Ingrezza is available only as a brand-name medication. It's not currently available in generic form.

Ingrezza contains the active drug valbenazine.

Ingrezza can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Ingrezza. These lists do not include all possible side effects.

For more information on the possible side effects of Ingrezza, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you've had with Ingrezza, you can do so through MedWatch.

More common side effects

The more common side effects of Ingrezza can include:

  • sleepiness
  • dry mouth
  • constipation
  • blurry vision
  • urinating less often than usual
  • dizziness
  • falling or having balance problems
  • headache
  • restlessness
  • feeling agitated
  • vomiting
  • nausea
  • weight gain
  • joint pain

Most of these side effects may go away within a few days or a couple of weeks. If they're more severe or don't go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ingrezza aren't common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Serious side effects, which are discussed below in the section "Side effect details," can include:

  • severe allergic reaction
  • parkinsonism (a condition that causes tremors, stiff muscles, and slow movements)

Side effect details

You may wonder how often certain side effects occur with this drug. Here's some detail on a few of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Ingrezza. It's not known how many people using Ingrezza have had allergic reactions to the drug. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Ingrezza. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency.

Weight gain

Weight gain isn't a common a side effect of Ingrezza. In clinical trials, weight gain occurred in between 1% and 2% of people taking the drug.

If you have weight gain that's bothersome to you while you're taking Ingrezza, talk with your doctor about ways to control your weight. They may recommend diet and exercise tips to help you maintain a healthy weight.

Sleepiness

Sleepiness was a common side effect of Ingrezza during clinical trials. Almost 11% of people taking Ingrezza felt sleepy during treatment. In comparison, only 4.2% of people taking a placebo (treatment with no active drug) felt sleepy.

You shouldn't drive or operate machinery until you know how Ingrezza affects your body. If you're taking Ingrezza and you develop sleepiness that's affecting your daily life, talk with your doctor about ways to manage this side effect.

Parkinsonism

Sometimes, parkinsonism can be a side effect of Ingrezza. With this condition, you may have:

  • tremors
  • drooling
  • slowed movements
  • changes in your ability to walk or keep your balance

In clinical studies, parkinsonism occurred in 3% of people taking Ingrezza. In comparison, less than 1% of people taking a placebo (treatment with no active drug) had parkinsonism.

Parkinsonism also occurred in post-marketing studies of Ingrezza. (These studies are done after a drug is approved and is available by prescription.) Some of the parkinsonism symptoms seen in the studies were severe. And some of the people affected needed to be hospitalized for medical care.

In studies, parkinsonism usually occurred within the first 2 weeks after people started taking Ingrezza or after their dosage of Ingrezza was increased. Once Ingrezza treatment is stopped, parkinsonism symptoms usually go away.

If you develop parkinsonism while you're taking Ingrezza, your doctor may lower your dosage of the drug. They may also recommend that you stop using Ingrezza.

The Ingrezza dosage your doctor prescribes will depend on several factors. These include:

  • the severity of the condition you're using Ingrezza to treat
  • other medical conditions you may have
  • other medications you may be taking

Typically, your doctor will start you on a low dosage. Then they'll adjust it over time to reach the amount that's right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Ingrezza comes as capsules that are taken by mouth each day. It's available in two strengths: 40 mg and 80 mg.

Dosage for tardive dyskinesia

The typical starting dosage of Ingrezza for tardive dyskinesia (TD) is 40 mg taken by mouth once each day for the first week of treatment. After this, your doctor may increase your dosage to 80 mg once daily. Ingrezza can be taken with or without food.

The dosage of Ingrezza may be different for people who:

  • have liver disease
  • are considered "poor metabolizers," which means their bodies can't metabolize (break down) Ingrezza as quickly as other people's bodies can
  • are taking certain medications that may interact with Ingrezza

Your doctor will recommend a dosage of Ingrezza that's right for you.

What if I miss a dose?

If you miss a dose of Ingrezza, take your dose as soon as you remember. However, if it's almost time for your next dose, just skip the missed dose and take you next regular dose. Never take more than one capsule of Ingrezza within the same day.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Ingrezza is meant to be used as a long-term treatment. If you and your doctor determine that Ingrezza is safe and effective for you, you'll likely take it long term.

In clinical trials, after 48 weeks of treatment, about 52% of people taking 80 mg of Ingrezza daily had at least a 50% reduction in their tardive dyskinesia symptoms. Your doctor may recommend that you use Ingrezza for longer than 48 weeks, if your TD symptoms are improved with treatment.

