Ingrezza (valbenazine)

Doctors prescribe Ingrezza (valbenazine) to adults for chorea associated with Huntington’s disease and tardive dyskinesia. It comes as an oral capsule. For details about these conditions and how the drug treats them, see the “Ingrezza: Uses” section below. You’ll also find information about Ingrezza’s side effects, dosage, and more.

The following table provides key facts about Ingrezza.

If you’re interested in taking this drug, search here to find a doctor who might prescribe it.

Ingrezza contains the active drug valbenazine. It is only available as a brand-name medication. It isn’t currently available as a generic drug.

A generic is an identical copy of the active drug found in a brand-name medication. Generics typically cost less than brand-name drugs.

As with most drugs, it’s possible to have side effects with Ingrezza. These can include some mild side effects, but also some serious ones.

To learn more about Ingrezza’s side effects, you can refer to this article. Or talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

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

Mild and serious side effects of Ingrezza are listed below. These lists do not include all of Ingrezza’s possible side effects.

Mild side effects* of Ingrezza may include:

• headache
• dry mouth
• blurred vision
• sleepiness
• joint pain
• akathisia (an uncontrollable urge to move the legs)
• urinary retention (inability to completely empty the bladder)
• digestive problems, such as constipation, vomiting, and nausea
• weight gain†
• problems with balance†

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

* This is not a complete list of Ingrezza’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† For additional information about this side effect, see “Ingrezza’s side effects explained” below.

Serious side effects from Ingrezza aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or your local emergency number.

Serious side effects of Ingrezza may include:

• parkinsonism (a condition that causes tremors and other unusual body movements)
• neuroleptic malignant syndrome (a serious reaction to certain drugs that may cause fast heart rate, rigid muscles, fever, and confusion)
• risk of depression and suicidal thoughts or behavior in people who take the drug to treat chorea associated with Huntington’s disease*
• allergic reaction†

* Ingrezza has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for this side effect. A boxed warning alerts doctors and patients about drug effects that may be dangerous. For more information about this side effect, see the “Ingrezza: Precautions” section below.
† An allergic reaction is possible after taking Ingrezza. However, this side effect wasn’t reported in clinical studies. For additional information about this side effect, see “Ingrezza’s side effects explained” below.

Below, you can find detailed information about some of Ingrezza’s side effects. To learn more about other side effects of this medication, talk with your doctor. 

Weight gain is rare with Ingrezza. To learn more about how often this side effect occurred in clinical studies, see the drug’s prescribing information.

What to do

If you have unintended weight gain while taking Ingrezza, talk with your doctor. They can determine whether Ingrezza may be the cause. Your doctor can also suggest changes to your diet or exercise routine that could help you reach or maintain a weight that is healthy for you.

Problems with balance are common with Ingrezza. To learn more about how often these side effects occurred in clinical studies, see the drug’s prescribing information.

Along with balance problems, you may have dizziness, trouble walking, and an increased risk of falling.

Keep in mind that problems with balance may be a sign of parkinsonism, which is a possible serious side effect of Ingrezza. With parkinsonism, you have tremors and other unusual body movements. These symptoms can cause you to have problems with balance.

What to do

If you have problems with balance while taking Ingrezza, talk with your doctor. They can suggest ways to ease these side effects. Your doctor can also check for unusual body movements or other possible signs of parkinsonism.

Prescription drugs, such as Ingrezza, are approved by the Food and Drug Administration (FDA) to treat certain conditions.

The FDA has approved Ingrezza to treat chorea associated with Huntington’s disease in adults.

With chorea, you have involuntary muscle movements that can affect your arms, legs, face, or other parts of your body. Huntington’s disease is a genetic condition that causes certain nerve cells in the brain to break down. (Certain other conditions may cause chorea, but Ingrezza is only approved to treat chorea caused by Huntington’s disease.)

Examples of common chorea symptoms include:

• difficulty talking or swallowing
• inability to hold objects
• writhing or twisting movements
• suddenly flinging out a limb

Doctors can prescribe Ingrezza to lessen symptoms of chorea associated with Huntington’s disease.

The FDA has approved Ingrezza to treat tardive dyskinesia (TD) in adults.

With TD, you have involuntary and repetitive muscle movements that typically affect your eyes, tongue, lips, or jaw. However, these movements can occur in any part of the body.

