How does Austedo work?

Austedo is a VMAT2 inhibitor that temporarily and reversibly reduces the amount of monoamine neurotransmitters in the brain, which is believed to play a role in its inhibition of involuntary movements.

What drugs should not be taken with Austedo?

Do not take this medication with Xenazine (tetrabenazine), Ingrezza (valbenazine), reserpine, monoamine oxidase inhibitors (MAOIs), or medications that are known to cause prolonged QT.

How do I safely stop taking Austedo?

You can stop taking Austedo without tapering the dose. You may experience chorea within 12 to 18 hours after you stop taking it.

Austedo (Deutetrabenazine) Oral: Uses, Side Effects, Dosages

Warning:

Austedo (deutetrabenazine) can increase the risk of depression and suicidal thoughts and behavior in people with Huntington's disease. It's important to balance this risk with your current medical needs. When taking Austedo, your healthcare provider will work with you to help look for any symptoms of emerging or worsening depression, suicidality, or changes in behavior.

This medication is contraindicated in people who are suicidal and in people with untreated or inadequately treated depression.

…

What Is Austedo?

Austedo (deutetrabenazine) is a medication that is prescribed to treat the symptoms of certain involuntary movement disorders. It belongs to a class of drugs called vesicular monoamine transporter 2 (VMAT2) inhibitors.

Austedo treats chorea, a type of involuntary movement caused by Huntington’s disease, as well as tardive dyskinesia, which is a side effect of antipsychotic medications.

Austedo works to reduce the amount of monoamine neurotransmitters (e.g., dopamine) released in the brain from nerve terminals. Dopamine is related to the involuntary movements of tardive dyskinesia and chorea.

This medication comes in tablet form to be taken by mouth.

Drug Facts

Generic Name: Deutetrabenazine

Brand Name(s): Austedo

Administration Route(s): Oral

Drug Availability: Prescription

Therapeutic Classification: Central nervous system agent

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Deutetrabenazine

Dosage Form(s): Tablet

What Is Austedo Used For?

When used on a daily basis, Austedo helps the symptoms of tardive dyskinesia and chorea caused by Huntington’s disease.

The Food and Drug Administration approved Austedo to treat the symptoms of:

Chorea: Chorea is a recurrent, abrupt, jerking movement of the body. It is one of the symptoms of Huntington’s disease, a progressive neurological disorder that causes movement problems and dementia.
Tardive dyskinesia: This condition is characterized by repetitive movements of the face, eyes, mouth, or body. It can develop as a side effect of antipsychotic medications, which are often prescribed for the treatment of schizophrenia, bipolar disorder, or certain gastrointestinal conditions. Tardive dyskinesia does not affect everyone who takes these medications, and it often resolves after stopping the medication causing its symptoms. However, it can sometimes continue after the medication is stopped.

Austedo is a symptomatic treatment that does not cure or reverse the underlying disease. Once you stop taking Austedo, you can expect the involuntary movements to resume. Huntington’s disease is a progressively worsening condition, and your underlying chorea can become more severe during the time that you are taking Austedo.

Verywell / Zoe Hansen

How to Take Austedo

Take this medication with food and swallow the tablets whole with water. Do not chew, crush, or break the tablets.

Storage

Keep Austedo in its original container, and store it away from light or moisture. Keep it at a standard room temperature of 77 F. You can briefly store this medication in a temperature range of 59 F to 86 F.

Off-Label Uses

Healthcare providers sometimes prescribe drugs off-label for medical conditions that are not listed on the product label. In this case, a health professional determines whether a patient will benefit from taking this medication.

Austedo has been used off-label to control involuntary movements associated with tic disorders.

How Long Does Austedo Take to Work?

Austedo can have an effect on your symptoms within a few days after you begin taking it. The dose may be gradually increased to reach a target dose, and this increase may improve your symptoms.

What Are the Side Effects of Austedo?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Austedo can cause mild to moderate side effects, as well as serious adverse effects. Talk to your healthcare provider about your side effects. Your provider might be able to adjust your medication dose or timing to minimize these effects. You might also benefit from treatment to reduce your symptoms.

Common Side Effects

Common side effects of Austedo can be tolerable for some people; in other cases, they can be distressing.

