Valbenazine
Indications
Valbenazine is used for:
Tardive Dyskinesia
Adult Dose
Tardive Dyskinesia
Indicated for treatment of tardive dyskinesia in adults
40 mg PO qDay x1 week, then increase to the recommended dose of 80 mg PO qDay
Continuation of 40 mg once daily may be considered for some patients
Hepatic impairment
Mild: No dose adjustment required
Moderate-to-severe (Child-Pugh 7-15): Not to exceed 40 mg/day
Child Dose
Renal Dose
Renal impairment
Mild-to-moderate (CrCl 30-90 mL/min): No dose adjustment required
Severe (CrCl <30 mL/min): Use not recommended
Administration
May take with or without food
Contra Indications
Patients with a history of hypersensitivity to drug or components of the formulation
Precautions
Can cause somnolence; warn patients not to perform activities requiring mental alertness (eg, driving or operating hazardous machinery) until they know how they will be affected
Pregnancy-Lactation
Pregnancy
Data are limited on use in pregnant women
Based on animal studies, may cause fetal harm; advise pregnant women of the potential risk
Lactation
Unknown if distributed in human breast milk
Valbenazine and its metabolites have been detected in rat milk at concentrations higher than in plasma following oral administration at doses 0.1-1.2 times the MRHD based on mg/m²
Interactions
Adverse Effects
Side effects of Valbenazine :
>10%
Somnolence (10.9%)
1-10%
Anticholinergic effects (5.4%)
Balance disorders/fall (4.1%)
Headache (3.4%)
Akathisia (2.7%)
Vomiting (2.6%)
Nausea (2.3%)
Arthralgia (2.3%)
Mechanism of Action
The mechanism of action of valbenazine in the treatment of tardive dyskinesia is unknown, but is thought to be mediated through the reversible inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release