The Food and Drug Administration (FDA) approves prescription drugs such as Ingrezza to treat certain conditions.

Ingrezza is FDA-approved to treat tardive dyskinesia (TD). Symptoms of TD include having repetitive and uncontrolled movements in certain areas of your body, usually in your face and mouth.

TD is a side effect that can be caused by taking other medications that are used to treat mental illness. TD usually occurs after you've been taking these medications for a long time.

Examples of medications that may cause TD as a side effect include:

  • haloperidol (Haldol)
  • fluphenazine
  • chlorpromazine
  • perphenazine
  • prochlorperazine (Compro)
  • metoclopramide (Reglan)

Sometimes, TD goes away after you've stopped taking or started using a lower dose of the medication that's causing the condition. However, sometimes TD doesn't go away.

Certain people are at a higher risk of developing TD while they're taking antipsychotic drugs. This includes women, people with diabetes, older people (ages 65 years and older), or people with other mental health conditions.

Effectiveness for tardive dyskinesia

In clinical trials, Ingrezza was effective at reducing TD symptoms. After 6 weeks of treatment, 40% of people taking 80 mg of Ingrezza daily had at least a 50% decrease in their TD symptoms. In comparison, 8.7% of people taking a placebo (treatment with no active drug) had the same result.

In these same studies, after 48 weeks of treatment, about 52% of people taking 80 mg of Ingrezza daily had at least a 50% decrease in their TD symptoms. In comparison, about 28% of people taking 40 mg of Ingrezza daily had the same result.

Other drugs are available that can treat tardive dyskinesia (TD). Some may be better suited for you than others. If you're interested in finding an alternative to Ingrezza, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that are used to treat TD include:

  • deutetrabenazine (Austedo)
  • clonazepam (Klonopin)
  • ginkgo biloba
  • tetrabenazine (Xenazine)
  • amantadine (Gocovri)
  • baclofen (Ozobax)
  • clonidine (Catapres)
  • propranolol (Inderal)

Note: Some of the drugs listed above are used off-label to treat this condition. Off-label use is when a drug that's approved to treat one condition is used to treat a different condition.

You may wonder how Ingrezza compares to other medications that are prescribed for similar uses. Here we look at how Ingrezza and Austedo are alike and different.

Uses

Ingrezza is approved to treat tardive dyskinesia (TD) in adults.

Austedo is approved to treat TD in adults as well. It's also used to treat chorea (a movement disorder) that may be associated with Huntington's disease.

Drug forms and administration

Ingrezza contains the drug valbenazine. It's available as tablets that are taken by mouth. Ingrezza can be taken with or without food.

Austedo contains the drug deutetrabenazine. It also comes as tablets that are taken by mouth. Austedo should be taken with food.

Side effects and risks

Both Ingrezza and Austedo work in very similar ways in your body. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Ingrezza, with Austedo, or with both drugs (when taken individually).

  • Can occur with Ingrezza:
    • dizziness
    • falling or having balance problems
    • joint pain
    • headache
    • blurry vision
    • nausea
    • vomiting
    • urinating less often than usual
    • weight gain
  • Can occur with Austedo:
  • Can occur with both Ingrezza and Austedo:
    • sleepiness
    • dry mouth
    • constipation
    • restlessness
    • feeling agitated

Serious side effects

These lists contain examples of serious side effects that can occur with Ingrezza, with Austedo, or with both drugs (when taken individually).

  • Can occur with Ingrezza:
    • no unique serious side effects
  • Can occur with Austedo:
    • neuroleptic malignant syndrome (a serious reaction to certain antipsychotic drugs)
    • increased prolactin level
  • Can occur with both Ingrezza and Austedo:
    • parkinsonism (a condition that causes tremors, stiff muscles, and slow movements)
    • severe allergic reaction

Effectiveness

Ingrezza and Austedo have different FDA-approved uses, but they're both used to treat TD.

These drugs haven't been directly compared in clinical studies. But separate studies have found both Ingrezza and Austedo to be effective for treating TD.

Costs

Ingrezza and Austedo are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Austedo generally costs less than Ingrezza. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Ingrezza compares to other medications that are prescribed for similar uses. Here we look at how Ingrezza and Klonopin are alike and different.

Uses

Ingrezza is approved to treat tardive dyskinesia (TD) in adults.

