Ingrezza (valbenazine)

Ingrezza generic

Ingrezza is available only as a brand-name medication. It’s not currently available in generic form.

Ingrezza contains the active ingredient valbenazine.

Ingrezza side effects

Ingrezza can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Ingrezza. These lists do not include all possible side effects.

For more information on the possible side effects of Ingrezza, refer to this Ingrezza side effects article. Or you can talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Ingrezza, you can do so through MedWatch.

More common side effects

The more common side effects of Ingrezza can include:

• sleepiness
• dry mouth
• constipation
• blurry vision
• difficulty emptying your bladder when you urinate
• dizziness
• falling or having balance problems
• headache
• restlessness
• feeling agitated
• nausea or vomiting
• weight gain
• joint pain
• mild allergic reaction

For more information about some of these side effects, see “Side effect details” later in this article.

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Ingrezza aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects can include:

• neuroleptic malignant syndrome (a serious reaction to certain drugs that may cause rigid muscles, fever, confusion, or fast heart rate)
• depression and suicidal thoughts or actions in people with Huntington’s disease
• severe allergic reaction
• parkinsonism (a condition that causes tremors, stiff muscles, and slow movements)

Ingrezza has a boxed warning for depression and suicidal thoughts or actions in people with Huntington’s disease. This is a serious warning from the FDA. To learn more about this and a few other side effects of Ingrezza, see the “Side effect details” section that follows.

Side effect details

You may wonder about certain side effects that occur with Ingrezza. Here are some details on a few of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Ingrezza. It’s not known how many people using Ingrezza have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing
• hives

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, face, hands, or feet
• swelling of your tongue, mouth, or throat
• difficulty breathing

Sudden swelling can happen after taking your first dose of Ingrezza or even after you’ve taken the drug for a while. Call your doctor right away if you have a severe allergic reaction to Ingrezza. If you develop severe swelling or otherwise have symptoms that feel life threatening, call 911 or a local emergency number or go to an emergency room immediately.

Weight gain

Weight gain isn’t a common side effect of Ingrezza. In clinical trials, weight gain occurred in a small percentage of people taking the drug.

If you have weight gain that’s bothersome to you while you’re taking Ingrezza, talk with your doctor about ways to manage your weight. They may recommend dietary changes and exercise to help you maintain a moderate weight.

Sleepiness

Sleepiness was a common side effect of Ingrezza reported in clinical trials.

You should not drive or operate machinery until you know how Ingrezza affects your body. If you’re taking Ingrezza and you develop sleepiness that’s affecting your daily life, talk with your doctor about ways to manage this side effect.

Parkinsonism

Parkinsonism is a possible side effect of Ingrezza. With this condition, you may have:

• tremors
• drooling
• slowed movements
• changes in your ability to walk or keep your balance
• rigid muscles

While rigid muscles are a symptom of parkinsonism, they may also indicate worsening Huntington’s disease. If you take Ingrezza for chorea resulting from Huntington’s disease and develop rigid muscles, tell your doctor. They’ll determine what is causing this symptom and suggest appropriate treatment options.

Parkinsonism has been reported in people taking Ingrezza since it was approved for use. In most cases, this side effect occurred within 2 weeks of starting Ingrezza or receiving a dosage increase. Some people had severe symptoms and required care in a hospital. Their symptoms reportedly went away after the treatment was stopped.

If you develop parkinsonism while you’re taking Ingrezza, your doctor may lower your dosage of Ingrezza. Or they may recommend that you stop taking the drug.

Depression and suicidal thoughts or actions in people with Huntington’s disease

Ingrezza has a boxed warning for depression and suicidal thoughts or actions in people with Huntington’s disease. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Ingrezza is prescribed to treat chorea resulting from Huntington’s disease, a genetic condition that affects nerve cells in the brain. This can cause mood changes, such as depression, and suicidal thoughts or actions. Taking Ingrezza or drugs like it may worsen these symptoms.

In clinical trials of Ingrezza, people reported depression and suicidal thoughts or actions as side effects. However, instances were rare.

Symptoms of depression include feelings of fatigue, sadness, and difficulty sleeping. Symptoms of suicidal thoughts include behaving as though you won’t see loved ones again and frequent thoughts about dying.

