Ingrezza (Valbenazine) - Oral

Additional Content Provided and Reviewed by IBM Micromedex

What Is Ingrezza?

Ingrezza (valbenazine) is an oral prescription medication used to treat and prevent tardive dyskinesia, a movement disorder that develops as a side effect of certain medications. It is available in capsule form.

Ingrezza is a vesicular monoamine transporter 2 (VMAT2) inhibitor that reduces the release of extra amounts of certain neurotransmitters (dopamine) in the brain. Dopamine helps to control movement. It is thought that too much dopamine release in the brain causes the symptoms of tardive dyskinesia.

Drug Facts

  • Generic Name: Valbenazine
  • Brand Name(s): Ingrezza
  • Administration Route(s): Oral
  • Drug Availability: Prescription
  • Therapeutic Classification: Central nervous system agent
  • Available Generically: No
  • Controlled Substance: N/A
  • Active Ingredient: Valbenazine
  • Dosage Form(s): Capsule

What Is Ingrezza Used For?

The Food and Drug Administration (FDA) approved Ingrezza for the treatment of adults with tardive dyskinesia. This condition can develop as a result of taking antipsychotic medications and some of the medications that are used to treat gastrointestinal problems. Most people who take these medications do not experience tardive dyskinesia.

Tardive dyskinesia causes recurrent involuntary movements, such as lip-smacking, facial gestures, and/or writhing movements of the extremities. It can be noticeable to others, and it can be distressing to the person experiencing it, although some people do not notice or become disturbed by their own symptoms. The movements of tardive dyskinesia are not harmful to your health, and they are not painful. Ingrezza does not permanently cure this condition but it helps with the symptoms.

Depending on the condition being treated, your healthcare provider may adjust or stop the medication that's causing tardive dyskinesia. Often, however, the medication that’s causing tardive dyskinesia is effective and crucial for controlling symptoms (such as psychosis). It might not be safe to make any changes, despite the side effects.

How to Take Ingrezza

Take Ingrezza as directed by your healthcare provider. In order for it to be effective, this medication must be taken daily, without skipping or changing your dose. You can take the capsule with or without food.

Storage

Keep this medication in its original container and away from the reach of children or pets. 

Store at a room temperature of 68 F to 77 F, away from light and moisture. You can briefly expose the medication to temperatures of 59 F to 86 F. Do not store it in the bathroom.

Properly discard this medication when it is expired or no longer needed. Do not flush medications down the toilet or pour them into a drain unless instructed to do so.

Off-Label Uses

Healthcare providers sometimes prescribe Ingrezza off-label for other purposes. Off-label use means a medication is prescribed for a condition that it is not specifically approved to treat.

Ingrezza can be used off-label to treat:

  • Tics: Tics are recurrent, involuntary, and brief muscle movements. Sometimes they involve a sequential pattern that includes several movements in a row. They can occur as part of Tourette’s syndrome or due to damage in the brain.
  • Chorea: Chorea is an involuntary type of movement characterized by twisting motions of the body. It can have several causes, including Huntington’s disease, medication, brain damage, and more.

The recommended dosage for Ingrezza when it is used off-label has not been well established.

How Long Does Ingrezza Take to Work?

Ingrezza can start to be detected in the blood within an hour of taking it. You can expect to notice the therapeutic effects within several days and a consistent effect within one week.

What Are the Side Effects of Ingrezza?

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.

Ingrezza can cause several side effects. The side effects can range from mild to severe, although many people do not experience side effects at all.

Common Side Effects

The most common side effects of Ingrezza include:

  • Fatigue
  • Balance problems and falls
  • Headaches
  • Nausea and vomiting
  • Joint pain
  • Extreme restlessness
  • Parkinsonism: This condition causes symptoms that resemble the symptoms of Parkinson’s disease. The symptoms of Parkinsonism can include a tremor, shaking, slow movements, and rigid movements. The difference between Parkinson’s disease and Parkinsonism is that Parkinson’s disease is associated with gradually progressive degeneration of certain brain areas. In contrast, Parkinsonism is usually caused by something else (e.g., medication).

Talk to your healthcare provider if you develop these side effects of Ingrezza, even if they are tolerable for you. While you might be able to stay on the medication, your provider must be aware of your symptoms so they can note any changes.

Severe Side Effects

Sometimes Ingrezza can cause serious and potentially dangerous side effects.

Severe side effects of Ingrezza include:

  • Hypersensitivity: A severe allergic reaction can cause trouble breathing
  • Somnolence: Profound tiredness that makes it difficult for you to function
  • QT prolongation: A heart problem that causes an altered heart rate and can result in symptoms such as shortness of breath, dizziness, or fainting
  • Anticholinergic effects: Can cause a dry mouth, blurred vision, constipation, and blood pressure changes; may affect your heart and lung function, and can be dangerous

Get medical attention promptly if you begin to experience the severe side effects of Ingrezza.

Long-Term Side Effects

Rarely, the Parkinsonism caused by Ingrezza can continue even after the medication is stopped.

Report Side Effects

Ingrezza 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 (1-800-332-1088).

Dosage: How Much Ingrezza Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex

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 (capsules):

For tardive dyskinesia:

  • Adults—At first, 40 milligrams (mg) once a day. After 1 week, your doctor may increase your dose to 80 mg once a day. Your doctor may adjust your dose to 40 or 60 mg once a day as needed and tolerated.
  • Children—Use and dose must be determined by your doctor.

Modifications

People with moderate to severe liver impairment may need a dosage reduction.

Missed Dose

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

Overdose: What Happens If I Take Too Much Ingrezza?