Examples of common TD symptoms include:

• grimacing (showing a facial expression of disgust, pain, or disapproval)
• sticking out your tongue
• blinking
• twitching
• smacking your lips

TD typically occurs as a side effect of certain medications, such as antipsychotic drugs. Doctors can prescribe Ingrezza to ease symptoms of TD caused by these medications.

Risperidone (Risperdal) is an example of an antipsychotic that may cause TD. You can learn about other medication examples by reading this article.

Doctors can prescribe Ingrezza to ease symptoms of TD caused by other drugs. (To learn more, see “Using Ingrezza for tardive dyskinesia” above.) Ingrezza is not approved to treat chorea caused by other drugs.

Examples of medications that may cause TD include antipsychotic drugs, such as risperidone (Risperdal). To learn about other medication examples, read this article.

If you’re taking a medication that has bothersome side effects, such as TD, talk with your doctor. They may have you stop taking the drug because of its side effects.

However, despite its side effects, you may feel the drug is working well to treat your condition. In this case, your doctor may have you continue the drug that’s causing TD. And they may prescribe Ingrezza to ease this side effect. This way, you’re able to continue the medication that’s treating your condition while having fewer symptoms of TD.

Your doctor will advise whether Ingrezza should be taken in combination with other drugs.

Doctors typically will not prescribe Ingrezza for children. The drug is approved only for adults.

If you’re interested in taking Ingrezza, search here to find a doctor who might prescribe it. If you have TD, You can prepare for your appointment by visiting Healthgrades’ appointment guide for TD.

Below you’ll find dosages that are commonly recommended for Ingrezza. However, you should take the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Most often, doctors start by prescribing a low dosage of Ingrezza. Then, they’ll change the dosage over time to an amount that’s right for the condition being treated. Doctors typically prescribe the smallest dosage that gives the desired outcome.

The dosage of Ingrezza that your doctor prescribes will depend on factors such as:

• the severity of the condition you’re taking Ingrezza to treat
• any health conditions you have, such as liver problems
• side effects you may have with Ingrezza
• other medications you’re currently taking

Ingrezza is available as follows.

• Form: oral capsule
• Strengths: 40 milligrams (mg), 60 mg, and 80 mg

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

Ingrezza’s recommended dosage for chorea associated with Huntington’s disease is as follows.

• Starting dosage: 40 mg once daily
• Maintenance dosage: 40–80 mg once daily
• Maximum dosage: 80 mg once daily

Ingrezza’s recommended dosage for TD is as follows.

• Starting dosage: 40 mg once daily
• Maintenance dosage: 40 mg to 80 mg once daily
• Maximum dosage: 80 mg once daily

Below are some things to consider about Ingrezza’s dosage.

• Missing a dose. If you miss a dose of Ingrezza, call your doctor or pharmacist. They can tell you whether to take the missed dose or skip it. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Length of treatment. Doctors typically prescribe Ingrezza as a long-term treatment. You’ll likely take it long term if you and your doctor feel it’s safe and effective for your condition.

Here are some common questions about Ingrezza and brief answers to them. If you’d like to know more about these topics, ask your doctor.

Both Ingrezza and Austedo are prescribed to treat chorea associated with Huntington’s disease and tardive dyskinesia (TD) in adults. (To learn more, see the “Ingrezza: Uses” section above.)

Both Ingrezza and Austedo belong to a class of drugs called vesicular monoamine transporter 2 (VMAT2) inhibitors. (For details about how VMAT2 inhibitors work, see the “Ingrezza: How it works” section below.) However, each medication contains a different active drug. Ingrezza’s active drug is valbenazine, while Austedo’s active drug is deutetrabenazine.

To learn more about how Ingrezza compares with Austedo, see this article. You can also discuss each medication with your doctor or pharmacist.

No, Ingrezza isn’t approved to treat Tourette syndrome. Instead, chorea associated with Huntington’s disease and tardive dyskinesia (TD) are the only conditions Ingrezza is approved to treat. (To learn more, see the “Ingrezza: Uses” section above.)

Tourette syndrome affects the nervous system. It causes a person to make unusual movements and sounds they can’t control. These can include:

• blinking
• grunting
• eye-rolling
• shouting
• squeaking

If you’re interested in learning more about treatments for Tourette syndrome, talk with your doctor. They can recommend a treatment option that’s best for you.