Klonopin is approved to treat certain seizure disorders and panic disorders. However, Klonopin can be used off-label to treat TD. Off-label use means that the drug hasn't been approved by the Food and Drug Administration (FDA) for this purpose, but it's sometimes used to treat the condition.

According to the American Academy of Neurology, Klonopin is probably effective to treat TD. The Academy recommends Klonopin as a second-choice treatment option for this condition.

Unlike Ingrezza, Klonopin is a controlled substance. This means that the medication can be used for medical treatment, but that it can also cause you to become dependent on the drug. With dependence, your body needs the drug in order for you to feel normal.

Drug forms and administration

Ingrezza contains the drug valbenazine. It's available as tablets that are taken by mouth. Ingrezza can be taken with or without food.

Klonopin contains the drug clonazepam. It comes as tablets that are swallowed whole. The generic form of Klonopin (called clonazepam) also comes as tablets that are swallowed whole. In addition, clonazepam comes as disintegrating tablets, which dissolve when placed inside your mouth.

Your dosage of Klonopin may vary depending on your symptoms and any other medications you're taking. Because Klonopin isn't FDA-approved to treat TD, there aren't any FDA-approved dosing guidelines available for this use.

Side effects and risks

Ingrezza and Klonopin both contain medications that treat symptoms of TD. These medications can cause similar side effects. However, some side effects may be different.

The side effects of Klonopin may vary depending on what condition the drug is being used to treat. The side effects listed below were seen in people using Klonopin for FDA-approved uses. If you're using Klonopin to treat TD, your side effects may vary from those listed below.

More common side effects

These lists contain examples of more common side effects that can occur with Ingrezza, with Klonopin, or with both drugs (when taken individually).

  • Can occur with Ingrezza:
    • vomiting
    • falling or having balance problems
    • dry mouth
    • urinating less often than usual
    • restlessness
    • weight gain
  • Can occur with Klonopin:
    • depression
    • infections, such as the common cold
    • nervousness
    • decreased libido (sex drive)
  • Can occur with both Ingrezza and Klonopin:
    • sleepiness
    • dizziness
    • constipation
    • blurry vision
    • nausea
    • headache
    • feeling agitated
    • joint pain

Serious side effects

These lists contain examples of serious side effects that can occur with Ingrezza, with Klonopin, or with both drugs (when taken individually).

  • Can occur with Ingrezza:
    • parkinsonism (a condition that causes tremors, stiff muscles, and slow movements)
  • Can occur with Klonopin:
    • withdrawal symptoms when stopping the drug
    • psychiatric reactions, such as aggression or anger
    • dependence (needing to use the drug in order to feel normal)
    • slowed breathing
    • suicidal thoughts and behaviors
  • Can occur with both Ingrezza and Klonopin:
    • severe allergic reaction

Effectiveness

Ingrezza and Klonopin have different FDA-approved uses. Ingrezza is FDA-approved to treat TD. Klonopin isn't FDA-approved for this condition, but sometimes it's used off-label to treat TD.

These drugs haven't been directly compared in clinical studies. But separate studies have found Ingrezza to be effective to treat TD.

And although it's not FDA-approved to treat TD, Klonopin has improved TD symptoms in people using the drug. According to the American Academy of Neurology, Klonopin is probably effective for reducing symptoms of TD.

Costs

Ingrezza and Klonopin are both brand-name drugs. There is currently no generic form of Ingrezza. There is a generic form of Klonopin available called clonazepam. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Klonopin (both the brand-name drug and generic clonazepam) are less expensive than Ingrezza. The actual price you'll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Here are answers to some frequently asked questions about Ingrezza.

Is Ingrezza a controlled substance?

No, Ingrezza isn't a controlled substance. Controlled substances are medications that have approved medical uses but can also cause dependence or be misused by some people. With dependence, your body needs the drug in order to feel normal.

Ingrezza isn't addictive, and it doesn't cause dependence in people taking it.

If I'm taking an antipsychotic, can I stay on it while I'm using Ingrezza?

Yes, you can usually stay on antipsychotic medications while you're taking Ingrezza. Ingrezza is used to treat tardive dyskinesia (TD), which may be caused as a side effect of certain antipsychotic drugs.

In clinical trials, about 85% of people taking Ingrezza also took their antipsychotic medications.

If you have questions about what medications you can take with Ingrezza, talk with your doctor.

Will Ingrezza eventually stop working for me?

That's not known for sure. Clinical studies of Ingrezza showed that the medication remained effective in treating TD for at least 48 weeks.

