WARNING

Taking Xenazine (tetrabenazine) involves certain risks and considerations. Here’s a brief overview of the potential risks associated with this medication:

• Depression and Suicidal Thoughts: Xenazine has been associated with an increased risk of depression and suicidal thoughts. Individuals taking the medication should be closely monitored, especially those with a history of depression.
• Sedation and Drowsiness: Xenazine can cause sedation and drowsiness. Individuals taking the medication should avoid activities that require mental alertness, such as driving or operating heavy machinery, until they understand how the medication affects them.
• QT Prolongation: Xenazine may prolong the QT interval on an electrocardiogram (ECG), increasing the risk of serious cardiac arrhythmias. Caution is advised in individuals with a history of QT prolongation or those taking medications that also prolong the QT interval.
• Neuroleptic Malignant Syndrome (NMS): NMS, a rare but serious condition, has been reported with the use of Xenazine. Symptoms include hyperthermia, muscle rigidity, altered mental status, and autonomic instability.
• Parkinsonism and Movement Disorders: Xenazine may cause symptoms similar to Parkinson’s disease, such as tremors, stiffness, and a shuffling walk.
• Increased Risk of Falls: Xenazine may increase the risk of falls, particularly in elderly individuals or those with a history of falls.
• Insomnia and Restlessness: Insomnia and restlessness are potential side effects of Xenazine.
• Dietary Considerations: There are no specific dietary restrictions associated with Xenazine. However, maintaining a balanced diet is generally recommended.
• Interactions with Other Medications: Xenazine may interact with other medications, and caution is advised, especially when taking it concurrently with drugs that affect the central nervous system.

It’s crucial for individuals taking Xenazine to be aware of these potential risks and to communicate openly with their healthcare provider. Regular monitoring and follow-up appointments are essential to assess the medication’s effectiveness, manage side effects, and make any necessary adjustments to the treatment plan. If any unusual or severe symptoms occur, seeking medical attention promptly is important.

Why is this medication prescribed?

Xenazine (tetrabenazine) is a medication primarily prescribed for the treatment of chorea associated with Huntington’s disease. Huntington’s disease is a genetic disorder that causes progressive degeneration of nerve cells in the brain, leading to motor and cognitive impairments.

Chorea is a characteristic symptom of Huntington’s disease, characterized by involuntary, rapid, and jerky movements. Xenazine helps to reduce these abnormal movements by inhibiting the reuptake of neurotransmitters such as dopamine, which are involved in the regulation of movement.

How should this medicine be used?

Here are some general guidelines on how Xenazine should be used:

• Dosage: The dosage of Xenazine varies depending on the individual patient’s needs. It is important to follow the prescribed dosage and instructions provided by the healthcare provider.
• Administration: Xenazine comes as a tablet taken by mouth, with or without food. It is typically taken two to three times a day.
• Titration: The dosage of Xenazine often needs to be titrated (adjusted) gradually. This means that the healthcare provider may start with a lower dose and increase it over time until the optimal dose is reached. This helps minimize side effects.
• Regular Monitoring: Patients taking Xenazine may require regular monitoring by their healthcare provider to assess the effectiveness of the medication and to manage any potential side effects.
• Adherence to Instructions: It is crucial to follow the healthcare provider’s instructions carefully. Do not change the dosage or stop taking Xenazine without consulting the healthcare provider.
• Potential Side Effects: Xenazine can have side effects, and these should be discussed with the healthcare provider. Side effects may include drowsiness, insomnia, depression, and an increased risk of suicidal thoughts, among others.
• Interaction with Other Medications: Inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and herbal supplements. Xenazine may interact with certain medications, and adjustments may be necessary.
• Special Considerations: Xenazine should be used with caution in patients with a history of depression or suicidal thoughts. It is important to discuss any mental health concerns with the healthcare provider.

It’s important to note that this information provides a general overview, and individual circumstances may vary. Always consult with a healthcare professional for personalized advice and information based on your specific health condition.

Other uses for this medicine

Xenazine is primarily approved for the treatment of chorea associated with Huntington’s disease. It may be used off-label for other hyperkinetic movement disorders or conditions involving involuntary movements, at the discretion of healthcare providers.

What special precautions should I follow?

As for special precautions when using Xenazine, here are some key considerations:

• Psychiatric Effects: Xenazine may cause or exacerbate depression and suicidal thoughts. Patients, especially those with a history of depression or suicidal tendencies, should be closely monitored. It’s important to report any changes in mood or behavior to the healthcare provider.
• QT Prolongation: Xenazine may prolong the QT interval on an electrocardiogram (ECG), which can increase the risk of serious cardiac arrhythmias. Patients with a history of QT prolongation, certain cardiac conditions, or those taking medications that prolong the QT interval should be closely monitored. Regular ECGs may be recommended.
• Neuroleptic Malignant Syndrome (NMS): NMS, a potentially life-threatening condition, has been reported with the use of Xenazine. Patients should be monitored for symptoms such as hyperthermia, muscle rigidity, altered mental status, and autonomic instability.
• Hepatic Impairment: Xenazine is metabolized in the liver, so caution is advised in patients with hepatic impairment. Dose adjustments may be necessary in such cases.
• Concomitant Use with Monoamine Oxidase Inhibitors (MAOIs): Concomitant use of Xenazine with MAOIs is contraindicated due to the risk of serotonin syndrome.
• Pregnancy and Lactation: The safety of Xenazine during pregnancy has not been established. It should be used during pregnancy only if the potential benefits justify the potential risks. It is also not known whether Xenazine is excreted in human milk, so caution is advised during lactation.
• Interactions with Other Medications: Xenazine may interact with other medications, including other drugs that affect the central nervous system. Inform your healthcare provider about all the medications you are taking, including prescription and over-the-counter medications.