No, Ingrezza isn’t approved to treat Parkinson’s disease. Currently, Ingrezza is approved only to treat chorea associated with Huntington’s disease and tardive dyskinesia (TD). (To learn more, see the “Ingrezza: Uses” section above.)

Parkinson’s disease (PD) is a neurological disorder. It develops due to damage of certain brain cells that make a brain chemical called dopamine. Symptoms of Parkinson’s disease include tremors, foot shuffling, and loss of balance.

Keep in mind that Ingrezza may cause parkinsonism as a side effect. This is a condition that causes tremors and other unusual body movements.

Both Parkinson’s disease and parkinsonism are caused by low dopamine levels in the brain. However, in parkinsonism, factors other than damaged brain cells affect dopamine levels. The factors can include Ingrezza itself. For additional information, see the “Ingrezza: How it works” section below.

If you’d like additional information about treatment options for Parkinson’s disease, talk with your doctor.

No, Ingrezza isn’t approved to treat essential tremor. Ingrezza is approved only to treat chorea associated with Huntington’s disease and tardive dyskinesia (TD). (To learn more, see the “Ingrezza: Uses” section above.)

Essential tremor is a condition that causes involuntary shaking or trembling. It typically affects the arms and hands and sometimes other areas of the body. Symptoms of essential tremor generally worsen with certain activities. Examples of these activities include writing, eating, or holding an object.

To learn more about treatments for essential tremor, talk with your doctor.

No, Ingrezza is not a controlled substance.

Controlled substances are medications that carry a high risk of misuse or dependence. (With misuse, a drug is taken differently from how a doctor prescribed it. With dependence, your body relies on a drug to function like usual.) To help avoid misuse or dependence, doctors must follow certain rules when prescribing controlled substances.

However, Ingrezza doesn’t have these risks.

As with other medications, prices for Ingrezza may vary. The drug’s price will depend on factors such as:

• the pharmacy you use
• your insurance coverage

Here’s a list of things to consider when looking into the cost of Ingrezza.

• Option for a 90-day supply. For some drugs, it’s possible to get a 90-day supply. If this option is approved by your insurance company, it can help lower the cost of the drug. It can also help you avoid frequent trips to your pharmacy. If you’d like to learn more about this option, ask your doctor, pharmacist, or insurance company.
• Need for prior authorization. Before insurance coverage for Ingrezza is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Ingrezza. Then, the insurance company will decide if the drug will be covered. To find out whether you need prior authorization for Ingrezza, contact your insurance company.
• Possible cost assistance options. Financial assistance to help lower the cost of Ingrezza is available. The INBRACE program for Ingrezza may help reduce its cost. To learn more and see whether you’re eligible for support, call 84-INGREZZA (844-647-3992) or visit the manufacturer’s website. Also, check out this article to learn about ways to save on prescription drugs.
• Use of a mail-order pharmacy. Ingrezza may be dispensed through mail-order pharmacies. Getting your prescription through a mail-order pharmacy could lower its cost. It can also allow you to get the drug without leaving home. To find out more about this option, check with your doctor, pharmacist, or insurance company.
• Availability of a generic form. Ingrezza isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Typically, generics cost less than brand-name drugs.

Ingrezza is approved to treat chorea associated with Huntington’s disease and tardive dyskinesia (TD).

With chorea, you have involuntary muscle movements that can affect your arms, legs, face, or other parts of your body. Ingrezza is only approved to treat chorea caused by Huntington’s disease, a genetic condition that causes certain nerve cells in the brain to break down.

TD typically occurs as a side effect of certain medications, such as antipsychotic drugs. With TD, you have involuntary and repetitive muscle movements that typically affect the eyes, tongue, lips, or jaw.

To learn more about these conditions, see the “Ingrezza: Uses” section above.

Ingrezza belongs to a class of drugs called vesicular monoamine transporter 2 (VMAT2) inhibitors. Its mechanism of action (the way it works) isn’t fully understood.

However, Ingrezza is thought to block the activity of VMAT2, which is a protein found in the brain. This blocking causes less of a chemical called dopamine to be released into the brain. By lowering dopamine levels in the brain, Ingrezza may help ease symptoms of chorea and TD.

Ingrezza may stay in your body for up to 4.5 days.

