Pronunciation: aw-STED-oh
Generic name: deutetrabenazine [ doo-TET-ra-BEN-a-zeen ]
Other brand names of deutetrabenazine [ doo-TET-ra-BEN-a-zeen ] include Austedo, Austedo XR
Dosage form: Austedo tablets (6 mg, 9 mg,12 mg), Austedo XR tablets (6 mg, 12 mg, 18 mg, 24 mg, 30 mg, 36 mg, 42 mg, 48 mg)
Drug class: VMAT2 inhibitors

Medically reviewed by Melisa Puckey, BPharm. Last updated on Feb 5, 2025.

What is Austedo?

Austedo and Austedo XR (deutetrabenazine) are used to treat involuntary movement disorders in tardive dyskinesia (TD) and Huntington's disease (Huntington's chorea) to help reduce the severity of symptoms and improve quality of life.

Austedo works by changing the activity of natural chemical messengers (dopamine, serotonin, norepinephrine, and histamine) between nerve cells which helps control involuntary muscle movements.  Austedo does this by blocking a protein called VMAT2 which is responsible amount of chemical messengers in the nerve terminals. Austedo belongs to a class of medications called vesicular monoamine transporter 2 (VMAT2) inhibitors. 

Austedo XR (extended-release tablet) is taken once daily and Austedo tablets are taken twice daily.

What is Tardive dyskinesia (TD) and Huntington’s disease chorea

• Tardive dyskinesia (TD) is a nervous system disorder that causes repetitive, uncontrolled muscle movements, usually in the face (chewing, lip smacking, frowning, tongue movement, blinking, or eye movement). Tardive dyskinesia can develop due to using certain medicines.
• Huntington's disease chorea is sudden involuntary movements usually of the arms, legs, face, and tongue. It is an inherited disease that causes the progressive breakdown of nerve cells in the brain. Deutetrabenazine is not a cure for Huntington's disease and will not treat other symptoms of this condition.

How does Austedo work?

Austedo mechanism of action (MOA) is as vesicular monoamine transporter 2 (VMAT2) inhibitors, blocking VMAT2, which decreases the activity of neurotransmitters and helps to reduce unwanted body movements.

Body movement or motor function is controlled in the brain by nerve cells (neurons) that speak to each other by passing chemical messengers (neurotransmitters) from one nerve cell to another nerve cell.

In movement disorders such as Huntington’s disease and tardive dyskinesia there can be a problem with this system, and by lowering the amount of chemical messengers between the nerve cells you relieve the uncontrolled movements.

A protein called VMAT2 controls how much neurotransmitter is stored in the nerve cell and how much is absorbed. The Austedo, the VMAT2 inhibitor, blocks VMAT2, so there is a lower amount of neurotransmitter available, which reduces the unwanted body movements.

What is the cost of Austedo?

The cost of prescription drugs varies depending on your insurance plan and which pharmacy you use. Refer to our Austedo price guide or Austedo XR price guide pages for more information about the cost of this medicine.

Austedo Copay Card or Coupon

You may pay as little as $0 out-of-pocket if you qualify for the Austedo copay card. The Austedo Coupon or Copay Card helps you save money on prescriptions for this medicine. 

Who is eligible for the Austedo Coupon or Copay Card?

You are eligible for the Austedo Copay Card if you have commercial or private insurance, a valid prescription, and are a resident of the United States and United States territories. 

You are not eligible for an Austedo Copay Card if you are enrolled in Medicare, Medigap, Medicaid, VA, DOD, TRICARE, Puerto Rico Government Health Insurance Plan, and Medicare-eligible patients enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees.

How can I apply for the Austedo Copay Card?

You can apply for the Austedo Copay Card or Coupon online; there is a link on the Austedo Price Guide page. 

Check the terms and conditions for the Austedo Savings Card online.

Austedo side effects

Common Austedo side effects

Common Austedo side effects when used for Huntington’s disease may include:

• Drowsiness (11%)
• Tiredness (9%)
• Dry mouth (9%)
• Urinary tract infection (7%)
• Anxiety (4%)
• Sleep problems or insomnia (7%)
• Diarrhea (9%)
• Constipation (4%)
• Confusion(4%)

The side effects that affected 4% or more of patients using Austedo for Huntington’s disease in clinical trial Study 1.

Common Austedo side effects when used for tardive dyskinesia may include:

• Nasopharyngitis (4%)
• Sleep problems or insomnia (4%)
• Depression/ Dysthymic disorder (2%)
• Agitation/Restlessness/Akathisia (2%)

The side effects that affected 4% or more of patients using Austedo for tardive dyskinesia in clinical trial Study 1 and Study 2.

Serious Austedo side effects

 Get emergency medical help if you have signs of an allergic reaction to Austedo: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some people have thoughts about suicide while taking Austedo. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior.

Some side effects may actually be signs that your Huntington's disease is progressing. Your doctor will need to check your progress on a regular basis.