If you have any mental health conditions or have ever experienced suicidal thoughts or actions, tell your doctor before taking Ingrezza. They can determine whether Ingrezza is a good treatment option for you.

During Ingrezza treatment, your doctor will monitor you for new or worsening depression and suicidal thoughts or actions. They may have you stop Ingrezza if you develop either of these side effects.

For more information about Ingrezza’s boxed warning, talk with your doctor or pharmacist.

Ingrezza dosage

The dosage of Ingrezza or Ingrezza Sprinkle that your doctor prescribes will depend on several factors. These include:

• the severity of the condition you’re using the drug to treat
• other medical conditions you may have
• other medications you may be taking

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug forms and strengths

Ingrezza comes as oral capsules that you take each day. It’s available in three strengths:

• 40 milligrams (mg)
• 60 mg
• 80 mg

Ingrezza Sprinkle is a sprinkle capsule. You can take this form of the drug by sprinkling the contents of the capsule on soft food, which you then consume. Or you can swallow the sprinkle capsule whole with water. Ingrezza Sprinkle comes in the same three strengths as Ingrezza.

Dosage for chorea resulting from Huntington’s disease

The typical starting dosage of Ingrezza or Ingrezza Sprinkle for chorea resulting from Huntington’s disease is 40 mg once each day.

After 2 weeks, your doctor will increase your dosage to 60 mg once each day for the next 2 weeks.

Then your doctor may increase your dosage to 80 mg once daily. However, your doctor may recommend an ongoing daily dose of 40 mg or 60 mg based on how your body responds to the medication.

Dosage for tardive dyskinesia

The typical starting dosage of Ingrezza or Ingrezza Sprinkle for tardive dyskinesia (TD) is 40 mg once each day for the first week of treatment.

After this, your doctor may increase your dosage to 80 mg once daily. However, your doctor may recommend an ongoing daily dose of 40 mg or 60 mg based on how your body responds to the medication.

Dosage adjustments

The dosage of Ingrezza or Ingrezza Sprinkle may be different for people who:

• have liver disease
• are considered “poor metabolizers,” which means their bodies can’t metabolize (break down) Ingrezza as quickly as other people’s bodies can
• are taking certain medications that may interact with Ingrezza or Ingrezza Sprinkle

Your doctor will recommend a dosage of Ingrezza or Ingrezza Sprinkle that’s right for you.

What if I miss a dose?

If you miss a dose of Ingrezza or Ingrezza Sprinkle, take your dose as soon as you remember. However, if it’s almost time for your next dose, just skip the missed dose and take your next regular dose. Never take more than one dose of either drug within the same day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Ingrezza and Ingrezza Sprinkle are meant to be used as long-term treatments. If you and your doctor determine that either is safe and effective for you, you’ll likely take it long term.

Ingrezza uses

The Food and Drug Administration (FDA) approves prescription drugs such as Ingrezza to treat certain conditions.

Ingrezza for chorea resulting from Huntington’s disease

Ingrezza is FDA approved to treat chorea resulting from Huntington’s disease. Chorea causes uncontrollable movements affecting your arms, legs, face, or other parts of your body.

Huntington’s disease is a genetic condition that affects nerve cells in the brain. Other conditions may cause chorea, but Ingrezza is FDA approved to treat chorea only if it’s caused by Huntington’s disease.

Effectiveness for chorea

In clinical trials, Ingrezza was effective at reducing chorea symptoms. For more information on how the drug performed in clinical trials, see Ingrezza’s prescribing information.

Ingrezza for tardive dyskinesia

Ingrezza is FDA approved to treat tardive dyskinesia (TD). Symptoms of TD include having repetitive and uncontrolled movements in certain areas of your body, usually in your face and mouth.

TD is a side effect that can be caused by taking other medications that are used to treat mental health conditions. TD usually occurs after you’ve been taking these medications for a long time.

Examples of medications that may cause TD as a side effect include:

• haloperidol (Haldol)
• fluphenazine
• chlorpromazine
• perphenazine
• prochlorperazine (Compro)
• metoclopramide (Reglan)

TD may go away after you’ve stopped taking or started using a lower dose of the medication that’s causing the condition. However, sometimes TD doesn’t go away.

Certain people have a higher risk of developing TD while they’re taking antipsychotic drugs. This includes females, people with diabetes, people ages 65 years and older, and people with other mental health conditions.

