10 Ingrezza Side Effects and How to Manage Them
Ingrezza can cause drowsiness and other symptoms. Read on to learn about Ingrezza side effects, including rare and long-term effects, and how to manage them.
Ingrezza
Used for Huntington's Chorea, Tardive Dyskinesia
Used for Huntington's Chorea, Tardive Dyskinesia
Ingrezza (valbenazine) is a VMAT2 inhibitor that treats tardive dyskinesia (TD) in adults. It can also treat chorea (random muscle movements) in adults with Huntington's disease. Ingrezza (valbenazine) is available as a capsule and the dose is taken by mouth once a day. But this medication can have side effects, like sleepiness and other movement problems (e.g., parkinsonism).
What is Ingrezza (valbenazine)?
What is Ingrezza (valbenazine) used for?
- Tardive dyskinesia (TD) in adults
- Chorea (random muscle movements) in adults with Huntington's disease
How Ingrezza (valbenazine) works
Ingrezza (valbenazine) is a vesicular monoamine transporter 2 (VMAT2) inhibitor. It's not exactly known how it helps with movement problems. But it's thought to block a protein in your brain called VMAT2. This lowers the release of chemicals like dopamine and serotonin into the brain and control signals that affect movement. It might help lessen involuntary movements over time.
When does Ingrezza (valbenazine) start working?Time passed since treatment started:
Drug facts
| Common Brands | Ingrezza, Ingrezza Sprinkle |
|---|---|
| Drug Class | VMAT2 inhibitor |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Ingrezza (valbenazine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Tardive dyskinesia:
- Sleepiness (11%)
- Dry mouth (5%)
- Constipation (5%)
- Blurry vision (5%)
- Trouble urinating (5%)
Chorea from Huntington's disease:
- Sleepiness (19%)
- Fatigue (14%)
- Hives (9%)
- Rash (8%)
- Can't stay still (6%)
- Trouble sleeping (6%)
- Diarrhea (5%)
- Nausea (5%)
- Depression (5%)
- Back pain (5%)
Less Common Side Effects
- Balance problems or falls
- Restlessness
- Joint pain
- Weight gain
Ingrezza (valbenazine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts and behaviors
- Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint, lightheaded
- Neuroleptic malignant syndrome (NMS): high fever, sweating, stiff muscles, confusion, not aware of your surroundings, fast or irregular heartbeat
- Abnormal movement (parkinsonism): tremor, slow movement, stiff muscles, losing balance easily, falls, trouble walking
- Serious allergic reaction: hives; rash; swelling of your face, tongue, or around the eyes; wheezing; trouble breathing; trouble swallowing
More on Ingrezza (valbenazine) side effects
The following Ingrezza (valbenazine) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- 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):
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Pros and cons of Ingrezza (valbenazine)
Pros
- Works well to control muscle movements from TD and chorea related to Huntington's disease
- Taken once per day, with or without food
- Easy-to-open sprinkle capsules available for people who have trouble swallowing
Cons
- Lots of drug interactions, including some common antidepressants
- Can take about 2 weeks to start working
- Can take a few months to get the most benefit from the medication
Pharmacist tips for Ingrezza (valbenazine)
- You can take Ingrezza (valbenazine) by mouth with or without food. Try taking the medication with food if it upsets your stomach.
- Ingrezza (valbenazine) can make you sleepy. Some people have also had blurry vision. Don't drive or use heavy machinery until you know how this medication affects you.
- It's best to avoid drinking alcohol while you're taking Ingrezza (valbenazine). Alcohol can make some side effects, like sleepiness, headache, and nausea, worse. Talk to your prescriber about how much you usually drink and how to take Ingrezza (valbenazine) safely.
- Ingrezza (valbenazine) can make you feel like you can't sit still, fidgety, or tense. You might also have tremors, slow movement, stiff muscles, or trouble with balance. If you notice these changes, tell your care team. Your prescriber can check what's going on and might lower your dose or stop the medication to help.
- Ingrezza (valbenazine) can raise the risk of depression and having thoughts about hurting yourself. Call 911 right away if you or someone closed to you notices that you have thoughts of suicide.
- Tell your prescriber and pharmacist about all the medications and supplements you take. Many can interact with Ingrezza (valbenazine). Some, like benzodiazepines and other medications that make you sleepy, can cause more side effects. Others, like seizure medications, can make Ingrezza (valbenazine) work less well. Your care team can make sure your medications are safe to take together. They can adjust your dose or switch your medications if needed.
- If you're pregnant or thinking of getting pregnant: Talk to your prescriber about if Ingrezza (valbenazine) is right for you. We don't know for sure if the medication is safe during pregnancy in people. But animal studies suggest that it might not be. Your prescriber can explain the risks and benefits and help you choose a safe option.
- If you're thinking about breastfeeding: Don't breastfeed while taking Ingrezza (valbenazine). It's not known if it can pass into breast milk, affect your milk supply, or harm your baby. If you want to breastfeed, wait at least 5 days after your last Ingrezza (valbenazine) dose.
More tips for Ingrezza (valbenazine) capsules:
- Swallow the Ingrezza capsule whole with water. If you have trouble swallowing, talk to your prescriber. They can switch you to Ingrezza Sprinkle capsules, which might be easier to take.
More tips for Ingrezza Sprinkle (valbenazine) capsules:
- You can swallow Ingrezza Sprinkle capsules whole with water. Don't crush or chew them.