At 48 weeks of treatment, people taking the drug reported about a 39% decrease in their TD symptoms. However, additional long-term studies are needed to know if Ingrezza will continue working after 48 weeks of use.

If you have questions about how long you should take Ingrezza, talk with your doctor.

Is tardive dyskinesia a dangerous condition?

No, TD isn't considered dangerous. With this condition, you may have uncontrolled jerking motions in certain areas of your body, such as your face or mouth.

TD usually occurs as a side effect of certain antipsychotic medications. TD isn't life-threatening.

If you have symptoms of TD, talk with your doctor right away. Sometimes, simply reducing the dose of your antipsychotic medication can decrease your TD symptoms.

Your doctor can recommend whether the dose of your antipsychotic medication can be adjusted. They can also recommend if you need treatment for your TD symptoms.

It may not be safe for you to drink alcohol while you're taking Ingrezza. Two very common side effects of Ingrezza are tiredness and sleepiness. Alcohol can also make you feel tired, which adds to the effects caused by Ingrezza.

Using alcohol and Ingrezza together can also slow down your breathing, which can become a serious concern.

Talk with your doctor about how much alcohol is safe for you to consume while you're taking Ingrezza. If you have trouble avoiding alcohol, talk with your doctor about whether it's safe for you to use Ingrezza.

Ingrezza can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Ingrezza and other medications

Below are lists of medications that can interact with Ingrezza. These lists do not contain all the drugs that may interact with Ingrezza.

Before taking Ingrezza, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Ingrezza and MAOIs

If you're taking a monoamine oxidase inhibitor (MAOI), you shouldn't take Ingrezza. Examples of MAOIs that should be avoided while you're using Ingrezza include:

  • isocarboxazid (Marplan)
  • tranylcypromine (Parnate)
  • selegiline (Emsam)
  • phenelzine (Nardil)
  • rasagiline (Azilect)

MAOIs can interact with Ingrezza and lead to very serious side effects, including serotonin syndrome. This is a very serious condition that's caused by elevated levels of serotonin (a brain chemical) in your body. Symptoms of serotonin syndrome include fever, rigid muscles, tremors, and seizures.

Using Ingrezza along with an MAOI can also lower the effectiveness of Ingrezza in treating your condition.

Ingrezza and certain antibiotics

Ingrezza can also interact with certain antibiotics, such as clarithromycin (Biaxin XL) and erythromycin (Erythrocin).

If you're taking Ingrezza with certain antibiotics, your doctor may decrease your dosage of Ingrezza. This is because certain antibiotics can stop your body from breaking down and clearing Ingrezza. This causes elevated levels of Ingrezza in your body, which may increase side effects of the medication.

If you're taking antibiotics while using Ingrezza, talk with your doctor or pharmacist about any possible interactions. Not all antibiotics interact with Ingrezza. Your doctor or pharmacist can let you know if you're at risk for interactions.

Ingrezza and certain antifungal treatments

Certain antifungal medications, such as itraconazole (Sporanox) or ketoconazole (Nizoral), can interact with Ingrezza.

If you're taking Ingrezza with certain antifungals, your doctor may decrease your dosage of Ingrezza. This is because certain antifungals can stop your body from breaking down and clearing Ingrezza. This causes elevated levels of Ingrezza in your body, which may increase side effects of the medication.

If you're taking antifungals while using Ingrezza, talk with your doctor or pharmacist about any possible interactions. Not all antifungals interact with Ingrezza. Your doctor or pharmacist can let you know if you're at risk for interactions.

Ingrezza and certain antidepressants

Ingrezza may interact with certain antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil).

It's possible that your body doesn't break down Ingrezza as quickly as usual if you take it with an antidepressant. This can lead to elevated levels of Ingrezza in your body, which may increase side effects from the drug.

If you're taking Ingrezza with certain antidepressants, your doctor may monitor you more often than usual to see if you're having side effects from Ingrezza. Your doctor may decrease your dosage of Ingrezza if you're having bothersome or severe side effects from the drug.

Ingrezza and certain seizure medications

If you're taking Ingrezza, you should avoid certain seizure medications, such as carbamazepine (Tegretol) and phenytoin (Dilantin).

These medications can cause Ingrezza to not work as well as it usually does. It's recommended that you don't take certain seizure medications along with Ingrezza.

If you need to take seizure medications while you're using Ingrezza, talk with your doctor about your treatment options.