Note: Sex and gender exist on spectrums. Use of the term “female” in this article refers to sex assigned at birth.

Effectiveness for tardive dyskinesia

In clinical trials, Ingrezza was effective at reducing TD symptoms. For more information on how the drug performed in clinical trials, see Ingrezza’s prescribing information.

Alternatives to Ingrezza

Other drugs are available that can treat chorea resulting from Huntington’s disease or tardive dyskinesia (TD). Some may be better suited for you than others. If you’re interested in finding an alternative to Ingrezza, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other drugs that are used to treat chorea include:

• deutetrabenazine (Austedo)
• tetrabenazine (Xenazine)
• olanzapine (Zyprexa)
• quetiapine (Seroquel)
• risperidone (Risperdal)

Examples of other drugs that are used to treat TD include:

• deutetrabenazine (Austedo)
• clonazepam (Klonopin)
• tetrabenazine (Xenazine)
• amantadine (Gocovri)
• baclofen (Ozobax DS)
• clonidine
• propranolol (Inderal LA)

A supplement called ginkgo biloba is also thought to help ease TD symptoms.

Note: Some of the drugs listed here are used off-label to treat this condition. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Ingrezza vs. Austedo

You may wonder how Ingrezza compares with other medications prescribed for similar uses. Here we look at how Ingrezza and Austedo are alike and different.

Uses

Ingrezza is approved to treat chorea resulting from Huntington’s disease and tardive dyskinesia (TD) in adults.

Austedo is also approved to treat these conditions.

Drug forms and administration

Ingrezza contains the drug valbenazine. It’s available as oral capsules. Ingrezza can be taken with or without food.

Ingrezza also comes as a sprinkle capsule called Ingrezza Sprinkle. You can take this form of the drug by sprinkling the contents of the capsule on soft food, which you then consume. Or you can swallow the sprinkle capsule whole with water.

Austedo contains the drug deutetrabenazine. It comes as oral tablets. Austedo should be taken with food.

Another version of Austedo is available called Austedo XR. This is an extended-release oral tablet. (“Extended release” means the drug is slowly released into your body over a long period of time.) Austedo XR may be taken with or without food.

Side effects and risks

Both Ingrezza and Austedo work in very similar ways in the body. Therefore, both medications can cause very similar side effects. The tables that follow feature examples of these side effects.

More common side effects

Here are examples of more common side effects that can occur with Ingrezza, with Austedo, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Austedo or with both drugs (when taken individually). There are no reports of unique serious side effects occurring with Ingrezza.

Ingrezza and Austedo have a boxed warning for depression and suicidal thoughts or actions in people with Huntington’s disease. This is a serious warning from the FDA. To learn more, see the “Side effect details” section earlier in this article.

Effectiveness

Ingrezza and Austedo are both used to treat chorea resulting from Huntington’s disease and TD.

These drugs haven’t been directly compared in clinical trials. However, separate trials have found both Ingrezza and Austedo to be effective for treating TD.

Costs

Ingrezza and Austedo are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Ingrezza vs. Klonopin

You may wonder how Ingrezza compares with other medications prescribed for similar uses. Here we look at how Ingrezza and Klonopin are alike and different.

Uses

Ingrezza is approved to treat chorea resulting from Huntington’s disease and tardive dyskinesia (TD) in adults.

Klonopin is approved to treat certain seizure disorders and panic disorders. However, Klonopin can be used off-label to treat chorea resulting from Huntington’s disease and TD. Off-label use means that the Food and Drug Administration (FDA) hasn’t approved the drug for this purpose, but it’s sometimes used to treat these conditions.

According to the American Academy of Neurology (AAN)Trusted Source, Klonopin is probably effective to treat TD. The AAN recommends Klonopin as a second-choice treatment option for this condition.

There have been no clinical trials on Klonopin for treating chorea resulting from Huntington’s disease.

Unlike Ingrezza, Klonopin is a controlled substance. This means that the medication can be used for medical treatment, but it can also cause you to become dependent on the drug. With dependence, your body needs the drug in order for your body to function as it usually does.

Drug forms and administration

Ingrezza contains the drug valbenazine. It’s available as oral capsules. Ingrezza can be taken with or without food.

