Austedo
Austedo (deutetrabenazine) is a medication used to ease chorea from Huntington's disease and tardive dyskinesia, which are conditions related to uncontrolled body movements. Austedo (deutetrabenazine) is taken by mouth once or twice daily, depending on your dose. There's a long-acting form available (Austedo XR) that's taken once daily. Some common side effects of Austedo (deutetrabenazine) include sleepiness, diarrhea, and dry mouth.
What is Austedo (deutetrabenazine)?
What is Austedo (deutetrabenazine) used for?
Chorea (random muscle movements) in people with Huntington's disease
How Austedo (deutetrabenazine) works
Austedo (deutetrabenazine) is a vesicular monoamine transporter 2 (VMAT2) inhibitor. It's not exactly known how Austedo (deutetrabenazine) helps with movement problems, but it's thought to block the VMAT2 protein in your brain. This lowers the amount of certain chemicals released in the brain (e.g., dopamine, serotonin, norepinephrine, histamine), which can potentially affect movement.
Drug Facts
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What are the side effects of Austedo (deutetrabenazine)?
Common Side Effects
- Sleepiness (11%)
- Diarrhea (9%)
- Dry mouth (9%)
- Tiredness (9%)
- Urinary tract infection or UTI (7%)
- Difficulty sleeping (7%)
- Runny nose, sore throat, and other symptoms of the common cold (4%)
- Difficulty sleeping (4%)
Other Side Effects
- Anxiety
- Constipation
- Bruising
- Depression
- Feeling restless
Serious Side Effects
- Suicidal thoughts and behaviors
- Neuroleptic malignant syndrome: high fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
- Akathisia: restlessness, inability to sit still, squirmy or fidgety, agitated
Source: DailyMed
More on Austedo (deutetrabenazine) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Agitation, feeling irritable or restless
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- High fever, stiff muscles, increased sweating, fast or irregular heartbeat, and confusion, which may be signs of neuroleptic malignant syndrome
- Muscle stiffness or spasms, tremors or shaking, loss of balance or coordination, shuffling walk
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Drowsiness
- Dry mouth
- Sore throat
- Trouble sleeping
Pros and cons of Austedo (deutetrabenazine)
Pros
Helps with movement problems due to tardive dyskinesia or chorea from Huntington's disease
Taken once or twice per day
Might have less side effects than tetrabenazine (Xenazine)
No need to lower the dose slowly if you're stopping the medication
Cons
Austedo IR needs to be taken with food twice per day
Can cause sleepiness
Doesn't cure tardive dyskinesia or chorea from Huntington's disease
Only available as a brand-name medication
Pharmacist tips for Austedo (deutetrabenazine)
Don't chew, crush, or break Austedo (deutetrabenazine) tablets. Doing so could damage the medication or change the way it works in your body. Swallow them whole.
Take Austedo IR with food. This helps your body absorb the medication.
If you're prescribed Austedo XR, you can take the medication with or without food.
Austedo (deutetrabenazine) can make you very sleepy, which can affect your ability to focus, think, or react. Don't drive or operate machinery until you know how this medication affects you.
While taking Austedo (deutetrabenazine), it's best if you can avoid drinking alcohol or taking other medications that cause sleepiness (e.g., opioids, benzodiazepines, sleep medications). This combination can worsen some side effects of Austedo (deutetrabenazine), such as sleepiness and dizziness worse.
Don't take Austedo (deutetrabenazine) at the same time or within 2 weeks of taking a monoamine oxidase (MAO) inhibitor, such as rasagiline (Azilect). This combination can cause a serious interaction. Make sure you tell your provider about all the medications you're taking before you start Austedo (deutetrabenazine). Don't start any new medications or vitamin supplements while taking Austedo (deutetrabenazine) without telling your provider or pharmacist first.
Frequently asked questions about Austedo (deutetrabenazine)
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What are the risks and warnings for Austedo (deutetrabenazine)?
Austedo (deutetrabenazine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Depression and suicidal thoughts (in people with Huntington's disease)
Austedo (deutetrabenazine) can raise the risk of depression and thoughts of suicide or harming yourself, especially in people with Huntington's disease. Your provider might screen you for depression and suicidal thoughts throughout your treatment. If you or anyone around you notice that you have suicidal thoughts, feelings of depression, or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking Austedo (deutetrabenazine), call your provider right away. If your depression or suicidal thoughts don't go away, you might have to stop taking Austedo (deutetrabenazine).
Worsening of symptoms of Huntington's disease
Risk factors: Huntington's disease
Certain symptoms of Huntington's disease, such as changes in mood and changes in the ability to think clearly, can be confused with side effects of Austedo (deutetrabenazine). If you're taking Austedo (deutetrabenazine) and have Huntington's disease, your provider will examine you every so often to make sure this medication is safe and working properly for you. Your provider might lower your dose of Austedo (deutetrabenazine) for a period of time to see if your symptoms are caused by the worsening of Huntington's disease or by Austedo (deutetrabenazine).
