Austedo (deutetrabenazine) is a prescription drug used to treat involuntary movements caused by certain conditions. Austedo can interact with alcohol, other drugs, and some supplements. For example, it can interact with opioids and certain antidepressants.

Austedo is used in adults to treat:

Austedo comes as an immediate-release oral tablet and an extended-release oral tablet (Austedo XR). Immediate-release tablets release the medication into your body right away. Extended-release tablets release the medication slowly over a period of time.

The two forms of Austedo have similar interactions.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Austedo’s possible interactions. And for more information about Austedo, including details about its uses, see this article.

Before you start taking Austedo, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Austedo interacts with herbs or vitamins and supplements, see the “Are there other interactions with Austedo?” section below.)

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

The table below lists drugs that may interact with Austedo. Keep in mind that this table does not include all drugs that may interact with Austedo. For more information about some of these interactions, see the “Drug interactions explained” section below.

Drug group or drug nameDrug examplesWhat can happen
monoamine oxidase inhibitors (MAOIs)*• isocarboxazid (Marplan)
• phenelzine (Nardil)
• rasagiline (Azilect)
• selegiline (Emsam, Zelapar)
• tranylcypromine (Parnate)
can increase the risk of side effects from MAOIs
drugs similar to Austedo*• tetrabenazine (Xenazine)
• valbenazine (Ingrezza)
can increase the risk of side effects of Austedo and similar drugs
antiarrhythmicsamiodarone (Pacerone)
quinidine
sotalol (Betapace)
can increase the risk of irregular heartbeat
antipsychotics• chlorpromazine
• haloperidol (Haldol)
• risperidone (Risperdal)
can increase the risk of side effects from Austedo and antipsychotics
certain antidepressantsbupropion (Wellbutrin)
fluoxetine (Prozac)
paroxetine (Paxil)
can increase the risk of side effects from Austedo
certain antibioticsazithromycin (Zithromax)
• clarithromycin
• moxifloxacin (Avelox)
can increase the risk of irregular heartbeat
opioids• morphine (MS Contin)
• oxycodone (OxyContin)
tramadol (ConZip)
can increase the risk of severe drowsiness
benzodiazepines• alprazolam (Xanax)
diazepam (Valium)
• lorazepam (Ativan)
can increase the risk of severe sleepiness

* Austedo should not be taken with these drugs. See “When should I avoid Austedo?” below for more information.

Certain health conditions or other factors could raise your risk of harm if you take Austedo. In such cases, your doctor may not prescribe Austedo for you. These are known as contraindications. The list below includes contraindications of Austedo.

If you have Huntington’s disease and you have suicidal thoughts or depression that’s not managed: If you have Huntington’s disease and you have depression that’s not well managed or have had suicidal thoughts or behaviors, your doctor likely won’t prescribe Austedo for you. The drug could worsen your depression and suicidal thoughts. Austedo has a boxed warning about this risk. To learn more, see the “Boxed warning” section at the beginning of this article.

If you have liver problems: If you have liver problems, your doctor likely won’t prescribe Austedo for you. This is because your liver helps clear Austedo from your body. If you have liver problems, Austedo levels can build up in your body. This can raise your risk of side effects. Talk with your doctor about other treatments that may be better options for you.

If you take an MAOI: If you take an MAOI drug, your doctor will likely not prescribe Austedo for you. This is because Austedo can increase the risk of serious side effects from these drugs. After you stop taking an MAOI, you should wait at least 14 days before starting Austedo treatment. Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), and rasagiline (Azilect).

If you take tetrabenazine or valbenazine: If you take tetrabenazine (Xenazine) or valbenazine (Ingrezza), your doctor will likely not prescribe Austedo for you. They belong to the same drug group as Austedo and can cause similar side effects. Only one of these drugs should be used at a time. Taking them together can raise the risk of side effects. To learn more, talk with your doctor or pharmacist.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Austedo or any of its ingredients, your doctor likely won’t prescribe Austedo for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Austedo, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Austedo is safe for you to take.

You should avoid or limit alcohol consumption while taking Austedo. Drinking alcohol during your Austedo treatment can cause severe drowsiness.

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

Learn more about certain drug interactions that can occur with Austedo.

Interaction with certain antidepressants

Austedo can interact with certain antidepressants, which are used to treat depression, anxiety, and other mental health conditions.

Examples of antidepressants that can interact with Austedo include:

  • amitriptyline
  • citalopram (Celexa)
  • bupropion (Wellbutrin)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)

What could happen

Taking Austedo with certain antidepressants, such as bupropion, fluoxetine, or paroxetine, can increase the amount of Austedo in your body. This can raise your risk of side effects from Austedo, such as drowsiness and long QT syndrome (a type of irregular heartbeat).

Austedo and certain other antidepressants can cause similar side effects. For example, Austedo and amitriptyline can both cause sleepiness, and Austedo and citalopram can both cause long QT syndrome. So taking these drugs together can raise your risk of these side effects.

What you can do

If you take Austedo with an antidepressant that can interact with it, your doctor may prescribe a lower dosage of Austedo or the antidepressant for you. You should not take a higher dose of either medication than your doctor prescribes. Your doctor may also monitor your heart rhythm with an electrocardiogram (EKG) during your Austedo treatment.

If you take Austedo with one of the antidepressants listed above, tell your doctor right away if you feel very drowsy or have symptoms of long QT syndrome. These may include heart palpitations, dizziness, or fainting.

