Recommended dose is 80 mg.
Adjust based on response and tolerability.
Capsules not actual size
Dosing INGREZZA and INGREZZA SPRINKLE in adults with TD or HD chorea
See dosing for TARDIVE DYSKINESIA (TD)
See dosing for Huntington’s disease (hd) chorea
Only INGREZZA offers a
therapeutic dose from Day 11:
No other VMAT2 inhibitor can offer
the simplicity of INGREZZA1:
Why wait?
Therapeutic dose from Day 1
Why titrate?
No required titration
Why overcomplicate?
Start with INGREZZA
Actor portrayal
GET YOUR PATIENTS STARTED ON INGREZZA RIGHT AWAY
Request samples of INGREZZA® (valbenazine) capsules today to start patients on treatment
The only VMAT2 inhibitor that offers an effective starting dosage you can adjust based on response and tolerability1
DOSING FOR Tardive dyskinesia (TD)
DOSING FOR
Tardive dyskinesia
DOSING FOR Huntington’s disease (HD) chorea
DOSING FOR
HD chorea
- Initial dosage of INGREZZA is 40 mg once daily for one week1
- After the first week, 80 mg is recommended once daily, but 40 mg or 60 mg once daily may be considered based on individual treatment needs, response, and tolerability1
Treat TD while preserving your patient’s antipsychotic regimen
Patients in 3 6-week controlled studies (KINECT, KINECT 2, KINECT 3) were allowed to remain on their stable psychiatric treatment regimen1:
85%
took second-generation antipsychotics
27%
took first-generation antipsychotics
In KINECT 3, the most common types of concomitant medications were2,3:
- Antipsychotics (85.5%)
- Antidepressants (66.5%)
- Anticholinergics (37.0%)
- Antiepileptics (35.2%)
- Anxiolytics (27.7%)
- ACE inhibitors (25.1%)
INGREZZA was proven across the widest range of patients1,4
INGREZZA1,3
Deutetrabenazine4
STUDIED?
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Hepatic impairment
STUDIED?
NO ADJUSTMENT REQUIRED for MILD impairment
40 MG RECOMMENDED for MODERATE/SEVERE impairment
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Risk for hyperprolactinemia
STUDIED?
Prolactin levels
NO RESTRICTIONS OR RECOMMENDATIONS
DOSE-RELATED INCREASE in prolactin observed
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Elderly Patients
(age 65+)
STUDIED?
NO ADJUSTMENT REQUIRED
STUDIED?
Dose selection should be cautious
INGREZZA1,3
Deutetrabenazine4
Renal impairment
STUDIED?
NO ADJUSTMENT REQUIRED
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Concomitant anticholinergics
(eg, benztropine)
STUDIED?
31%
patientsII
INCLUDED in pivotal studies
STUDIED?
EXCLUDED from pivotal studies
INGREZZA1,3
Deutetrabenazine4
Swallowing issues/
pill aversion
SPRINKLE FORMULATION
NO OPTION AVAILABLE
Dosing considerations do not imply differences in safety, efficacy, or clinical outcomes.
*See deutetrabenazine prescribing information section 8.6.
†See deutetrabenazine prescribing information section 8.5.
‡See deutetrabenazine prescribing information section 12.3.
§See deutetrabenazine prescribing information section 5.8.
IIINGREZZA-treated patients taking concomitant anticholinergics at baseline across clinical studies (KINECT, KINECT 2, KINECT 3, KINECT 4).
Recommended dose is 80 mg.
Adjust based on response and tolerability.
*Increase the dose in 20 mg increments every two weeks to the recommended dose.
Capsules not actual size
The initial dosage for INGREZZA is 40 mg once daily. Increase the dose in 20 mg increments every two weeks to the recommended dosage of 80 mg once daily. A dosage of 40 mg or 60 mg once daily may be considered depending on response and tolerability.1
INGREZZA was studied and proven effective in the widest range of patients1,3,4
INGREZZA1,3
Deutetrabenazine4
STUDIED?
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Hepatic impairment
STUDIED?
40 mg once daily
MODERATE-SEVERE IMPAIRMENT
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Renal impairment
STUDIED?
NO ADJUSTMENT REQUIRED
STUDIED?
INGREZZA1,3
Deutetrabenazine4
Elderly patients
(age 65+)
NO DOSE ADJUSTMENT REQUIRED
DOSE SELECTION SHOULD BE CAUTIOUS
INGREZZA1,3
Deutetrabenazine4
Swallowing issues/
pill aversion
SPRINKLE FORMULATION
NO OPTION AVAILABLE
Dosing considerations do not imply differences in safety, efficacy, or clinical outcomes.
