Austedo (deutetrabenazine) treats chorea in adults with Huntington's disease. It also treats tardive dyskinesia in adults. It works as a vesicular monoamine transporter 2 (VMAT2) inhibitor to help control body movements. Austedo (deutetrabenazine) comes as a tablet you take by mouth. The immediate-release version (Austedo) is taken twice a day, and the extended-release version (Austedo XR) is taken once a day. You start at a low dose, and then your prescriber slowly raises it over a few weeks. Austedo XR has a 4-week titration pack to help with this. Side effects include sleepiness, diarrhea, and dry mouth. As of mid-2025, it's only as a brand-name version; there's no generic yet.
Chorea (uncontrolled movements) in adults with Huntington's disease
Tardive dyskinesia in adults
Austedo (deutetrabenazine) is a vesicular monoamine transporter 2 (VMAT2) inhibitor. It's not exactly known it works.
But researchers think the medication blocks a protein in your nerves called VMAT2. This helps lower the amount of certain chemicals in your nerves. These chemicals can include dopamine, serotonin, norepinephrine, and histamine. They play a role in body movement.
Lowering these chemicals in your nerves might help with movement problems.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Can cause sleepiness
Doesn't cure tardive dyskinesia or chorea from Huntington's disease
Swallow Austedo (deutetrabenazine) tablets whole with water. Don't chew, crush, or break them. This could damage the medication or change how it works in your body.
For Austedo (immediate-release): Take the medication twice a day with food. This helps your body absorb it better.
For Austedo XR (extended-release): Take the medication once a day. You can take it with or without food. After you take the medication, don't be alarmed if you see a tablet shell in your stool. This is normal, but ask your pharmacist if you're worried.
Austedo (deutetrabenazine) can raise the risk of having thoughts about hurting yourself. Call 911 right away if you or someone closed to you notices that you have thoughts of suicide.
Some people might feel sleepy after taking Austedo (deutetrabenazine). Don't drive or do anything that needs your full attention until you know how the medication affects you.
It's best to avoid drinking alcohol or taking other medications that make you sleepy. These include opioids, benzodiazepines, and sleep medications. It can make you feel even sleepier or more tired.
Tell your healthcare team about all the medications you're taking. Also, don't start any new medications or vitamins without checking with your prescriber or pharmacist first. Austedo (deutetrabenazine) can interact with other medications and cause harmful side effects. For example, don't take Austedo (deutetrabenazine) at the same time or within 2 weeks of a monoamine oxidase inhibitor (MAOI).
If you're pregnant, planning to get pregnant, or breastfeeding, talk to your prescriber. They can help you understand the risks and benefits of taking Austedo (deutetrabenazine). It's not completely clear if it's safe to take while pregnant or breastfeeding.
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.
People with Huntington's disease have a higher risk of depression and thoughts of suicide. Austedo (deutetrabenazine) might make this risk even higher.
If you or a loved one notices that you have signs of depression or unusual behavior while taking Austedo (deutetrabenazine), talk to your prescriber right away. Call 911 as soon as possible if you think about hurting yourself. If these feelings don't go away, you might have to stop taking this medication.
Some side effects of Austedo (deutetrabenazine) can look like symptoms of Huntington's disease. These include mood changes, trouble thinking clearly, and stiff muscles.
Your prescriber will check on you regularly while you take Austedo (deutetrabenazine). Tell them if you notice these symptoms or if they get worse. They might lower your dose or stop the medication for a while. This can help figure out if the symptoms are from the medication or if your Huntington's disease is getting worse.
Risk factors: Low heart rate | Born with QT prolongation | History of abnormal heart rhythms (arrhythmias) | Low potassium or magnesium levels | Taking other medications that cause QT prolongation
Although it's rare, Austedo (deutetrabenazine) might make your heart take longer to recharge between beats. This is called QT prolongation and can sometimes cause changes in heart rhythm. It's not likely to be harmful if you take the recommended dose.
Tell your prescriber about your full medical history and all the medications you take. Some health problems and medications can raise your risk of QT prolongation. Your prescriber can check if Austedo (deutetrabenazine) is safe for you.
Get medical help right away if you have chest pain, trouble breathing, or feel faint or dizzy while taking Austedo (deutetrabenazine). These could be signs of heart rhythm changes.