This is based on Ingrezza’s half-life, which is between 15 to 22 hours. (Half-life is the time it takes for half of a drug’s dose to leave your body.)

It typically takes about five half-lives for a drug to leave your body completely. For Ingrezza, this means the drug stays in your body for about 3 to 4.5 days.

It may take several weeks for you to notice the symptoms of chorea or TD easing after starting Ingrezza.

No clinical studies have been done to determine whether Ingrezza can cause drug dependence. (With dependence, your body relies on a drug to function like usual.)

Medications that cause dependence generally cause withdrawal symptoms after the drug is stopped. However, these symptoms weren’t reported in studies of Ingrezza. (Withdrawal symptoms are side effects that can occur when you stop taking a drug your body is dependent on.)

Still, if you’d like to stop taking Ingrezza, it’s important that you talk with your doctor first. They can recommend whether it’s best for you to keep taking Ingrezza or stop treatment. If you and your doctor decide that you’ll stop taking Ingrezza, they’ll help you stop the drug safely.

It may be best to avoid drinking alcohol while taking Ingrezza.

Ingrezza can cause sleepiness, and so can consuming alcohol. So drinking alcohol while taking Ingrezza could worsen this side effect.

If you have questions about consuming alcohol while taking Ingrezza, talk with your doctor or pharmacist.

Ingrezza may interact with other medications, certain supplements, and certain foods.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

• Ingrezza and monoamine oxidase inhibitors (MAOIs). The manufacturer of Ingrezza advises that certain antidepressants called MAOIs should not be taken with Ingrezza. Be sure to talk with your doctor before taking these drugs together. Examples include:
  • tranylcypromine (Parnate)
  • phenelzine (Nardil)
  • selegiline (Zelapar)
• Ingrezza and other medications. Because Ingrezza may interact with the following drugs, your doctor may recommend that you do not take it with these drugs. Examples include:
  • the antifungal drugs itraconazole (Sporanox) and ketoconazole
  • the antibiotic drugs rifampin (Rimactane) and clarithromycin
  • the antidepressant drugs fluoxetine (Prozac) and paroxetine (Paxil)
  • the heart condition drugs digoxin (Lanoxin) and quinidine
  • the seizure drugs phenytoin (Dilantin) and carbamazepine (Carbatrol, Tegretol)
• Ingrezza and herbs and supplements. Certain herbs and supplements may interact with Ingrezza. An example is St. John’s wort.
• Ingrezza and foods. Grapefruit and grapefruit juice may interact with Ingrezza. As a result, your doctor may recommend not consuming products containing grapefruit during Ingrezza treatment. If you have questions about eating certain foods with Ingrezza, talk with your doctor or pharmacist.

Your doctor will recommend how you should take Ingrezza. It’s important that you take the drug exactly as your doctor instructs.

Ingrezza comes as an oral capsule. You’ll take the capsule by swallowing it.

Here’s a list of common questions related to taking Ingrezza.

• When should I take Ingrezza? You’ll likely take Ingrezza once daily. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
• Do I need to take Ingrezza with food? You can take Ingrezza with or without food.
• Can Ingrezza be chewed, split, or crushed? The manufacturer of Ingrezza doesn’t state whether the capsules can be chewed, split, or crushed. If you have trouble swallowing Ingrezza capsules whole, talk with your doctor or pharmacist.
• Is there a best time of day to take Ingrezza? No, you can take Ingrezza any time of day. However, keep in mind that Ingrezza may cause sleepiness in some people. If you find that Ingrezza makes you sleepy, it may be best to take it at night. Talk with your doctor about the time of day that’s best for you to take Ingrezza. 

It isn’t known whether Ingrezza is safe to take during pregnancy. Clinical studies of the drug in pregnant people have not provided enough information to know for sure.

Studies in pregnant animals who received the drug showed harm in offspring. However, animal studies don’t always predict what happens in humans. To be safe, your doctor may recommend that you do not take Ingrezza while you’re pregnant.

If you’re pregnant or planning to become pregnant, talk with your doctor. They can explain the risks and benefits of taking Ingrezza during pregnancy.

Doctors aren’t sure whether it’s safe to take Ingrezza during pregnancy. Talk with your doctor about your birth control needs with Ingrezza if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend whether you should use birth control with this medication.

It isn’t known whether Ingrezza passes into human breast milk. So it’s not known whether the drug could affect a child who is breastfed.