The most common side effects of Austedo are:

Sleepiness
Diarrhea
Dry mouth
Fatigue
Nasopharyngitis (symptoms of a cold)
Insomnia

Severe Side Effects

Austedo can cause serious side effects that can be dangerous to your health.

Severe side effects of Austedo include:

Neuroleptic malignant syndrome (NMS): This serious condition causes a fever, confusion, rigid muscles, and alterations in body functions. It requires urgent medical treatment and can be fatal.
Parkinsonism: Parkinsonism causes symptoms that resemble those of Parkinson’s disease, such as stiff movements and tremors.
QT prolongation: This condition affects the heart rhythm. It may not cause symptoms, but it can cause problems such as lightheadedness or fainting. Your medical provider might monitor your heart rhythm with an electrocardiogram (EKG) while you are taking Austedo.
Depression: Severe depression can develop while taking this medication.
Suicidal thoughts or action: People who are taking Austedo can have thoughts of suicide or plans of suicide. Your provider may monitor these symptoms periodically while you are taking this medication.

If you or a loved one is taking Austedo, be sure to have a plan regarding urgent medical attention in the event that you experience any of these serious side effects.

Long-Term Side Effects

Austedo leaves the body within a few days of stopping the medication. However, you can have lasting problems due to the serious side effects, especially if they are not treated.

Report Side Effects

Austedo may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Austedo Should I Take?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (tablets):
- For tardive dyskinesia and chorea caused by Huntington's disease:
  - Adults—At first, 12 milligrams (mg) per day taken in 2 divided doses (6 mg two times a day). Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 48 mg per day.
  - Children—Use and dose must be determined by your doctor.

Modifications

There is not enough research to determine the safety of Austedo use during pregnancy. However, animal studies have shown an increased rate of stillbirths and post-birth mortality. If you are pregnant or plan to become pregnant, discuss how to best manage your medication use with your healthcare provider.

Additionally, experts don’t know if Austedo passes into breast milk during breastfeeding. Your provider will advise you on the best way to feed your baby during treatment.

Your provider might adjust your dose of Austedo if you take certain medications or do not metabolize certain medications well. These medications are known as CYP2D6 inhibitors (e.g., quinidine, fluoxetine, bupropion, and some antidepressants).

Missed Dose

If you miss a dose, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and return to your normal dosing frequency. Do not double up on doses.

Overdose: What Happens If I Take Too Much Austedo?

Taking too much Austedo can cause symptoms of:

Acute dystonia (severe muscle contraction)
Oculogyric crisis (eye movement deviation)
Nausea and vomiting
Sweating
Extreme tiredness
Low blood pressure
Confusion
Diarrhea
Hallucinations (seeing things that are not present)
Flushing
Tremors

If you have taken too much Austedo, a healthcare professional may monitor you for symptoms, including monitoring your blood pressure and heart rhythm. You would be treated symptomatically as needed.

What Happens If I Overdose on Austedo?

If you think you or someone else may have overdosed on Austedo, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Austedo, call 911 immediately.

911

Precautions

It is very important that your doctor check your progress at regular visits to see if the medicine is working properly and to allow for changes in the dose.

Deutetrabenazine may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed, especially if they have a condition called Huntington's disease. If you or your caregiver notice any of these side effects, tell your doctor right away.

Do not take this medicine if you are also taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan®), phenelzine (Nardil®), selegiline (Eldepryl®), or tranylcypromine (Parnate®) within 14 days of each other. If you have questions, check with your doctor.

Do not take this medicine if you are also taking reserpine (Serpalan® or Renese®-R). Wait at least 20 days after stopping reserpine before starting deutetrabenazine. If you have questions, check with your doctor.

Do not take this medicine if you are also taking tetrabenazine (Xenazine®) or valbenazine (Ingrezza®). Take deutetrabenazine one day after stopping tetrabenazine. If you have questions, check with your doctor.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you had a heart rhythm problem, such as QT prolongation.

Check with your doctor right away if you have difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, seizures, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).

Check with your doctor right away if you have an inability to sit still, need to keep moving, or restlessness. These could be symptoms of a movement disorder called akathisia.