Ingrezza and rifampin

It's recommended that you don't take Ingrezza with rifampin (Rifadin). Taking these medications together will cause Ingrezza to not work as well in treating your tardive dyskinesia (TD). In some cases, this drug interaction can make Ingrezza not work at all.

To prevent this interaction, you should avoid taking rifampin with Ingrezza.

Ingrezza and quinidine

It's possible that quinidine may interact with Ingrezza. Taking these medications together may increase levels of Ingrezza in your body. This can cause increased side effects of the drug.

Your doctor may monitor you for side effects more often than usual if you're taking Ingrezza with quinidine. Your doctor may also decrease your dosage of Ingrezza if you have bothersome side effects of the drug.

Ingrezza and digoxin

Taking Ingrezza while you're using digoxin (Lanoxin) can cause your digoxin levels to increase. This happens because Ingrezza can block your body's breakdown of digoxin.

If you're taking these drugs together, your doctor will check blood tests to monitor your digoxin levels. Your doctor may lower your dosage of digoxin if your digoxin levels are too high.

It's important that your digoxin levels are monitored regularly if you're using these drugs together. If your digoxin level gets too high, you can have serious side effects, which can sometimes be dangerous. These side effects include nausea, vomiting, heart palpitations, and irregular heart rhythm.

If you need to take digoxin with Ingrezza, talk with your doctor about this possible drug interaction.

Ingrezza and herbs and supplements

Some herbal products or supplements may interact with Ingrezza. Always check with your doctor or pharmacist before using any herbs or supplements while you're taking Ingrezza.

Ingrezza and St. John's wort

St. John's wort is an herbal supplement that some people use to treat depression symptoms. It's recommended that you don't take St. John's wort with Ingrezza. This herb will cause Ingrezza to not work as well to treat your condition.

You should avoid using St. John's wort while you're taking Ingrezza. If you have questions about this interaction, talk with your doctor or pharmacist.

As with all medications, the cost of Ingrezza can vary. To find current prices for Ingrezza in your area, check out WellRx.com.

The cost you find on WellRx.com is what you may pay without insurance. The actual price you'll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Ingrezza, or if you need help understanding your insurance coverage, help is available.

Neurocrine Biosciences, Inc., the manufacturer of Ingrezza, offers the INBRACE Support Program, which may help lower the cost of Ingrezza. For more information and to find out if you're eligible for support, call 84-INGREZZA (844-647-3992) or visit the program website.

You should take Ingrezza according to your doctor or healthcare provider's instructions. Typically, Ingrezza capsules are taken by mouth once each day.

When to take

Ingrezza should be taken once daily at about the same time each day. You shouldn't stop taking Ingrezza unless you've discussed doing so with your doctor. They'll recommend the best way to stop taking the medication.

To help make sure that you don't miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Ingrezza with food

Ingrezza may be taken with or without food.

Can Ingrezza be crushed, split, or chewed?

Ingrezza comes as capsules. The maker of Ingrezza hasn't stated whether the capsules can be opened and sprinkled onto food, or crushed, split, or chewed. It's probably best to swallow the capsules whole.

It's not known exactly how Ingrezza works to treat tardive dyskinesia (TD). With this condition, you have involuntary movements in your body, especially in your face and mouth. TD may be caused by abnormal functioning of a brain chemical called dopamine.

Dopamine works inside your brain to control your movements. Abnormal functioning of this chemical is thought to be the cause of TD. This condition often occurs after using certain antipsychotic medications.

It's thought that Ingrezza works by blocking the action of a protein in your brain called vesicular monoamine transporter 2 (VMAT2). This protein increases dopamine levels in certain areas of your brain.

By blocking VMAT2, Ingrezza may decrease the levels of dopamine in your brain. This likely causes a decrease in your TD symptoms.

How long does it take to work?

You may notice a decrease in your TD symptoms as early as the second week of treatment with Ingrezza.

In clinical trials, just 6 weeks after starting Ingrezza, 23.8% to 40% of people had at least a 50% decrease in their TD symptoms. In comparison, 8.7% of people taking a placebo (treatment with no active drug) had the same result.

It's not known if Ingrezza can harm a developing fetus if it's used during pregnancy. There haven't been any studies of this drug in pregnant women.

However, animal studies have shown a possible increased risk of stillbirth and problems with development when Ingrezza was given to pregnant females. It's not known if Ingrezza would have this same affect in humans using the drug during pregnancy.

If you're pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of using Ingrezza.

It's not known if Ingrezza is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you're using Ingrezza.