Ingrezza has been detected in the milk of lactating animals in clinical studies. However, what happens in animals doesn’t always reflect what may happen in humans.

To be safe, your doctor may recommend that you do not take Ingrezza while breastfeeding. And they may suggest you avoid breastfeeding for at least 5 days after your last dose of the drug.

If you’re breastfeeding or planning to do so, talk with your doctor before starting Ingrezza. They can recommend healthy ways to feed your child.

This drug comes with several precautions.

This drug has a boxed warning Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Risk of depression and suicidal thoughts or behavior for people with Huntington’s disease. Ingrezza may increase the risk of depression and suicidal thoughts or behavior in people who take the drug to treat chorea associated with Huntington’s disease.

Huntington’s disease is a genetic condition that causes certain nerve cells in the brain to break down. Symptoms include mood changes, such as depression. This disease may also lead to suicidal thoughts or behavior. Taking certain drugs, including Ingrezza, may worsen these symptoms.

Before you start taking Ingrezza, let your doctor know if you’ve ever experienced depression or suicidal thoughts or behavior. They will recommend whether Ingrezza is a good treatment option for you. If you do take Ingrezza, your doctor will monitor you for depression or suicidal thoughts or behavior during treatment.

Tell your doctor about your health history before starting treatment with Ingrezza. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

• Liver problems. Before starting Ingrezza treatment, tell your doctor whether you have liver problems. They may give you a dosage of Ingrezza that’s lower than usual.
• Abnormal heart rhythm. Ingrezza may cause long QT syndrome (a type of abnormal heart rhythm). If you already have an abnormal heart rhythm, the drug may worsen it. Your doctor can recommend whether Ingrezza is safe for you to take.
• Neuroleptic malignant syndrome (NMS). If you develop NMS from taking Ingrezza, your doctor will have you stop Ingrezza. They’ll treat the NMS before you can start taking the drug again. However, restarting Ingrezza treatment may cause NMS to come back. Your doctor will monitor you closely for NMS if they recommend you start taking Ingrezza again.
• Allergic reaction. Your doctor will likely not prescribe Ingrezza if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
• Pregnancy. It’s not known whether Ingrezza is safe to take during pregnancy. If you’d like to learn additional information about taking Ingrezza while pregnant, view the “Ingrezza: Taking while pregnant” section above.
• Breastfeeding. It’s not known whether Ingrezza passes into breast milk. If you’d like to learn additional information about taking Ingrezza while breastfeeding, view the “Ingrezza: Taking while breastfeeding” section above.

To learn more about effects of Ingrezza that could be harmful, see the “Ingrezza: Side effects” section above.

For some drugs, taking more than the recommended dosage may lead to unwanted side effects or overdose. Do not take more Ingrezza than your doctor advises.

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

Here’s some information about Ingrezza’s expiration date, as well as how to store and dispose of the drug.

• Expiration. Your pharmacist will add an expiration date to the label on Ingrezza’s bottle. This date is typically 1 year from the date the medication was dispensed to you. Expiration dates help ensure that a medication is effective during a period of time. The Food and Drug Administration (FDA) advises Trusted Source Food and Drug Administration (FDA) Governmental authority Go to source that you avoid using expired drugs. If you have an unused medication and it’s past the drug’s expiration date, talk with your pharmacist. They can let you know how to correctly dispose of it.
• Storage. Many factors determine how long a medication remains good to use. These factors include how and where you store the drug. Ingrezza capsules should be stored at temperatures between 59–86°F (15–30°C). Avoid storing Ingrezza in areas where it could get damp or wet, such as bathrooms.
• Disposal. It’s important to safely dispose of Ingrezza if you no longer need to take it and have unused medication. Doing so helps prevent others, including children and pets, from accidentally taking the drug. It also helps avoid causing harm to the environment. Ask your pharmacist for information about disposing of Ingrezza. Also, check out this page for several tips on safe medication disposal.

If you have questions about Ingrezza, talk with your doctor. They can help advise you on whether Ingrezza could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

• Will Ingrezza cure my condition?
• How is Ingrezza different from other medications that treat movement disorders?
• Does Ingrezza interact with any other medications I’m taking?

Your doctor may also tell you about other treatment options for your condition.

Disclaimer: Healthgrades 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.