It’s crucial to discuss your medical history, current medications, and any concerns you may have with your healthcare provider before starting Xenazine or any other medication. They can provide personalized guidance based on your individual health status and needs.

What special dietary instructions should I follow?

There are no specific dietary restrictions associated with Xenazine. However, it’s essential to maintain a well-balanced diet unless your healthcare provider advises otherwise.

What should I do if I forget a dose?

If you miss a dose of Xenazine, take it as soon as you remember. However, if it’s close to the time of your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double up on doses to make up for a missed one. If you have questions about missed doses or need further guidance, contact your healthcare provider or pharmacist.

What side effects can this medication cause?

Xenazine (tetrabenazine) can cause various side effects, and it’s important to be aware of them. Not everyone will experience these side effects, and their severity can vary. Common side effects include:

• Sedation/Drowsiness: Xenazine may cause drowsiness. It’s important to avoid activities that require alertness, such as driving or operating heavy machinery, until you know how the medication affects you.
• Insomnia: Some individuals may experience difficulty sleeping (insomnia) as a side effect of Xenazine.
• Depression: Xenazine has been associated with an increased risk of depression. Individuals taking the medication should be closely monitored for changes in mood, and healthcare providers should be informed of any symptoms of depression.
• Parkinsonism: Symptoms similar to Parkinson’s disease, such as tremors, stiffness, and a shuffling walk, may occur in some individuals.
• Akathisia: This is a condition characterized by restlessness and a need to move, often accompanied by an inability to sit still.
• Restlessness: Some individuals may experience restlessness as a side effect.
• Increased Risk of Falls: Xenazine may increase the risk of falls, so caution is advised, especially in elderly individuals or those with a history of falls.
• Nausea: Nausea is a common side effect of Xenazine.
• Fatigue: Some individuals may experience fatigue or weakness.
• QT Prolongation: Xenazine can prolong the QT interval on an electrocardiogram (ECG), which can increase the risk of serious cardiac arrhythmias.
• Neuroleptic Malignant Syndrome (NMS): Although rare, NMS is a serious side effect that has been reported with the use of Xenazine. Symptoms include hyperthermia, muscle rigidity, altered mental status, and autonomic instability.

It’s important to report any unusual or severe side effects to your healthcare provider promptly. Additionally, individuals taking Xenazine should be monitored regularly, and healthcare providers may adjust the dosage or consider other interventions based on the patient’s response to the medication.

This is not an exhaustive list of side effects, and individual responses to medication can vary. If you have concerns about potential side effects or experience any unusual symptoms while taking Xenazine, consult with your healthcare provider for guidance.

What should I know about storage and disposal of this medication?

Storage and Disposal of Xenazine:

• Storage:
  • Store Xenazine at room temperature away from light and moisture.
  • Keep it in a tightly closed container.
  • Do not store it in the bathroom.
  • Keep Xenazine out of reach of children and pets.
• Disposal:
  • Follow your healthcare provider’s or pharmacist’s instructions on how to dispose of unused or expired medications.
  • Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
  • Check with your local pharmacy or government for information on medication take-back programs or other disposal options.

In case of emergency/overdose

• In case of an overdose or emergency, contact your local poison control center or emergency room immediately.
• Symptoms of overdose may include severe drowsiness, confusion, agitation, hallucinations, seizures, and difficulty breathing.
• If possible, bring the Xenazine container or packaging to the emergency room for reference.

What other information should I know?

• Regular Monitoring: Regularly attend follow-up appointments with your healthcare provider to monitor the effectiveness of Xenazine and address any concerns or side effects.
• Medication Interactions: Inform your healthcare provider about all medications you are taking, including prescription, over-the-counter, and herbal supplements, as Xenazine may interact with certain drugs.
• Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of using Xenazine with your healthcare provider.
• Medical Alert Bracelet/ID: If applicable, wear a medical alert bracelet or carry a medical ID card indicating that you are taking Xenazine. This is especially important in case of emergencies.
• Avoid Alcohol: Limit or avoid alcohol while taking Xenazine, as it may enhance the sedative effects of the medication.
• Drowsiness and Impaired Alertness: Xenazine can cause drowsiness and impair alertness. Avoid activities that require mental alertness, such as driving or operating heavy machinery, until you know how the medication affects you.
• Inform Healthcare Providers: Inform all healthcare providers (doctors, dentists, and pharmacists) that you are taking Xenazine before undergoing any medical procedures or surgeries.
• Dietary Considerations: There are no specific dietary restrictions associated with Xenazine. However, maintain a balanced diet unless advised otherwise by your healthcare provider.
• Follow Instructions: Always follow your healthcare provider’s instructions regarding the use of Xenazine, including dosage adjustments and any specific recommendations.

Remember, the information provided here is general, and individual circumstances may vary. It’s crucial to consult with your healthcare provider for personalized advice based on your specific health condition and needs.