†See deutetrabenazine prescribing information section 12.3.
‡See deutetrabenazine prescribing information section 8.6.
DRUG INTERACTIONS AND DOSING CONSIDERATIONS
The VMAT2 inhibitor with the most clinically informed dosing recommendations for drug interactions1
INGREZZA1
Deutetrabenazine4
STUDIED?
STUDIED?
INGREZZA1
Deutetrabenazine4
Strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine)
STUDIED?
90% increase in exposure to active metabolite
Recommended dosage is 40 mg/day
STUDIED?
550% increase in exposure to active metabolite
Max dosage of 36 mg/day
CYP2D6 >6x greater exposure with deutetrabenazine4
INGREZZA1
Deutetrabenazine4
Poor CYP2D6 metabolizers
STUDIED?
90% increase in exposure to active metabolite
Recommended dosage is 40 mg/day
STUDIED?
Max dosage of 36 mg/day
INGREZZA1
Deutetrabenazine4
Strong CYP3A4 inhibitors
(eg, itraconazole, ketoconazole, clarithromycin)
STUDIED?
110% increase in exposure to active metabolite
Recommended dosage is 40 mg/day
STUDIED?
INGREZZA1
Deutetrabenazine4
Strong CYP3A4 inducers
(eg, rifampin, phenytoin, carbamazepine, St. John’s wort)
STUDIED?
NO ADDED SAFETYADDED SAFETY CONCERNS
80% decrease in exposure to active metabolite
Not recommended due to subtherapeutic exposure
STUDIED?
Dosing considerations do not imply differences in safety, efficacy, or clinical outcomes
OTHER INTERACTIONS1:
P-gp substrates:
No dose adjustment required when taking INGREZZA with P-gp substrates (eg, calcium channel blockers, statins, antimicrobials) with the exception of digoxin. Concomitant use of INGREZZA with digoxin increased digoxin levels due to inhibition of intestinal P-gp; monitor and adjust digoxin if needed.
MAOIs:
VMAT2 inhibitors should not be used with MAOIs.
INGREZZA IS THE ONLY VMAT2 INHIBITOR TO OFFER A SPRINKLE FORMULATION1
For patients who will not or cannot take a pill**
**Do not administer INGREZZA SPRINKLE via nasogastric, gastrostomy, or other enteral tubes as it may cause obstruction.
UNIQUELY SELECTIVE PHARMACOLOGY
Only INGREZZA: 100% on-target activity at VMAT25-7,††
VIEW PHARMACOLOGYEXPLORE FINANCIAL ASSISTANCE OPTIONS
$10 or less out-of-pocket is what most patients pay for INGREZZA8
FIND SAVINGS & SUPPORT††Based on in vitro VMAT2 binding affinity of dihydrotetrabenazine (HTBZ) metabolites and the primary active metabolite of INGREZZA, + α HTBZ. The clinical significance of in vitro data is unknown and is not meant to imply clinical outcomes.
REFERENCES:
- INGREZZA [package insert]. San Diego, CA: Neurocrine Biosciences, Inc.
- Hauser RA, Factor SA, Marder SR, et al. KINECT 3: a phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. Am J Psychiatry. 2017;174(5):476-484.
- Data on file. Neurocrine Biosciences, Inc.
- Deutetrabenazine [prescribing information]. Parsippany, NJ: Teva Neuroscience, Inc.
- Brar S, Vijan A, Scott FL, et al. Pharmacokinetic and pharmacologic characterization of the dihydrotetrabenazine isomers of deutetrabenazine and valbenazine. Clin Pharmacol Drug Dev. 2023;12(4):447-456.
- Grigoriadis DE, Smith E, Hoare SRJ, Madan A, Bozigian H. Pharmacologic characterization of valbenazine (NBI-98854) and its metabolites. J Pharmacol Exp Ther. 2017;361(3):454-461.
- Skor H, Smith EB, Loewen G, O’Brien CF, Grigoriadis DE, Bozigian H. Differences in dihydrotetrabenazine isomer concentrations following administration of tetrabenazine and valbenazine. Drugs R D. 2017;17(3):449-459.
- Measured by NDC; data on file as of Q3 2023. Neurocrine Biosciences, Inc.