Valbenazine

Indications

Valbenazine is used for: Tardive Dyskinesia

Adult Dose

Tardive Dyskinesia Indicated for treatment of tardive dyskinesia in adults 40 mg PO qDay x1 week, then increase to the recommended dose of 80 mg PO qDay Continuation of 40 mg once daily may be considered for some patients Hepatic impairment Mild: No dose adjustment required Moderate-to-severe (Child-Pugh 7-15): Not to exceed 40 mg/day

Child Dose

Renal Dose

Renal impairment Mild-to-moderate (CrCl 30-90 mL/min): No dose adjustment required Severe (CrCl <30 mL/min): Use not recommended

Administration

May take with or without food

Contra Indications

Patients with a history of hypersensitivity to drug or components of the formulation

Precautions

Can cause somnolence; warn patients not to perform activities requiring mental alertness (eg, driving or operating hazardous machinery) until they know how they will be affected

Pregnancy-Lactation

Pregnancy Data are limited on use in pregnant women Based on animal studies, may cause fetal harm; advise pregnant women of the potential risk Lactation Unknown if distributed in human breast milk Valbenazine and its metabolites have been detected in rat milk at concentrations higher than in plasma following oral administration at doses 0.1-1.2 times the MRHD based on mg/m²

Interactions

Side Effects

Side effects of Valbenazine : >10% Somnolence (10.9%) 1-10% Anticholinergic effects (5.4%) Balance disorders/fall (4.1%) Headache (3.4%) Akathisia (2.7%) Vomiting (2.6%) Nausea (2.3%) Arthralgia (2.3%)

Mode of Action

The mechanism of action of valbenazine in the treatment of tardive dyskinesia is unknown, but is thought to be mediated through the reversible inhibition of vesicular monoamine transporter 2 (VMAT2), a transporter that regulates monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release