Ingrezza also comes as a sprinkle capsule called Ingrezza Sprinkle. You can take this form of the drug by sprinkling the contents of the capsule on soft food, which you then consume. Or you can swallow the sprinkle capsule whole with water.

Klonopin contains the drug clonazepam. It comes as oral tablets. The generic form of Klonopin, called clonazepam, also comes as oral tablets. In addition, clonazepam comes as orally disintegrating tablets, which dissolve when placed inside your mouth.

Your dosage of Klonopin may vary depending on your symptoms and any other medications you’re taking. Because Klonopin isn’t FDA approved to treat the same conditions as Ingrezza, there aren’t any FDA-approved dosing guidelines available for this use.

Side effects and risks

Ingrezza and Klonopin both contain medications that treat symptoms of chorea resulting from Huntington’s disease and TD. These medications can cause similar side effects. However, some side effects may be different.

The side effects of Klonopin may vary depending on what condition the drug is being used to treat. The side effects that follow were seen in people using Klonopin for FDA-approved uses. If you’re using Klonopin to treat chorea or TD, your side effects may vary from those listed in the tables.

More common side effects

Here are examples of more common side effects that can occur with Ingrezza, with Klonopin, or with both drugs (when taken individually).

Serious side effects

These lists contain examples of serious side effects that can occur with Ingrezza, with Klonopin, or with both drugs (when taken individually).

Klonopin has a boxed warning for misuse, addiction, dependence, and withdrawal. This is a serious warning from the FDA. Misuse refers to taking a drug in a way other than how it’s prescribed. With addiction, it’s difficult to stop taking a drug even if doing so is causing harm. With dependence, your body needs the drug in order for your body to function as it usually does. If a person has developed dependence on a drug, suddenly stopping that drug can cause withdrawal symptoms.

Ingrezza has a boxed warning for depression and suicidal thoughts or actions. This is a serious warning from the FDA. To learn more, see the “Side effect details” section earlier in this article.

Effectiveness

Ingrezza and Klonopin have different FDA-approved uses. Ingrezza is FDA approved to treat chorea resulting from Huntington’s disease and TD. Klonopin isn’t FDA approved for these conditions, but sometimes it’s used off-label for them.

These drugs haven’t been directly compared in clinical trials. However, separate trials have found Ingrezza to be effective to treat chorea from Huntington’s disease and TD.

And although it’s not FDA approved to treat chorea resulting from Huntington’s disease and TD, Klonopin has improved symptoms of these conditions in people using the drug. According to the American Academy of NeurologyTrusted Source, Klonopin is probably effective for reducing symptoms of TD. (There have been no clinical trials on Klonopin for treating chorea resulting from Huntington’s disease.)

Costs

Ingrezza and Klonopin are both brand-name drugs. There is currently no generic form of Ingrezza. There is a generic form of Klonopin available called clonazepam. Brand-name medications usually cost more than generics.

The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Common questions about Ingrezza

Here are answers to some frequently asked questions about Ingrezza.

Is Ingrezza a controlled substance?

No, Ingrezza isn’t a controlled substance. Controlled substances are medications that have approved medical uses but can also cause dependence or be misused by some people. With dependence, your body needs the drug in order for your body to function as it usually does. Misuse refers to taking a drug in a way other than how it’s prescribed.

Ingrezza isn’t addictive, and it doesn’t cause dependence in people taking it.

If I’m taking an antipsychotic, can I stay on it while I’m using Ingrezza?

Yes, you should continue taking antipsychotic medications as prescribed by your doctor while you’re taking Ingrezza.

One of the conditions Ingrezza is used to treat is tardive dyskinesia (TD), which may be caused as a side effect of certain antipsychotic drugs. (Ingrezza is also used to treat chorea resulting from Huntington’s disease.)

In clinical trials, a majority of people taking Ingrezza also took antipsychotic medications, though some were not taking antipsychotics. Ingrezza was equally effective for TD in both groups of people.

If you have questions about what medications you can take with Ingrezza, talk with your doctor.

Will Ingrezza eventually stop working for me?

That’s not known for sure. Clinical trials of Ingrezza showed that the medication remained effective at treating TD for at least 48 weeks.

A study found that the drug’s effectiveness for TD lasted for more than a year. However, additional studies are needed to know whether Ingrezza will continue working longer than this.