If you have questions about taking Austedo with an antidepressant, talk with your doctor or pharmacist.

Interaction with certain antibiotics

Austedo can interact with certain antibiotics, which are used to treat bacterial infections.

Examples of antibiotic medications that can interact with Austedo include:

  • azithromycin (Zithromax)
  • clarithromycin
  • moxifloxacin (Avelox)

What could happen

Austedo and certain antibiotics can both cause long QT syndrome. Taking these drugs together can raise your risk of this side effect.

If you have a slow or irregular heartbeat, you may have a higher risk of this side effect if you take Austedo with an antibiotic that interacts with it.

What you can do

Your doctor will likely avoid prescribing certain antibiotics with Austedo. If you need treatment for a bacterial infection, your doctor will usually prescribe an antibiotic that doesn’t interact with Austedo.

If you take Austedo with one of the antibiotics listed above, tell your doctor right away if you feel very drowsy or have symptoms of long QT syndrome. These can include heart palpitations, dizziness, or fainting.

Interaction with opioids

Austedo can interact with opioids, which are strong pain relievers prescribed for moderate to severe pain.

Examples of opioid medications include:

  • morphine (MS Contin)
  • oxycodone (OxyContin)
  • tramadol (ConZip)

What could happen

Austedo and opioids can both cause drowsiness. So taking Austedo with an opioid can raise your risk of severe drowsiness. It can also raise your risk of respiratory depression (slow, shallow breathing).

What you can do

If you take Austedo with an opioid, your doctor may prescribe a lower dosage of Austedo or the opioid for you. You should not take a higher dose of either medication than your doctor prescribes.

If you take Austedo with an opioid, call your doctor right away if you feel very drowsy or have slow, shallow breathing. You should also have your family or people close to you watch you for these side effects.

As a precaution, your doctor may recommend keeping naloxone (Narcan) on hand in case of an emergency. Narcan is a nasal spray that another person can give you in an emergency. It reverses the effects of opioids, including respiratory depression. For more information, talk with your doctor or pharmacist.

Austedo may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Austedo.

Does Austedo interact with supplements?

Before you start taking Austedo, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

Austedo can interact with supplements used to help with sleep problems, such as melatonin. Taking Austedo with supplements that cause sleepiness can make you very drowsy.

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

Austedo interactions with herbs

Austedo can interact with herbs used to help with sleep problems, such as valerian. Taking Austedo with herbs that cause sleepiness can make you very drowsy.

If you have questions about taking Austedo with other herbs, talk with your doctor or pharmacist.

Austedo and vitamins

There are currently no reports of Austedo interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Austedo.

Does Austedo interact with food?

There are currently no reports of Austedo interacting with food. If you have questions about eating certain foods during your treatment with Austedo, talk with your doctor.

Does Austedo interact with vaccines or lab tests?

There are currently no reports of Austedo interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Austedo treatment, talk with your doctor.

Does Austedo interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Austedo.

Taking cannabis with Austedo can make you very drowsy. Your doctor will likely recommend avoiding cannabis while taking Austedo.

Before you start treatment with Austedo, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Austedo. Before taking Austedo, talk with your doctor about your health history. They’ll determine whether Austedo is right for you.

Health conditions or other factors that might interact with Austedo include:

Liver problems: If you have liver problems, your doctor will likely not prescribe Austedo for you. This is because your liver helps clear Austedo from your body. If you have liver problems, Austedo levels can build up in your body. This can raise your risk of side effects.

If you have liver problems, talk with your doctor about other treatments that may be better options for you.

Drug metabolism problems: Austedo is metabolized (broken down) by an enzyme in your body called CYP2D6. If this enzyme doesn’t work well, Austedo levels could build up in your body. This could raise your risk of side effects. Due to this risk, your doctor may prescribe a lower dosage of Austedo for you.

Certain heart problems: Austedo can increase the risk of dangerous irregular heartbeats in certain people. If you have a slow or irregular heartbeat, such as long QT syndrome, you may have a higher risk of this side effect. Talk with your doctor about whether Austedo is right for you.

Low potassium or magnesium levels: Austedo can increase the risk of dangerous irregular heartbeats in certain people. If you have low levels of potassium or magnesium in your blood, you may have a higher risk of this side effect. Talk with your doctor about whether Austedo is right for you.

Pregnancy: It’s not known whether Austedo is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Austedo.

Breastfeeding: It’s not known whether it’s safe to take Austedo while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Austedo or any of its ingredients, your doctor will likely not prescribe Austedo for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Depression or suicidal thoughts: Austedo can increase the risk of new or worsening depression and suicidal thoughts or behavior in people with Huntington’s disease. The drug has a boxed warning about this risk. To learn more, see the “Boxed warning” section at the beginning of this article.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Was this helpful?

Taking certain steps can help you avoid interactions with Austedo. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • Whether you drink alcohol or use cannabis.
  • Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
  • What to do if you start taking a new drug during your Austedo treatment.

It’s also important to understand Austedo’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Austedo, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Austedo exactly as prescribed can also help prevent interactions.

If you still have questions about Austedo and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

  • Does my risk of interactions depend on my dosage of Austedo?
  • What pain relievers are safe to take with Austedo?
  • Do other drugs that could treat my condition have similar interactions to Austedo?

To learn more about Austedo, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.