valbenazine

Valbenazine is a prescription medication approved for the treatment of tardive dyskinesia in adults. It is marketed as Ingrezza and belongs to a class of drugs known as vesicular monoamine transporter 2 (VMAT2) inhibitors. Valbenazine is a prodrug that is converted in the body to active metabolites that reduce the storage and release of monoamines, particularly dopamine, from presynaptic neurons. By lowering dopaminergic activity in relevant brain circuits, it helps diminish the involuntary movements characteristic of tardive dyskinesia.

The drug is taken orally once daily. The typical titration starts at 40 mg once daily for about one week, followed by an increase to 80 mg once daily, which is the usual maintenance dose. It can be taken with or without food. Dosing may be adjusted based on tolerance, response, and potential drug interactions. Valbenazine is metabolized in the liver, primarily involving CYP enzymes, and care is advised when coadministering with strong inhibitors or inducers of these enzymes.

Common adverse effects reported in clinical use include somnolence (sleepiness), fatigue, headache, and nausea. Other effects can include dry mouth and lightheadedness. Valbenazine has the potential to prolong the QT interval in susceptible individuals, so baseline and follow-up ECG monitoring may be recommended for patients with preexisting cardiac risk or concurrent QT-prolonging medications. It is not recommended during pregnancy unless clearly needed, and breastfeeding is generally advised against. Caution is advised in hepatic impairment, and clinicians may adjust dosing when significant liver function concerns are present. Valbenazine is one option among VMAT2 inhibitors for tardive dyskinesia, alongside related agents such as deutetrabenazine and tetrabenazine.