Long-term studies of Ingrezza for treating chorea resulting from Huntington’s disease haven’t been done. However, a clinical trial is currently underway to evaluate long-term safety and effectiveness of Ingrezza for this condition.

If you have questions about how long you should take Ingrezza, talk with your doctor.

Is tardive dyskinesia a dangerous condition?

No, TD isn’t considered dangerous. With this condition, you may have uncontrolled jerking motions in certain areas of your body, such as your face or mouth.

TD usually occurs as a side effect of certain medications. TD isn’t life threatening.

If you have symptoms of TD, talk with your doctor right away. Sometimes, simply reducing the dose of your antipsychotic medication can decrease your TD symptoms.

Your doctor can recommend whether the dose of your medication can be adjusted. They can also recommend whether you need treatment for your TD symptoms.

Ingrezza and alcohol

It may not be safe for you to drink alcohol while you’re taking Ingrezza. Two very common side effects of Ingrezza are tiredness and sleepiness. Alcohol can also make you feel tired, which adds to the effects caused by Ingrezza.

Using alcohol and Ingrezza together can also slow down your breathing, which can become a serious concern.

If you drink alcohol, talk with your doctor about how much is safe for you to consume while you’re taking Ingrezza. If you have difficulty avoiding alcohol, talk with your doctor about whether it’s safe for you to use Ingrezza.

Ingrezza interactions

Ingrezza can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Ingrezza and other medications

This section lists medications that can interact with Ingrezza. However, it does not include all the drugs that may interact with Ingrezza.

Before taking Ingrezza, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Ingrezza and MAOIs

If you’re taking a monoamine oxidase inhibitor (MAOI), you should not take Ingrezza. Examples of MAOIs that should be avoided while you’re using Ingrezza include:

• isocarboxazid (Marplan)
• tranylcypromine (Parnate)
• selegiline (Emsam)
• phenelzine (Nardil)
• rasagiline (Azilect)

MAOIs can interact with Ingrezza and lead to serious side effects, including serotonin syndrome. This is a very serious condition caused by elevated levels of serotonin (a brain chemical) in your body. Symptoms of serotonin syndrome include fever, rigid muscles, tremors, and seizures.

Using Ingrezza along with an MAOI can also lower the effectiveness of Ingrezza in treating your condition.

Ingrezza and certain antibiotics

Ingrezza can also interact with certain antibiotics, such as clarithromycin and erythromycin (Erythrocin).

If you’re taking Ingrezza with certain antibiotics, your doctor may decrease your dosage of Ingrezza. Certain antibiotics can stop your body from breaking down and clearing Ingrezza. This causes elevated levels of Ingrezza in your body, which may increase side effects of the medication.

If you’re taking antibiotics while using Ingrezza, talk with your doctor or pharmacist about any possible interactions. Not all antibiotics interact with Ingrezza. Your doctor or pharmacist can let you know if you’re at risk of interactions.

Ingrezza and certain antifungal treatments

Certain antifungal medications, such as itraconazole (Sporanox) or ketoconazole, can interact with Ingrezza.

If you’re taking Ingrezza with certain antifungals, your doctor may decrease your dosage of Ingrezza. This is because certain antifungals can stop your body from breaking down and clearing Ingrezza. This causes elevated levels of Ingrezza in your body, which may increase side effects of the medication.

If you’re taking antifungals while using Ingrezza, talk with your doctor or pharmacist about any possible interactions. Not all antifungals interact with Ingrezza. Your doctor or pharmacist can let you know if you’re at risk of interactions.

Ingrezza and certain antidepressants

Ingrezza may interact with certain antidepressants, such as fluoxetine (Prozac) and paroxetine (Paxil). (It may also interact with a type of antidepressant called an MAOI. For more information, see the “Ingrezza and MAOIs” section earlier.)

It’s possible that your body doesn’t break down Ingrezza as quickly as usual if you take it with an antidepressant. This can lead to elevated levels of Ingrezza in your body, which may increase side effects from the drug.

If you’re taking Ingrezza with certain antidepressants, your doctor may monitor you more often than usual to see whether you’re having side effects from Ingrezza. Your doctor may decrease your dosage of Ingrezza if you’re having bothersome or severe side effects from the drug.

