Frequently Asked Questions
What is Xenazine?
Xenazine® (tetrabenazine) treats a Huntington's disease symptom called chorea (Kor-EE-ya),
or involuntary movements. These movements can be brief, repetitive, jerky, or uncontrolled
and dance-like.
Xenazine may reduce the chorea associated with HD so that patients can regain some control
over their movements. Xenazine does not cure the cause of Huntington's chorea, nor
does it treat any other Huntington's disease symptoms, such as problems with emotions
or thinking. It`s not known whether Xenazine is safe and effective in children.
How does Xenazine work?
Xenazine® (tetrabenazine) reduces the activity of chemicals in the brain called monoamines, that
include dopamine (DOH-puh-meen). Dopamine helps control body movements. Although
the exact mechanism of action is not known, it is thought that by reducing the amount
of dopamine, Xenazine will lessen the chorea.
In clinical studies, Xenazine reduced chorea in more than two-thirds of the individuals
who took it. On the Clinical Global Impression (CGI) scale, a scale that doctors
and researchers use to rate symptom severity or how effective treatments are, 69%
of patients improved with Xenazine compared with 24% of patients treated with a
placebo (sugar pill).
Xenazine does not cure the cause of chorea, nor does it treat other symptoms of
Huntington's disease, such as problems with thinking or emotions.
Who should not take Xenazine?
Do not take Xenazine® (tetrabenazine) if you:
- are depressed or have thoughts of suicide.
- have liver problems.
- are taking a monoamine oxidase inhibitor (MAOI) medicine. Ask your doctor or pharmacist
if you are not sure.
- are taking reserpine. Do not take medicines that contain reserpine (such as Serpalan®
and Renese®-R) with Xenazine. If your doctor plans to switch you from taking reserpine
to Xenazine, you must wait at least 20 days after your last dose of reserpine before
you start taking Xenazine.
What should I tell my doctor before taking Xenazine?
Tell your doctor about all your medical conditions, including if you:
- have emotional or mental problems (for example, depression, nervousness, anxiety,
anger, agitation, psychosis, previous suicidal thoughts or suicide attempts).
- have liver disease.
- have any allergies. See the end of the
Medication Guide for a complete list of the ingredients in Xenazine® (tetrabenazine).
- have breast cancer or a history of breast cancer.
- have heart disease that is not stable, have heart failure or recently had a heart
attack.
- have an irregular heartbeat (cardiac arrhythmia).
- are pregnant or plan to become pregnant. It is not known if Xenazine can harm your
unborn baby.
- are breast-feeding. It is not known if Xenazine passes into breast milk.
Tell your doctor about all the medicines you take, including prescription medicines
and nonprescription medicines, vitamins and herbal products. Using Xenazine with
certain other medicines may cause serious side effects. Do not start any new medicines
while taking Xenazine without talking to your doctor first.
How do I take Xenazine?
Tablets not actual size
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Xenazine® (tetrabenazine) is a tablet you swallow. You can take Xenazine with or without food. Xenazine
comes in two different tablet sizes, 12.5 milligrams (mg) and 25 mg.
You should always take Xenazine as prescribed by your doctor. Depending on you or
your loved one's condition and previous history with taking Xenazine, your doctor
will start slowly and may increase the strength and number of tablets (dose) you
take over the course of several weeks up to a few months.
Tell your doctor if you stop taking Xenazine for more than 5 days. Do not take another dose until you talk to your doctor.
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The process of slowly increasing your dose is also known as titration. Your doctor
may give you a
dosing schedule to help you keep track of when and how much Xenazine to
take.
While taking Xenazine, it is important to remain patient since it may take awhile
for your physician to find the right dose that works for you. During this time,
you may experience some side effects,
so be sure to communicate with your doctor about how you are feeling. Your doctor
may adjust your dose.
What are the possible side effects of Xenazine?
Xenazine® (tetrabenazine) can cause serious side effects, including:
- Depression, suicidal thoughts, or actions.