Risk factors: Taking antipsychotic medications or other medications that lower dopamine levels
Some people taking tetrabenazine (Xenazine), a medication like Austedo (deutetrabenazine), had a rare but very serious problem called neuroleptic malignant syndrome (NMS). People taking Austedo (deutetrabenazine) haven't had NMS. But the risk is still possible.
The risk might be higher if you take other medications that can cause NMS. Examples include haloperidol and olanzapine (Zyprexa). Make sure to tell your prescriber about all the medications you take.
If you have symptoms of NMS while taking Austedo (deutetrabenazine), get medical help right away. Signs include a high fever, sweating, stiff muscles, confusion, or an uneven heartbeat.
Austedo (deutetrabenazine) can make you feel like you can't sit still. You might feel restless, squirmy, fidgety, or tense.
Austedo (deutetrabenazine) can also cause movement problems called parkinsonism. These include tremors, slow movement, stiff muscles, or losing balance. This usually happens within the first 2 weeks after starting the medication or raising the dose. It can sometimes lead to falls.
Tell your care team if you have these abnormal movements while taking Austedo (deutetrabenazine). It's especially important to mention stiff muscles. This is because it can be a sign that your Huntington's disease might be getting worse. If the medication is causing these problems, your prescriber might lower your dose or have you stop taking it.
Tetrabenazine (Xenazine), a similar medication to Austedo (deutetrabenazine), can raise prolactin levels. To be safe, it's important to be aware of this risk with Austedo (deutetrabenazine).
Prolactin is a hormone that helps with milk production and breast growth in females. Males also make some prolactin as well. Too much prolactin can cause weak bones, leakage of milk from the breast, and breast growth. These symptoms can happen in both females and males. Males can also have erectile dysfunction (ED).
If you notice any of these symptoms while taking Austedo (deutetrabenazine), talk to your care team. They might have you get a blood test to check your prolactin levels.
Austedo (immediate-release): The typical starting dose is 6 mg by mouth twice daily. Your prescriber will raise your dose weekly if needed. The maximum dose is 24 mg twice daily.
Austedo XR (extended-release): The typical starting dose is 12 mg by mouth once daily. Your prescriber will raise your dose weekly if needed. The maximum dose is 48 mg once daily.
Your starting dose will be different if you're from tetrabenazine (Xenazine). It will depend on your current tetrabenazine (Xenazine) dose.
Also, the highest dose you can take might be different if you take certain other medications or have certain genes that raise Austedo (deutetrabenazine) levels in your body.
People with Huntington's disease who think about hurting themselves or have attempted suicide
People with Huntington's disease who have depression that's not treated or not completely treated
Liver problems
Currently take or have taken monoamine oxidase inhibitors (MAOIs) in the last 14 days
Chorea (uncontrolled movements) in adults with Huntington's disease
Tardive dyskinesia in adults
Chorea (random muscle movements) from Huntington's disease
Tardive dyskinesia (TD) in adults
Chorea (random muscle movements) in adults with Huntington's disease
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Dean, L. (2019). Deutetrabenazine therapy and CYP2D6 genotype. Medical Genetics Summaries.
Dean, M., et al. (2018). Review of deutetrabenazine: A novel treatment for chorea associated with Huntington’s disease. Drug Design, Development and Therapy.
DrugBank. (n.d.). Cytochrome P-450 CYP2D6 inhibitors (strong).
MedlinePlus. (2024). Prolactin levels.
MedlinePlus. (2024). Secondary parkinsonism.
National Heart, Lung, and Blood Institute. (2022). Long QT syndrome.
National Institute of Neurological Disorders and Stroke. (2025). Huntington's disease.
Teva Neuroscience, Inc. (2025). Austedo- deutetrabenazine tablet, coated; Austedo- deutetrabenazine kit; Austedo XR- deutetrabenazine tablet, film coated, extended release [package insert]. DailyMed.
Teva Pharmaceuticals. (2017). Teva announces FDA approval of AUSTEDO® (deutetrabenazine) tablets for the treatment of tardive dyskinesia in adults. Business Wire.
Teva Pharmaceuticals. (2023). Teva announces FDA approval of AUSTEDO® XR (deutetrabenazine) extended-release tablets, a new once-daily formulation of AUSTEDO® (deutetrabenazine) tablets. Business Wire.
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