Ingrezza and certain seizure medications

If you’re taking Ingrezza, you should avoid certain seizure medications, such as carbamazepine (Tegretol) and phenytoin (Dilantin).

These medications can cause Ingrezza to not work as well as it usually does. It’s recommended that you do not take certain seizure medications along with Ingrezza.

If you need to take seizure medications while you’re using Ingrezza, talk with your doctor about your treatment options.

Ingrezza and rifampin

It’s recommended that you do not take Ingrezza with rifampin (Rifadin). Taking these medications together will cause Ingrezza to not work as well in treating either chorea resulting from Huntington’s disease or tardive dyskinesia (TD). In some cases, this drug interaction can make Ingrezza not work at all.

To prevent this interaction, you should avoid taking rifampin with Ingrezza.

Ingrezza and quinidine

It’s possible that quinidine may interact with Ingrezza. Taking these medications together may increase levels of Ingrezza in your body. This can cause increased side effects of the drug.

Your doctor may monitor you for side effects more often than usual if you’re taking Ingrezza with quinidine. Your doctor may also decrease your dosage of Ingrezza if you have bothersome side effects of the drug.

Ingrezza and digoxin

Taking Ingrezza while you’re using digoxin (Lanoxin) can cause your digoxin levels to increase. This happens because Ingrezza can block your body’s breakdown of digoxin.

If you’re taking these drugs together, your doctor will check blood tests to monitor your digoxin levels. Your doctor may lower your dosage of digoxin if your digoxin levels are too high.

It’s important that your digoxin levels are monitored regularly if you’re using these drugs together. If your digoxin level gets too high, you can have serious side effects, which can sometimes be dangerous. These side effects include nausea, vomiting, heart palpitations, and irregular heart rhythm.

If you need to take digoxin with Ingrezza, talk with your doctor about this possible drug interaction.

Ingrezza and herbs and supplements

Some herbal products or supplements may interact with Ingrezza. Always check with your doctor or pharmacist before using any herbs or supplements while you’re taking Ingrezza.

Ingrezza and St. John’s wort

St. John’s wort is an herbal supplement that some people use to treat depression symptoms. It’s recommended that you do not take St. John’s wort with Ingrezza. This herb will cause Ingrezza to not work as well to treat your condition.

You should avoid using St. John’s wort while you’re taking Ingrezza. If you have questions about this interaction, talk with your doctor or pharmacist.

Ingrezza and foods

Ingrezza can interact with grapefruit and products that contain it, such as grapefruit juice.

Grapefruit can increase your risk of side effects from Ingrezza because it slows the activity of an enzyme called CYP3A4. (Enzymes are proteins that aid chemical changes in the body.) This can raise the level of Ingrezza in your body, which increases your risk of side effects.

Due to this interaction, your doctor may suggest that you do not consume grapefruit or grapefruit products while you’re taking Ingrezza.

To find out more about Ingrezza and possible food interactions, talk with your doctor or pharmacist.

Ingrezza cost

As with all medications, the cost of Ingrezza can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Financial and insurance assistance

If you need financial support to pay for Ingrezza, or if you need help understanding your insurance coverage, help is available.

Neurocrine Biosciences, Inc., the manufacturer of Ingrezza, offers the INBRACE Support Program, which may help lower the cost of Ingrezza. For more information and to find out whether you’re eligible for support, call 84-INGREZZA (844-647-3992) or visit the program’s website.

How to take Ingrezza

You should take Ingrezza or Ingrezza Sprinkle according to your doctor or another healthcare professional’s instructions.

Taking Ingrezza

Typically, you take Ingrezza oral capsules by mouth once each day.

Taking Ingrezza Sprinkle

You can take Ingrezza Sprinkle in one of two ways: by sprinkling the capsule contents on soft food, which you then consume, or by swallowing the capsule whole with water.

If you choose to take the drug with food, the manufacturer recommends this method:

1. Put about 1 tablespoon of soft food, such as yogurt or applesauce, in a bowl. (The manufacturer does not recommend sprinkling the drug into water or milk.)
2. Open one Ingrezza Sprinkle capsule and sprinkle its contents over the food.
3. Stir the drug into the food with a spoon.
4. Swallow the mixture, and then drink a glass of water.