It's not known for sure if Ingrezza passes into human breast milk when it's used by lactating women. In an animal study, Ingrezza did pass (in high concentrations) into the breast milk of lactating rats.

Keep in mind that the results of animal studies don't always predict what will happen in humans. However, because of the possible risks, breastfeeding should be avoided if you're taking Ingrezza. You should continue to avoid breastfeeding for 5 days after your last dose of the drug.

If you have questions about breastfeeding while you're taking Ingrezza, talk with your doctor. They can recommend healthy and safe ways to feed your child.

Before taking Ingrezza, talk with your doctor about your health history. Ingrezza may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • QT prolongation. Taking Ingrezza may cause an increase in your QT interval. This condition, called QT prolongation, is a type of abnormal heart rhythm. It can be very serious in some cases. Your doctor may monitor your heart for this condition while you're taking Ingrezza. At normal doses of Ingrezza, QT prolongation is not usually dangerous for most people. However, you may have an increased risk of QT prolongation if you also take other medications (such as certain antipsychotics), have a heart condition, or have a metabolism disorder. Talk to your doctor about all of the medications or supplements you're taking before you start using Ingrezza. Also, talk with your doctor if you start using any new medications while you're taking Ingrezza. If you have any history of heart problems, let your doctor know before you start Ingrezza.
  • Pregnancy. It's not known if Ingrezza can cause harm to a developing fetus. If you're pregnant or planning to become pregnant, talk with your doctor about the risks of taking Ingrezza. For more information, please see the "Ingrezza and pregnancy" section above.
  • Breastfeeding. Animal studies have shown that there may be risks to using Ingrezza while breastfeeding. You shouldn't breastfeed while taking Ingrezza, or for 5 days after your last dose of Ingrezza. For more information, please see the "Ingrezza and breastfeeding" section above.
  • Severe kidney disease. You shouldn't take Ingrezza if you have severe kidney disease. If you have kidney problems, talk to your doctor about whether Ingrezza is safe for you.
  • Allergic reaction to Ingrezza. If you've had an allergic reaction to Ingrezza in the past, you should not take this medication.

Note: For more information about the potential negative effects of Ingrezza, see the section above called "Ingrezza side effects."

Using more than the recommended dosage of Ingrezza can lead to serious side effects.

Overdose symptoms

In clinical trials, no one taking Ingrezza overdosed on the medication. It's not known for sure what symptoms you may have if you take too much of the drug. And no specific treatments have been recommended for treating an Ingrezza overdose.

What to do in case of overdose

If you think you've taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Ingrezza from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications.

If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Ingrezza tablets should be stored at room temperature, between 68°F and 77°F (20°C and 25°C). Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

Disposal

If you no longer need to take Ingrezza and have leftover medication, it's important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

Ingrezza is approved for use in adults with tardive dyskinesia (TD).

Mechanism of action

The mechanism of action of Ingrezza to treat TD is unknown. This condition can be caused by long-term use of dopamine receptor blocking agents (DRBAs). This group of drugs includes antipsychotic medications. It is believed that DRBAs cause TD by producing extra signaling in the D2 dopamine receptor in the motor function region of the brain.

Ingrezza works by targeting and blocking a transporter protein called VMAT2. Typically, this protein releases extra dopamine into the synapse, causing a boost in dopamine. By blocking VMAT2, Ingrezza reduces the amount of dopamine that is released. This reduces signaling in the brain and may reduce excess motor function as well.

Pharmacokinetics and metabolism

Maximum plasma concentration is reached between 4 to 8 hours after oral administration of Ingrezza. Steady state is attained within 1 week of using the drug. It is possible that eating a high-fat meal can increase the concentration of Ingrezza available. Ingrezza has a half-life lasting between 15 and 22 hours.

Ingrezza is primarily metabolized by the liver. First, the medication is broken down into its active metabolite, [+]-α-dihydrotetrabenazine ([+]-α-HTBZ), via hydrolysis. Then, [+]-α-HTBZ is metabolized further into mono-oxidized valbenazine and other metabolites. This occurs via CYP3A4/5 and possibly CYP2D6 initiation through oxidative metabolism.

Ingrezza excretion is about 60% through urine and 30% through feces.

Contraindications

Ingrezza is contraindicated for use in people who have an allergy to the active drug valbenazine or any other components of the tablet.

Storage

Ingrezza should be stored between 68°F and 77°F (20°C to 25°C). It should not be stored in the bathroom, where moisture and humidity can reduce stability of the capsules.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.