- If needed, you can open the Ingrezza Sprinkle capsule and add the granules into a bowl with about 1 tablespoon of soft food. Examples include applesauce, yogurt, or pudding. Don't mix with milk or drinking water. Stir the medication well into the soft food, being careful not to crush the granules. Then, swallow the mixture right away without chewing the granules. After, drink a glass of water to make sure you've taken all the medication.
- After preparing the Ingrezza Sprinkle mixture, it's best to take it right away. But if needed, you can keep it at room temperature for up to 2 hours. Throw the mixture away if you haven't taken it or if you have any leftovers 2 hours after preparing.
- Don't place the Ingrezza Sprinkle capsule, granules, or prepared mixture through any feeding tubes. The medication can block the tube.
- Keep Ingrezza Sprinkle capsules in the original bottle or in a tight container. This protects it from moisture and keeps the medication dry.
Risks and warnings for Ingrezza (valbenazine)
Ingrezza (valbenazine) 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.
Risk of depression and suicidal thoughts and behavior
- Risk factors: Huntington's disease | History of mental health problems
Ingrezza (valbenazine) can raise the risk of depression and thoughts of suicide, especially in people with Huntington's disease. Your prescriber might check for depression and suicidal thoughts during treatment.
Watch for signs of depression or unusual behavior while taking Ingrezza (valbenazine). This includes anxiety, panic attacks, trouble sleeping, or feeling more angry or irritable. If you or a loved one notices changes in mood or behavior, tell your care team right away. And if you have thoughts about hurting yourself, call 911 as soon as possible.
Allergic reactions
Serious allergic reactions to Ingrezza (valbenazine) can happen. This can include swelling of the throat, tongue, lips, and eyelids. And it can sometimes be life-threatening.
Get medical help right away if you notice swelling in your face, lips, tongue, or around your eyes after you take Ingrezza (valbenazine). Also call 911 right away if you feel dizzy, nauseous, your throat closing up, or have trouble breathing. These can be signs of a serious allergic reaction.
Sleepiness
- Risk factors: Drinking alcohol while taking Ingrezza (valbenazine) | Taking other medications that cause sleepiness
Ingrezza (valbenazine) can make you feel sleepy. This can make it hard to focus, think clearly, or react quickly. This side effect is more likely to happen if you drink alcohol with Ingrezza (valbenazine). The risk is also higher if you take other medications that cause sleepiness, like opioids or benzodiazepines.
Don't drive or use heavy machines until you know how Ingrezza (valbenazine) affects you.
Life-threatening abnormal heart rhythm (QT prolongation)
- Risk factors: Born with QT prolongation | History of abnormal heart rhythms (arrhythmias)| Taking other medications that cause QT prolongation | Taking medications that interact with Ingrezza (valbenazine)
It's rare, but Ingrezza (valbenazine) can make your heart take longer to relax between beats. This is known as QT prolongation. It can affect your heart rhythm and can sometimes be life-threatening.
Tell your prescriber about your medical history. People born with QT prolongation or have had arrhythmias should avoid Ingrezza (valbenazine). Also tell your care team about all the medications you take, and don't start new ones without asking first. Your risk can be greater if you take other QT-prolonging medications or those that interact with Ingrezza (valbenazine). Your prescriber can make sure Ingrezza (valbenazine) is safe for you.
If you're at risk, your prescriber might check your heart with tests during treatment. Call 911 right away if you feel your chest pounding, short of breath, chest pain, faint, or lightheaded while taking Ingrezza (valbenazine). These can be signs of an abnormal heart rhythm.
Neuroleptic malignant syndrome
It's rare, but some people taking Ingrezza (valbenazine) have had a serious problem called neuroleptic malignant syndrome (NMS). Signs can include a high fever, sweating, stiff muscles, confusion, or an uneven heartbeat. If you notice these symptoms, get medical help right away.
Abnormal movements (parkinsonism)
Ingrezza (valbenazine) can cause movement problems called parkinsonism. Signs include tremors, slow movement, stiff muscles, or trouble with balance. It can also sometimes lead to falls and walking issues. Severe cases have happened within the first 2 weeks after starting the medication or raising the dose.
Tell your care team if you notice these changes while taking Ingrezza (valbenazine). It's very important to mention stiff muscles if you have Huntington's disease. This is because it could mean your condition is getting worse. If Ingrezza (valbenazine) is causing these problems, your prescriber might lower your dose or stop it if needed.
Ingrezza (valbenazine) dosage
Dose pack| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 28 tablets of 40mg and 80mg | 1 dose pack | $8,461.94 | $8,461.94 |
Typical dosage for Ingrezza (valbenazine)
The typical starting dose is 40 mg by mouth once a day. Your dose will be slowly raised to the recommended dose of 80 mg once a day. Your prescriber can adjust your dose based on how you tolerate and respond to the medication.
Your dose might differ if you have liver problems or certain genetics that affect the medication levels in your body.
Your dose might also be different if you take certain medications that interact with Ingrezza (valbenazine).
How much does Ingrezza (valbenazine) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Ingrezza (brand)
$8,461.94
What are alternatives to Ingrezza (valbenazine)?
There are a number of medications that your doctor can prescribe in place of Ingrezza (valbenazine). Compare a few possible alternatives below.
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Ingrezza (valbenazine) images
