Treatment of adults with Tardive Dyskinesia.
Neuromuscular Disorder Drug
Valbenazine and its active metabolites bind to and inhibit vesicular monoamine transporter 2 (VMAT2) with high selectivity with no significant binding to VMAT1. This prevents the reuptake and storage of monoamine neurotransmitters noradrenaline, dopamine, and serotonin in synaptic vesicles making them vulnerable to metabolism by cytosolic enzymes. The presynaptic release of monoamine neurotransmitters is decreased due to the lack of vesicles with packaged neurotransmitters ready for release into the synapse. Neither valbenazine nor its active metabolite exhibits significant off-target binding at dopamine, serotonin, or adrenaline receptors.
The initial daily dose is 40 mg. After one week, the daily dose should be increased to the recommended 80 mg. Some patients may benefit from continuing to take 40 mg once daily. Oral administration with or without sustenance.
Concomitant use of Valbenazine and MAOIs may increase the concentration of monoamine neurotransmitters in synapses, increasing the risk of adverse reactions such as serotonin syndrome or diminishing the efficacy of Valbenazine. Avoid using Valbenazine concurrently with MAOIs. Valbenazine combined with potent CYP3A4 inhibitors enhanced exposure (Cmax and AUC) to valbenazine and its active metabolite compared to valbenazine alone. Reduce the dose when co-administering valbenazine with a potent CYP3A4 inhibitor. Consider reducing the dose based on tolerance when co-administering valbenazine with a potent CYP2D6 inhibitor. The concurrent use of potent CYP3A4 inducers and valbenazine is not advised. When co-administering valbenazine and digoxin, digoxin concentrations should be monitored. Increased digoxin exposure may increase the risk of adverse reactions related to exposure.
Patients with congenital long QT syndrome or arrhythmias associated with prolonged QT interval. Concomitant use with MAOIs (e.g. isocarboxazid, phenelzine, selegiline).
Somnolence, QT Prolongation
The limited available data on Valbenazine use in pregnant women are insufficient to inform a drug-associated risk. A woman should not breastfeed during treatment with valbenazine and for 5 days after the final dose.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, admit hospital.
Store below 25°C, in a cool & dry place. Keep away from light. Keep all the medicines out of the reach of children.
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