Ingrezza Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Ingrezza Capsule (valbenazine) is a prescription VMAT2 inhibitor used in adults to help control certain movement disorders, including tardive dyskinesia and chorea associated with Huntington's disease. It comes as a capsule you swallow or a sprinkle capsule you can open and mix with soft food. It works by lowering dopamine release in the brain to calm overactive signals that cause uncontrolled movements. Ingrezza manages symptoms but does not cure the underlying condition.

What is Ingrezza Capsule

Ingrezza is a prescription medicine that comes as a capsule you swallow or as a sprinkle capsule you can open and mix with soft food. It is used in adults to help control certain movement disorders. Its generic name is valbenazine, and it belongs to the VMAT2 inhibitor drug class.

Ingrezza Capsule uses

• Tardive dyskinesia
• Involuntary movements caused by long-term antipsychotic use
• Repetitive facial movements
• Uncontrolled tongue and jaw movements
• Huntington's disease chorea (in certain formulations/indications, depending on country approval)

Benefits of Ingrezza Capsule

• Helps treat tardive dyskinesia
• Reduces involuntary movements
• Helps control repetitive facial movements
• Helps reduce uncontrolled body movements
• Treats chorea associated with Huntington's disease

How Ingrezza Capsule works

Ingrezza blocks a protein in the brain called VMAT2, which controls how much dopamine is released. By lowering the amount of dopamine released, it helps calm the overactive signals that cause uncontrolled movements. It controls symptoms but does not cure the underlying condition.

Ingrezza Capsule dosage

Take Ingrezza once a day, with or without food, at about the same time each day. Swallow capsules whole with water; do not crush, split, or chew them. Sprinkle capsules can be swallowed whole with water, or opened and sprinkled onto about a tablespoon of soft food such as yogurt or applesauce, then eaten and followed with a glass of water. Do not mix the sprinkle capsule contents into water or milk. If using the sprinkle method, the mixture can be kept at room temperature for up to 2 hours before taking it.

Do not stop taking this medicine without talking to your doctor first. If you take an antipsychotic medication, you can usually continue taking it while using Ingrezza, but check with your doctor.

Available forms and strengths

• Oral capsule (40 mg, 60 mg, 80 mg)

Side effects of Ingrezza Capsule

Common

• Sleepiness or tiredness
• Dry mouth
• Constipation
• Blurred vision
• Difficulty emptying your bladder
• Dizziness
• Falling or balance problems
• Headache
• Restlessness or feeling agitated
• Nausea or vomiting
• Weight gain
• Joint pain
• Mild allergic reaction (skin rash, itchiness, hives)
• Trouble falling or staying asleep

Serious

• Severe allergic reaction, including swelling of the face, lips, tongue, or throat and difficulty breathing
• Neuroleptic malignant syndrome (rigid muscles, high fever, confusion, fast or irregular heartbeat)
• Depression and suicidal thoughts or actions, especially in people with Huntington's disease
• Parkinson-like symptoms (tremors, drooling, stiffness, trouble walking or keeping balance)
• Heart rhythm problems (QT prolongation), with symptoms such as fast, slow, or irregular heartbeat, dizziness, fainting, or shortness of breath

Warnings and precautions

• Ingrezza carries the FDA's most serious warning (boxed warning) for depression and suicidal thoughts or actions in people with Huntington's disease.
• Ingrezza may cause an increase in heart rhythm (QT interval) that can be serious, especially when combined with certain other drugs or in people who process the drug more slowly.
• Ingrezza should be avoided with MAOI medicines, as the combination can cause serious effects including serotonin syndrome.
• Parkinson-like symptoms have been reported, sometimes severe enough to require hospital care, usually within the first two weeks of starting the drug or increasing the dose.
• Taking Ingrezza with digoxin can raise digoxin levels in the body, which may require monitoring and dose adjustment.
• It isn't known if Ingrezza can harm a developing baby in humans, but animal studies showed possible risks. Tell your doctor if you are pregnant or planning to become pregnant.
• Breastfeeding should be avoided while taking Ingrezza and for 5 days after the last dose, since it isn't known if the drug passes into breast milk.
• No dosage change is needed for kidney problems, since the drug does not primarily clear through the kidneys.
• People with moderate or severe liver problems need a lower dose of Ingrezza. Tell your doctor if you have liver disease.
• Drinking alcohol while taking Ingrezza may not be safe, since both can cause tiredness and sleepiness, and together they can slow breathing. Talk to your doctor about how much alcohol, if any, is safe for you.
• Ingrezza can make you sleepy and slow your reaction time, so avoid driving or operating machinery until you know how the medicine affects you.

Storage

• Store capsules at 59°F to 86°F (15°C to 30°C)
• Store Sprinkle capsules between 68°F to 77°F (20°C to 25°C)
• Keep the bottle tightly closed to protect sprinkle capsules from moisture
• Sprinkle capsule granules added to soft food can be stored for up to 2 hours at room temperature between 68°F to 77°F (20°C to 25°C); after 2 hours, throw away any unused portion
• Keep out of the reach of children

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as swelling of the face, lips, tongue, or throat, or trouble breathing.
• Call your doctor right away if you notice new or worsening depression, unusual mood or behavior changes, or thoughts of harming yourself.
• Call your doctor at once if you have extreme drowsiness, fast, slow, or uneven heartbeats, pounding or fluttering in your chest, shortness of breath, or a light-headed feeling like you might pass out.
• Seek care right away for symptoms of neuroleptic malignant syndrome, such as high fever, stiff muscles, confusion, irregular pulse or blood pressure, or fast/uneven heartbeat.
• Tell your doctor if you develop Parkinson-like symptoms such as tremors, stiffness, drooling, or trouble walking or keeping balance.
• If you think you've taken too much of this medicine, contact your doctor or local poison control center right away, or seek emergency care if symptoms are severe.

Alternatives

• Tetrabenazine
• Risperidone
• Deutetrabenazine