Austedo may cause serious side effects. Call your doctor at once if you have:

• fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out);
• severe restlessness or agitation;
• tremors, shaking;
• muscle stiffness;
• problems with balance or coordination; or
• severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Related/similar drugs

Warnings

QTc Prolongation 

This medicine may prolong the QT interval, but the degree of QT prolongation is not clinically significant when administered within the recommended dosage range.  Austedo XR and Austedo should be avoided in patients with congenital long QT syndrome and in patients with a history of cardiac arrhythmias associated with a prolonged QT interval. 

Certain circumstances may increase the risk of the occurrence of torsade de pointes and/or sudden death in association with the use of drugs that prolong the QTc interval, including: 

• slow heart rate (bradycardia),
• low potassium levels (hypokalemia), 
• low magnesium blood levels (hypomagnesemia), 
• having a congenital prolongation of the QT interval, and
• concomitant use of other drugs that prolong the QTc interval.

Depression and Suicide

Some people have thoughts about suicide while taking Austedo tablets and extended release tablets; stay alert to changes in your mood, feelings, thoughts, or behaviors. Tell your doctor right away if you have any sudden changes in mood or behavior or thoughts about suicide.

You should not use Austedo tablets or extended-release tablets if you have Huntington’s disease and you have untreated or uncontrolled depression or if you have thoughts about suicide.

Other medicines

Do not use this medicine if you have taken reserpine (Serpalan, Renese-R) in the past 20 days, or if you have used an MAO inhibitor (isocarboxazid, linezolid, rasagiline, selegiline, and others) in the past 14 days. See Interactions section for more interactions with this medicine.

Before taking this medicine

You should not use Austedo if you are allergic to deutetrabenazine, or if you have:

• untreated or uncontrolled depression;

• thoughts about suicide or hurting yourself;

• if you have recently taken tetrabenazine or valbenazine; or

• liver disease.

Do not use Austedo if you have taken reserpine in the past 20 days, or if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.

To make sure Austedo is safe for you, tell your doctor if you have ever had:

• depression, anxiety, nervousness, or agitation;

• mental illness or psychosis;

• suicidal thoughts or actions;

• breast cancer;

• a heart rhythm disorder;

• long QT syndrome (in you or a family member);

• an electrolyte imbalance (such as low blood levels of potassium or magnesium); or

• liver disease.

People with Huntington's disease may have a higher risk of depression and suicidal thoughts or behaviors. Taking Austedo may further increase this risk. However, the benefits of taking this medicine (improvement in daily living) may outweigh any suicidal risks.

Taking Austedo may cause symptoms similar to Parkinson's disease (resting tremor, stiff muscles, slow movements, difficulty maintaining balance and walking). Ask your doctor about your risk.

Your doctor will need to check your progress on a regular basis. Your family or caregivers should also watch for sudden changes in your behavior.

Tell your doctor if you are pregnant or breastfeeding.

How should I take Austedo?

Take Austedo as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

If you are switching from a similar medicine called tetrabenazine, take your first dose of Austedo one day after your last dose of tetrabenazine.

Austedo tablets are taken twice daily with food. Swallow whole. Do not chew, crush, or break tablets. Take Austedo's total daily dosage of 12 mg or above in two divided doses.

Austedo XR tablets are taken once daily with or without food. Swallow whole. Do not chew, crush, or break tablets. XR tablets are taken once daily with or without food. Swallow whole. Do not chew, crush, or break tablets. The XR tablets are made with a shell that is not absorbed or melted in the body. Part of this shell may appear in your stool. This is normal and will not make the medicine less effective.

You may need medical tests to check your heart function using an electrocardiograph or ECG (sometimes called an EKG).

Do not stop the medicine without your doctor's advice. If you stop taking Austedo for longer than 1 week, do not start taking it again without your doctor's advice.

Store at room temperature away from moisture and heat. Keep the medicine in the original container, along with the packet or canister of moisture-absorbing preservatives.

Dosing information

Austedo dosing information 

Initial Dose: 6 mg twice daily (12 mg per day).
Dose titration: May increase dose in increments of 6 mg/day at weekly intervals, based on reduction of chorea or tardive dyskinesia, and tolerability up to a maximum of 48 mg/day in divided doses.
Maximum Dose: 48 mg/day in divided doses.
Important Administration Instructions: 

• Take Austedo with food
• Swallow whole. Do not chew, crush, or break tablets
• Take Austedo total daily dosages of 12 mg or above in two divided doses. 

Austedo XR dosing information 

Initial Dose: 12 mg once daily (12 mg per day).
Dose titration: May increase dose in increments of 6 mg/day at weekly intervals, based on reduction of chorea or tardive dyskinesia, and tolerability up to a maximum of 48 mg/day.
Maximum Dose:  48 mg/day
Important Administration Instructions:

• Take XR tablets with or without food 
• Swallow whole. Do not chew, crush, or break tablets.
• Take Austedo XR once daily. 

Switching Between Austedo and Austedo XR

When switching between Austedo tablets (twice daily) and Austedo XR extended-release tablets (once daily), switch to the same total daily dosage. 

Dose modifications

Dose modification is required for Strong CYP2D6 Inhibitors and in Poor CYP2D6 Metabolizers.