If needed, you can keep the mixture at room temperature for up to 2 hours before taking it.

When to take

Ingrezza or Ingrezza Sprinkle should be taken once daily at about the same time each day. You should not stop taking either drug unless you’ve discussed doing so with your doctor. They’ll recommend the best way to stop taking the medication.

To help make sure that you do not miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Ingrezza with food

Ingrezza and Ingrezza Sprinkle may be taken with or without food.

Can Ingrezza be crushed, split, or chewed?

Ingrezza comes as capsules. The maker of Ingrezza hasn’t stated whether the capsules can be opened and sprinkled onto food, or crushed, split, or chewed. It’s probably best to swallow the capsules whole.

Ingrezza Sprinkle capsules should not be crushed or chewed.

How Ingrezza works

It’s not known what Ingrezza’s mechanism of action is for treating chorea resulting from Huntington’s disease or tardive dyskinesia (TD). (A drug’s mechanism of action is how it works.)

With chorea and TD, you have involuntary movements. These conditions may be caused by atypical functioning of a brain chemical called dopamine. Dopamine works inside your brain to control your movements.

TD often occurs after using certain antipsychotic medications. The chorea Ingrezza is approved to treat results from Huntington’s disease, a genetic condition that affects nerve cells in the brain.

It’s thought that Ingrezza works by blocking the action of a protein in your brain called vesicular monoamine transporter 2 (VMAT2). This protein increases dopamine levels in certain areas of your brain.

By blocking VMAT2, Ingrezza may decrease the levels of dopamine in your brain. It’s thought that this causes a decrease in your chorea or TD symptoms.

How long does it take to work?

Ingrezza begins working as soon as your first dose. However, it can take up to 1 week before Ingrezza reaches a steady level in your body. You may notice a decrease in your symptoms of chorea or TD during the first or second week of treatment with Ingrezza.

Ingrezza and pregnancy

It’s not known whether Ingrezza can harm a developing fetus if it’s used during pregnancy. There haven’t been any studies of this drug in pregnant people.

However, animal studies have shown a possible increased risk of stillbirth and problems with development when Ingrezza was given to pregnant animals. It’s not known whether Ingrezza would have this same effect in humans taking the drug during pregnancy.

If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of using Ingrezza.

Ingrezza and birth control

It’s not known whether Ingrezza is safe to take during pregnancy. If you or your sexual partner can become pregnant, talk with your doctor about your birth control needs while you’re using Ingrezza.

Ingrezza and breastfeeding

It’s not known whether Ingrezza passes into human breast milk when it’s used by lactating people. In an animal study, Ingrezza did pass in high concentrations into the milk of lactating rats.

Keep in mind that the results of animal studies don’t always predict what will happen in humans. However, because of the possible risks, breastfeeding should be avoided if you’re taking Ingrezza. You should continue to avoid breastfeeding for 5 days after your last dose of the drug.

If you have questions about breastfeeding while you’re taking Ingrezza, talk with your doctor. They can recommend healthy and safe ways to feed your child.

Ingrezza precautions

This drug comes with several precautions.

FDA warning: Depression and suicidal thoughts or actions in people with Huntington’s disease

Ingrezza has a boxed warning for depression and suicidal thoughts or actions in people with Huntington’s disease. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Ingrezza is prescribed to treat chorea resulting from Huntington’s disease, a genetic condition that affects nerve cells in the brain. This can cause mood changes, such as depression, and suicidal thoughts or actions. Taking Ingrezza or drugs like it may worsen these symptoms.

For details, see the “Ingrezza side effects” section.

Other warnings

Before taking Ingrezza, discuss your health history with your doctor. Ingrezza may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• QT prolongation
• neuroleptic malignant syndrome
• liver problems
• previous allergic reaction to this or a similar drug
• pregnancy
• breastfeeding

Note: For more information about the potential negative effects of Ingrezza, see the “Ingrezza side effects” section.

Ingrezza overdose

Using more than the recommended dosage of Ingrezza can lead to serious side effects.

Overdose symptoms

In clinical trials, no one taking Ingrezza experienced overdose on the medication. It’s not known for sure what symptoms you may have if you take too much of the drug. And no specific treatments have been recommended for treating an Ingrezza overdose.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or go to the nearest emergency room right away.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.