenazine during pregnancy and breastfeeding has not been fully established. It should only be used during pregnancy if the potential benefit outweighs the risks. Consult your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.

• CYP2D6 Inhibitors: Medications that inhibit the CYP2D6 enzyme (e.g., fluoxetine, paroxetine) can increase the concentration of Deutetrabenazine in the body, leading to an increased risk of side effects. Dose adjustments may be required.
• CYP2D6 Substrates: Deutetrabenazine may interfere with the metabolism of other medications that are broken down by the CYP2D6 enzyme, potentially increasing their concentration in the blood.
• Monoamine Oxidase Inhibitors (MAOIs): Combining Deutetrabenazine with MAO inhibitors can lead to dangerous interactions, including increased blood pressure and other severe effects. It’s important to avoid using these medications together.
• Alcohol: Alcohol can amplify the sedative effects of Deutetrabenazine, so it’s advisable to limit alcohol consumption while using this medication.

• Huntington’s Disease: The starting dose is typically 6 mg daily, with an increase to a target dose of 12 mg to 48 mg per day, based on the patient’s response and tolerability.
• Tardive Dyskinesia: The starting dose for Tardive Dyskinesia is 12 mg daily, with a maximum dose of 48 mg per day.
• Liver Impairment: For patients with moderate liver impairment, the starting dose should be reduced to 6 mg daily, and careful monitoring is recommended.

Deutetrabenazine is a prescription-only medication, meaning it must be prescribed by a healthcare provider. It is essential for individuals to have an open discussion with their healthcare provider about the potential benefits and risks of this medication, as well as to receive regular follow-up appointments to monitor side effects and treatment progress.

1. What is Deutetrabenazine used for?

   • To treat chorea associated with Huntington’s disease and tardive dyskinesia.

2. What is the brand name of Deutetrabenazine?

   • Austedo.

3. How does Deutetrabenazine work?

   • It depletes dopamine by inhibiting vesicular monoamine transporter 2 (VMAT2).

4. Is Deutetrabenazine a pill or injection?

   • It is an oral medication (tablet).

5. How is Deutetrabenazine different from tetrabenazine?

   • It has a modified structure that allows for longer half-life and potentially fewer side effects.

6. What are common side effects of Deutetrabenazine?

   • Drowsiness, fatigue, depression, nausea.

7. Is Deutetrabenazine addictive?

   • It is not considered addictive but should be used under medical supervision.

8. Can Deutetrabenazine cause depression or suicidal thoughts?

   • Yes, it may increase risk of depression and suicidal ideation.

9. How long does it take for Deutetrabenazine to work?

   • Effects can be seen within 1 to 2 weeks.

10. How should Deutetrabenazine be taken?

    • Orally, usually twice daily with food.

11. Can Deutetrabenazine interact with other drugs?

    • Yes, especially with antidepressants, antipsychotics, and CYP2D6 inhibitors.

12. Is dose adjustment needed for liver problems?

    • Yes, dose adjustments may be necessary for hepatic impairment.

13. Can Deutetrabenazine cause sedation?

    • Yes, sedation is a common side effect.

14. Can Deutetrabenazine impair driving or operating machinery?

    • Yes, it may affect alertness and coordination.

15. Is Deutetrabenazine safe during pregnancy?

    • Safety during pregnancy is unknown; consult your doctor.

16. Can patients stop Deutetrabenazine abruptly?

    • No, tapering is recommended to avoid withdrawal symptoms.

17. Does Deutetrabenazine have any controlled substance status?

    • No, it is not a controlled substance.

18. How is Deutetrabenazine dosed?

    • Dosing is individualized, starting low and titrating up.

19. Can Deutetrabenazine cause weight changes?

    • Weight changes are uncommon but possible.

20. Where can I buy Deutetrabenazine?

    • Available by prescription at pharmacies.