Discontinuation and Interruption of Treatment

Treatment with this medicine can be discontinued without tapering. Following treatment interruption of greater than one week, this therapy should be re-titrated when resumed. For treatment interruption of less than one week, treatment can be resumed at the previous maintenance dose without titration. 

Austedo is avialable as: 

• Austedo tablets are available as 6 mg, 9 mg, and 12 mg.
• Austedo XR (extended-release tablet) is available as 6 mg, 12 mg, 18 mg, 24 mg, 30 mg, 36 mg, 42 mg, and 48 mg.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include involuntary muscle movements, tremors, rapid eye movements, nausea, vomiting, diarrhea, flushing, sweating, severe drowsiness, confusion, hallucinations, or feeling light-headed.

What should I avoid while taking Austedo?

Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Drinking alcohol with this medicine can cause side effects.

What other drugs will affect Austedo and Austedo XR?

QT Prolongation This medicine may prolong the QT interval and should not be used with medicines that prolong the QTc interval. Talk to your healthcare provider about other medicines you take, or if you start taking new medicines.

Reserpine. Do not take Austedo or Austedo XR if you are taking reserpine.  If your healthcare provider plans to switch you from taking reserpine to this medicine you must wait at least 20 days after your last dose of reserpine before you start taking Austedo or Austedo XR.

Monoamine oxidase inhibitor (MAOI) medicine. Do not take an MAOI within 14 days after you stop taking Austedo or Austedo XR. Do not start this medicine if you stopped taking an MAOI (isocarboxazid, linezolid, rasagiline, selegiline, and others) in the last 14 days. Ask your healthcare provider or pharmacist if you are not sure.

Tetrabenazine. Austedo or Austedo XR is contraindicated in patients currently taking tetrabenazine. If your healthcare provider plans to switch you from tetrabenazine to Austedo or Austedo XR take your first dose of Austedo or Austedo XR on the day after your last dose of tetrabenazine.

Valbenazine. Austedo or Austedo XR is contraindicated in patients currently taking valbenazine.

Neuroleptic Drugs The risk of parkinsonism, Neuroleptic Malignant Syndrome (NMS), and being unable to remain still (akathisia) may be increased by using this medicine with dopamine antagonists or antipsychotics. Talk to your healthcare provider about other medicines you take, or if you start taking new medicines.

Alcohol or Other Sedating Drugs Using alcohol or other sedating drugs may have additive effects and make sedation and sleepiness worse.

Strong CYP2D6 inhibitors. A dose reduction in Austedo or Austedo XR may be necessary when adding a strong CYP2D6 inhibitor in patients maintained on a stable dose of Austedo or Austedo XR. Using strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine, bupropion) has been shown to increase Austedo or Austedo XR effectiveness. If you are using strong CYP2D6 inhibitors the maximum recommended dose of Austedo or Austedo XR is 36 mg per day. 

This list is not complete, and many other drugs can interact with Austedo or Austedo XR. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
See the link below to check for interactions with this medicine.

Austedo Package Insert

Review the Austedo Package Insert (PI) for more detailed information about this medicine. The Austedo PI contains more comprehensive information on Indications and Usage, Dosage and Administration, Clinical Pharmacology, Clinical Studies, Drug Interaction, and more. Discuss any medical questions you have with your doctor or other health care provider. This is not all the information you need to know about this medicine for safe and effective use, and it does not take the place of talking to your doctor about your treatment.

The Package Insert is sometimes called Austedo Prescribing Information or FDA label.

Storage

• Store tablets at room temperature between 68°F to 77°F (20°C to 25°C).
• Keep the bottle tightly closed to protect tablets from light and moisture.
• Do not throw away the desiccant canister in the bottle until the last dose has been taken. 

Ingredients

Active ingredient: deutetrabenazine.
Inactive ingredients:

Austedo: ammonium hydroxide, black iron oxide, n-butyl alcohol, butylated hydroxyanisole, butylated hydroxytoluene, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol, polyethylene oxide, polysorbate 80, polyvinyl alcohol, povidone, propylene glycol, shellac, talc, titanium dioxide, and FD&C blue #2 lake. The 6 mg tablets also contain FD&C red #40 lake. The 12 mg tablets also contain FD&C yellow #6 lake.

Austedo XR: ammonium hydroxide, black iron oxide, butyl alcohol, butylated hydroxyanisole, butylated hydroxytoluene, cellulose acetate, hydroxypropyl cellulose, hypromellose, isopropyl alcohol, magnesium stearate, polyethylene glycol, polyethylene glycol 3350, polyethylene oxide, polyvinyl alcohol, propylene glycol, shellac, sodium chloride, talc, titanium dioxide, and FD&C red #40 lake.

The 6 mg, 12 mg, 18 mg, 30 mg, 36 mg, and 42 mg extended-release tablets also contain FD&C yellow #6 lake.

The 6 mg, 12 mg, 24 mg, and 36 mg extended-release tablets also contain FD&C blue #2 lake. The 18 mg extended-release tablets also contain carmine. 

Manufacturer

Teva Neuroscience, Inc.: Parsippany, NJ 07054 USA.

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