Taking too much of this medication can increase the risk of side effects. Seek medical attention if you think you may have taken too much Ingrezza. You may need observation or treatment for the effects of an overdose.

What Happens If I Overdose On Ingrezza?

If you think you or someone else may have overdosed on Ingrezza, call a healthcare provider or the Poison Control Center (1-800-222-1222).

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

Precautions

Drug Content Provided and Reviewed by IBM Micromedex

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

This medicine may cause some people to become sleepy or drowsy. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that requires you to be alert.

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 or anyone in your family has ever had a heart rhythm problem, including QT prolongation.

This medicine may cause Parkinson-like symptoms. Check with your doctor if you have difficulty with moving, loss of ability to move muscles voluntarily, clumsiness or unsteadiness, drooling, or trembling and shaking of the fingers and hands.

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 Ingrezza?

Other medical conditions may affect the use of this medication. Tell your healthcare provider if you have underlying health problems, such as:

  • Heart rhythm problems (e.g., arrhythmia, congenital long QT syndrome)
  • Liver disease

It is not advised to breastfeed during treatment with Ingrezza and for five days after the final dose.

Ingrezza may also cause harm to unborn babies if taken during pregnancy. Talk to your healthcare provider if you are pregnant or plan to become pregnant.

What Other Medications Interact With Ingrezza?

Ingrezza can interact with other medications. Some medications are contraindicated with Ingrezza, meaning they should not be used at the same time. Other medications may interact with Ingrezza and can still be taken, but may require dosing adjustments.

Do not take the following medications with Ingrezza:

  • Monoamine oxidase inhibitors (MAOIs) (e.g., linezolid, selegiline, isocarboxazid, phenelzine)
  • Strong CYP3A4 inducers (e.g., itraconazole, ketoconazole, clarithromycin)

Dose changes may be needed when taking Ingrezza with: 

  • Strong CYP3A4 inhibitors (e.g., indinavir for HIV, rifampin, carbamazepine, phenytoin, St. John’s wort): Your healthcare provider will reduce your Ingrezza dose when taking these medications.
  • Strong CYP2D6 inhibitors (e.g., antidepressants such as fluoxetine, paroxetine, quinidine): Your healthcare provider may reduce your dose of Ingrezza if you take these medications. 
  • Digoxin: Your healthcare provider should monitor digoxin concentrations and adjust the digoxin dose as necessary.

Tell your healthcare provider about any medications, supplements, and herbs that you are taking or will start taking when you begin treatment with Ingrezza.

What Medications Are Similar?

Austedo (deutetrabenazine) is another VMAT2 inhibitor approved for chorea treatment in Huntington’s disease and tardive dyskinesia. Do not take Austedo and Ingrezza together.

Frequently Asked Questions

  • What is Ingrezza used for?

    Ingrezza is often prescribed to treat tardive dyskinesia, a movement disorder that can sometimes occur due to taking antipsychotic medications and certain medications used for treating gastrointestinal conditions.

  • How does Ingrezza work?

    It isn’t known how Ingrezza works exactly. It affects neurotransmitter activity in the brain and reversibly inhibits the VMAT2, a protein that regulates monoamine uptake in the nerves of the brain. This may help to prevent the involuntary movements of tardive dyskinesia.

  • What drugs should not be taken with Ingrezza?

    Do not take Ingrezza with monoamine oxidase inhibitors (MAOIs) or strong CYP3A4 inducers. There are many medications in these categories, so it is important to have your pharmacist check for drug interactions when prescribed Ingrezza.

  • What are the side effects of Ingrezza?

    This medication can cause tiredness, a hypersensitivity reaction, Parkinsonism (symptoms similar to Parkinson’s disease), or heart rhythm changes.

  • How do I safely stop taking Ingrezza?

    You should not suddenly stop taking this medication. Follow instructions for stopping as provided by your healthcare provider.

How Can I Stay Healthy While Taking Ingrezza?

Take Ingrezza and the medication causing your tardive dyskinesia every day as directed by your healthcare provider. Do not make any adjustments to any of your medications without consulting with your provider, as this can worsen any underlying medical conditions.

People who are considered poor CYP2D6 metabolizers are at increased risk of side effects from Ingrezza. This problem can be detected with a genetic test. Your provider may recommend this test for you and adjust your medication as needed.

Additionally, be sure to manage your underlying medical issue:

  • If you have a psychiatric condition, see your psychiatrist and therapist as recommended. 
  • If you have a gastrointestinal condition, follow any dietary guidelines to keep your condition under control.

Contact your healthcare team if your condition worsens while you are taking Ingrezza.

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.

Was this page helpful?
5 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.
  1. Farber RH, Angelov A, Kim K, et al. Clinical development of valbenazine for tics associated with Tourette syndrome. Expert Rev Neurother. 2021 Apr;21(4):393-404. doi:10.1080/14737175.2021.1898948

  2. Ganz ML, Chavan A, Dhanda R, et al. Cost-effectiveness of valbenazine compared with deutetrabenazine for the treatment of tardive dyskinesia. J Med Econ. 2021 Jan-Dec;24(1):103-113. doi:10.1080/13696998.2020.1867443

  3. Food and Drug Administration. Ingrezza label. Updated April 2021.

  4. Feinstein E, Walker R. An update on the treatment of chorea. Curr Treat Options Neurol. 2018 Sep 25;20(10):44. doi:10.1007/s11940-018-0529-y

  5. Uhlyar S, Rey JA. Valbenazine (Ingrezza): The first FDA-approved treatment for tardive dyskinesia. P T. 2018 Jun;43(6):328-331. PMID: 29896031