- Neuroleptic Malignant Syndrome (NMS), a potentially fatal side affect. Call your doctor right away and go to the
nearest emergency room if you develop these signs and symptoms that do not have
another obvious cause:
- high fever
- stiff muscles
- problems thinking
- very fast or uneven heartbeat
- increased sweating
- Parkinsonism. Symptoms of parkinsonism include: slight shaking, body stiffness,
trouble moving or keeping your balance.
- Restlessness. You may get a condition where you feel a strong urge to move.
This is called akathisia.
- Trouble swallowing. Xenazine may increase the chance that you will have trouble
swallowing. Increased coughing may be the first sign that you are having trouble
swallowing. Trouble swallowing increases your risk of pneumonia.
- Irregular heartbeat. Xenazine increases your chance of having certain changes
in the electrical activity in your heart which can be seen on an electrocardiogram
(EKG). These changes can lead to a dangerous abnormal heartbeat. Taking Xenazine
with certain medicines may increase this chance.
- Dizziness due to blood pressure changes when you change position (orthostatic
hypotension). Change positions slowly from lying down to sitting up and from
sitting up to standing when taking Xenazine. Tell your doctor right away if you
get dizzy or faint while taking Xenazine. Your doctor may need to watch your blood
pressure closely.
- Tardive dyskinesia (TD). TD is a condition where there is repeated facial
grimacing that cannot be controlled, sticking out of the tongue, smacking of the
lips, puckering and pursing of the lips, and rapid eye blinking. Xenazine works
like other drugs that can cause TD. If you get TD with Xenazine, it is possible
that the TD will not go away.
Common side effects with Xenazine include:
- sleepiness (sedation)
- trouble sleeping
- depression
- tiredness (fatigue)
- anxiety
- restlessness
- agitation
- nausea
Tell your doctor if you have any side effects. Do not stop taking Xenazine without
talking to your doctor first.
What happens if I skip a dose of Xenazine or stop taking it?
Before starting Xenazine® (tetrabenazine), you should talk to your health care provider about what
to do if you miss a dose. If you miss a dose and it is time for your next dose,
do not double the dose.
If you stop taking Xenazine, your chorea may return or worsen in 12 to 18 hours
after you took the last dose. Tell your doctor if you stop taking Xenazine for more
than 5 days. Do not take another dose until you talk to your doctor.
Xenazine has a boxed warning. What does that mean?
A Boxed Warning, according to the FDA, is the most serious warning for a prescription
medication. Boxed Warnings highlight important safety information and help doctors
and nurses understand how to handle it.
The Boxed Warning for Xenazine® (tetrabenazine) warns of the increase in risk of depression and suicidal
thoughts and behavior in patients taking Xenazine. Anyone considering
the use of Xenazine must balance the risks of depression and suicidality with the
clinical need for control of Huntington's chorea.
How much does Xenazine cost, and will my insurance pay for it?
The Xenazine® (tetrabenazine) Information Center (XIC) is available to talk to you about your prescription
coverage. They will make sure that they have your complete and accurate insurance
information. If you have not already provided this information, you need to tell
them if you have private medical insurance, Medicare, Medicaid, or any other prescription
drug coverage.
Most medical insurance policies require a co-payment from you before you get your
medicine. Your team member at the XIC will tell you what your co-payment will be
for Xenazine.
If you do not have prescription insurance, you may qualify to get Xenazine through
a patient assistance program. Your team member at the XIC can help you apply for
this assistance program. The XIC can be reached toll-free at 1-888-882-6013.
How do I get my prescription filled?
Xenazine® (tetrabenazine) is mailed to you from a Specialty Pharmacy—you cannot get it from a local
drugstore. Your Specialty Pharmacy will contact you to discuss any payments due
and confirm a proper shipping address. It may take up to two weeks before you receive
your medicine.
The Specialty Pharmacy will also remind you when it's time to refill your prescription
for Xenazine. Please read the
Medication Guide that comes with Xenazine every time you refill your prescription.