This medicine may cause parkinsonism (a movement disorder). Check with your doctor right away if you have difficulty swallowing, loss of balance control, mask-like face, shuffling walk, slowed movements, slurred speech, stiffness of the arms and legs, tic-like or jerky movements of the head, face, mouth, and neck, or trembling and shaking of the fingers and hands.

This medicine may cause drowsiness, trouble with thinking, or trouble with controlling movements. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. Also, lying down for a while may relieve dizziness or lightheadedness. If the problem continues or worsens, check with your doctor.

Check with your doctor before using this medicine with alcohol or other medicines that affect the central nervous system (CNS). This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, barbiturates or medicine for seizures, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop taking this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Austedo?

You should not take this medication if you are depressed or have thoughts of suicide, since Austedo can make these conditions worse. Before taking Austedo, make sure to let your provider know of any medical conditions.

What Other Medications Interact With Austedo?

You should not take Austedo with:

Tetrabenazine or valbenazine
Monoamine oxidase inhibitors (MAOIs)
Medications that can cause QT prolongation
Reserpine (a medication used to treat high blood pressure)
Alcohol or sedating drugs

Austedo can interact with paroxetine, fluoxetine, quinidine, and other medications that are considered strong CYP2D6 inhibitors. Your provider might change your Austedo dose if you take any of these medications.

Taking Austedo with dopamine antagonists or antipsychotics can also increase the risk of Parkinsonism.

What Medications Are Similar?

Besides Austedo, other VMAT2 inhibitors include:

Xenazine (tetrabenazine): Used to treat chorea in Huntington’s disease
Ingrezza (valbenazine): Used to treat tardive dyskinesia

Your provider might have you switch from one of these medications to another due to the persistence of symptoms, side effects, or health insurance considerations.

If you switch from tetrabenazine to Austedo, you should discontinue tetrabenazine and start your treatment with Austedo the next day. Talk to your prescriber about how to convert your dosing.

Frequently Asked Questions

What is Austedo used for?

This medication is approved for the prevention and treatment of symptoms associated with chorea in Huntington’s disease and tardive dyskinesia, a side effect of antipsychotic medication.
How does Austedo work?

Austedo is a VMAT2 inhibitor that temporarily and reversibly reduces the amount of monoamine neurotransmitters in the brain, which is believed to play a role in its inhibition of involuntary movements.
What drugs should not be taken with Austedo?

Do not take this medication with Xenazine (tetrabenazine), Ingrezza (valbenazine), reserpine, monoamine oxidase inhibitors (MAOIs), or medications that are known to cause prolonged QT.
What are the side effects of Austedo?

This medication can cause mild to moderate fatigue, sleepiness, diarrhea, dry mouth, nasopharyngitis, and/or insomnia. Serious side effects can include depression, suicidal thoughts or actions, Parkinsonism, neuroleptic malignant syndrome, and/or QT prolongation.
How do I safely stop taking Austedo?

You can stop taking Austedo without tapering the dose. You may experience chorea within 12 to 18 hours after you stop taking it.

How Can I Stay Healthy While Taking Austedo?

There are several important considerations to keep in mind when you use Austedo. This medication can cause serious side effects, and it is important that you get medical attention if you develop signs of serious side effects.

To stay healthy while taking this medication, you should:

Use it as directed.
Take your other medications (such as antipsychotics) as directed.
Tell your healthcare provider about any side effects that you experience.
Maintain consistent care for your psychiatric illness, Huntington’s disease, or gastrointestinal condition.
Seek emergency medical attention if you begin to experience any of the serious side effects.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Claassen DO, Philbin M, Carroll B. Deutetrabenazine for tardive dyskinesia and chorea associated with Huntington's disease: a review of clinical trial data. Expert Opin Pharmacother. 20(18):2209-2221. doi:10.1080/14656566.2019.1674281
Food and Drug Administration. Austedo label.
Koch J, Shi WX, Dashtipour K. VMAT2 inhibitors for the treatment of hyperkinetic movement disorders. Pharmacol Ther. 212:107580. doi:10.1016/j.pharmthera.2020.107580

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.

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Austedo (Deutetrabenazine) - Oral