(Legend)

Generic Name

• Valbenazine
  Vesicular monoamine transporter 2 (VMAT2) inhibitor
  T½ = 15–22 hr
  Protein binding = >99%
  Pregnancy/lactation, avoid valbenazine. Not enough studies, may cause fetal harm. Advise not to breastfeed.

Trade Name

• Ingrezza

Dose Range/Adult Daily Dose

• 40 mg capsule PO once daily; after 1 wk increase to recommended daily dose of 80 mg. Some patients may continue w 40 mg/d.

Use/Common Side Effects (CSE)

• Use: Adults with tardive dyskinesia.
  CSE: Somnolence, dry mouth, constipation, blurred vision, urinary retention, dizziness, akathisia, N & V, headache
  Warnings: Somnolence (may impair driving), QT Prolongation (clients w congenital long QT syndrome or arrhythmias w prologued QT interval, avoid valbenazine). Parkinsonism.

Geriatric & Dose Considerations

• Use caution: Although no dose adjustments required for the elderly, need to monitor for somnolence. Somnolence and dizziness could result in falls. Also issues related to anticholinergic effects: Dry mouth, constipation, blurred vision, urinary retention.

Assessment Cautions

See product insert/prescribing info for dosing recommendations for:

• CYP2D6 poor metabolizes and those w hepatic impairment. And for concomitant use w CYP3A4 Inducers and Inhibitors. And strong CYP2D6 Inhibitors, as well as Digoxin.
• Dosage reduction for mod-severe hepatic impairment.