Possible changes in heart rhythm (QT prolongation)
Risk factors: Low heart rate | Low potassium and magnesium blood levels | Taking other medications that cause QT prolongation | Born with QT prolongation | History of abnormal heart rhythms (arrhythmias)
Although rare, Austedo (deutetrabenazine) might affect heart rhythm and cause a condition known as QT prolongation. But based on clinical studies, you're unlikely to experience harm if you're taking the recommended dose of Austedo (deutetrabenazine). To be safe, your provider might ask you to avoid taking Austedo (deutetrabenazine) if you're also taking other medications that cause QT prolongation or if you already have heart rhythm problems. If you have symptoms of heart rhythm problems, such as trouble breathing, chest pain, or feel faint or lightheaded while taking Austedo (deutetrabenazine), get medical help right away.
Possible risk for neuroleptic malignant syndrome (NMS)
Risk factors: Taking antipsychotic medications or other medications that lower dopamine levels
Tetrabenazine (Xenazine), a very similar medication to Austedo (deutetrabenazine), can cause a rare, but life-threatening condition called neuroleptic malignant syndrome (NMS). While people taking Austedo (deutetrabenazine) haven't reported experiencing NMS, the risk is still possible.
Symptoms include high fever, sweating, stiff muscles, confusion, not being aware of your surroundings, and fast or irregular heartbeat. Your risk is higher if you take other medications that can cause NMS, such as haloperidol (Haldol) and olanzapine (Zyprexa)). If you experience any of these symptoms while taking Austedo (deutetrabenazine), get medical attention as soon as possible. You'll likely have to stop taking Austedo (deutetrabenazine) and switch to another medication.
Restlessness and movement problems (parkinsonism)
Austedo (deutetrabenazine) can make you feel restless (like you can't sit still), squirmy or fidgety, or agitated. These are signs of a complex movement problem called akathisia.
Austedo (deutetrabenazine) can also cause parkinsonism, or abnormal movements, such as a tremor, slow movement, impaired speech, muscle stiffness, and losing your balance easily. These abnormal movements can lead to falls. Since muscle stiffness can be a symptom of Huntington's disease, it's important to tell your provider if you experience this. They can help you figure out if it's from the disease or if it's a side effect of the medication.
If you or your loved ones notice any of these abnormal movements while taking Austedo (deutetrabenazine), contact your provider right away. Your provider might lower your dose of Austedo (deutetrabenazine) or ask you to stop it completely.
High prolactin levels
Risk factors: History of breast cancer
Although not specifically tested in Austedo (deutetrabenazine), tetrabenazine (Xenazine), a similar medication to Austedo (deutetrabenazine), can raise your prolactin levels. Prolactin is a hormone made in your brain that causes milk production and breast growth in females, although males also make some prolactin as well. Too much prolactin can cause weak bones, breast growth (for both men and women), and can even play a role in breast cancer. If you experience breast growth, breast milk leakage, or loss of interest in sex while taking Austedo (deutetrabenazine), contact your provider so you can be tested to see if you have a high prolactin level.
Austedo (deutetrabenazine) dosage forms
Typical dosing for Austedo (deutetrabenazine)
Immediate-release tablet: The typical starting dose is 6 mg by mouth twice daily. Your provider will raise your dose weekly if needed. The typical maximum daily dose is 48 mg, divided into two doses and taken twice daily.
Extended-release tablet: The typical starting dose is 12 mg by mouth once daily. Your provider will raise your dose weekly if needed. The typical maximum daily dose is 48 mg.
How much does Austedo (deutetrabenazine) cost?
Austedo (deutetrabenazine) contraindications
People with Huntington's disease who are suicidal or have depression that's untreated or not completely treated
Liver problems
Currently taking or have taken monoamine oxidase inhibitors (MAOIs), such as selegiline, phenelzine (Nardil), or tranylcypromine (Parnate), in the last 14 days
What are alternatives to Austedo (deutetrabenazine)?
Chorea (random muscle movements) in people with Huntington's disease
Chorea (random muscle movements) from Huntington's disease
Tardive dyskinesia (TD) in adults
Chorea (random muscle movements) in adults with Huntington's disease
What is the latest news about Austedo (deutetrabenazine)?
Austedo (deutetrabenazine) images
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References
Best studies we foundAUSTEDO. (2023). Clinical study details.
AUSTEDO. (2023). How AUSTEDO may help.
Claassen, D. O., et al. (2017). Indirect tolerability comparison of deutetrabenazine and tetrabenazine for Huntington disease. Journal of Clinical Movement Disorders.
Frank, S., et al. (2022). The safety of deutetrabenazine for chorea in Huntington disease: An open-label extension study. CNS Drugs.
Huntington's Disease Society of America. (n.d.). Overview of Huntington's disease.
International Parkinson and Movement Disorder Society. (n.d.). Chorea & Huntington's disease.
MedlinePlus. (2020). Prolactin levels.
National Alliance on Mental Illness. (n.d.). Tardive dyskinesia.
National Institute of Neurological Disorders and Stroke. (2023). Huntington's disease.
Teva Neuroscience, Inc. (2023). AUSTEDO- deutetrabenazine tablet, coated. AUSTEDO- deutetrabenazine kit. AUSTEDO XR- deutetrabenazine tablet, film coated, extended release [package insert]. DailyMed.
Teva Pharmaceuticals. (2023). Teva announces FDA approval of AUSTEDO XR (deutetrabenazine) extended-release tablets, a new once-daily formulation of AUSTEDO (deutetrabenazine) tablets.
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