If you have tardive dyskinesia (TD), your doctor may recommend that you take Ingrezza.
Ingrezza is a prescription drug used to treat TD in adults. TD causes involuntary movements, which can occur in your face, arms, or legs. It’s usually a side effect of taking certain medications, such as antipsychotic drugs. To learn more, see the “What is Ingrezza used for?” section below.
The active ingredient in Ingrezza is valbenazine.
Ingrezza comes as a capsule that you swallow. At this time, it’s only available in the brand-name form. It’s not currently available as a generic drug.
Read on to learn more about Ingrezza, its uses, side effects, dosages, and more.
Ingrezza is prescribed to treat tardive dyskinesia (TD). TD causes involuntary (uncontrollable) movements, usually in your face, jaw, tongue, or lips. But it can also affect other areas of your body, such as your arms or legs. The kinds of movement that result from this condition include twitching, jerking motions, and other abnormal movements that you can’t control.
Usually, TD occurs as a side effect of certain medications. Below are some medications that may cause TD:
- haloperidol (Haldol)
- olanzapine (Zyprexa)
- risperidone (Risperdal)
- metoclopramide (Reglan)
TD may result from having too much of a chemical called dopamine in your brain. It’s not known exactly how Ingrezza works to treat TD. But it’s believed to stop a certain protein from working in your brain. By doing so, Ingrezza may help decrease the messages dopamine sends in your brain that cause involuntary movements.
Ingrezza is only used in adults with TD. It’s not known at this time if this medication may be a safe or effective treatment option for children.
Like most drugs, Ingrezza may cause mild or serious side effects. The lists below describe some of the more common side effects that Ingrezza may cause. These lists don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Ingrezza. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a short list of some of the mild side effects that Ingrezza can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Ingrezza’s prescribing information.
Mild side effects of Ingrezza that have been reported include:
- trouble with balance
- joint pain
- blurry vision
- weight gain*
- nausea or vomiting*
- dry mouth*
* For more information about this side effect, see the “Side effect focus” section below.
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
Serious side effects
Serious side effects from Ingrezza can occur, but they aren’t common. If you have serious side effects from Ingrezza, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Ingrezza that have been reported include:
- parkinsonism, a condition that causes symptoms such as slow movement, muscle stiffness, or slower speech
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
Side effect focus
Learn more about some of the side effects Ingrezza may cause.
Weight gain may occur from taking Ingrezza. But this wasn’t a common side effect reported in studies of people taking this medication.
What might help
If you notice changes in your weight while you’re taking Ingrezza, talk with your doctor. They’ll try to figure out whether Ingrezza or something else may be the cause. Your doctor may recommend modifying your diet or exercise routine to help you manage weight changes.
Nausea or vomiting
You may have nausea or vomiting from taking Ingrezza, though these weren’t commonly reported side effects of this drug.
What might help
If you have nausea or vomiting while taking Ingrezza, tell your doctor. They may recommend taking your dose with food to help prevent these side effects.
If these side effects are severe for you, your doctor may recommend that you take a medication to help treat the nausea and vomiting that you’re experiencing from Ingrezza.
Ingrezza can cause dry mouth. In fact, this medication can cause dryness throughout your body, which may result in symptoms such as:
- blurry vision
- urinary retention
In studies of Ingrezza, dry mouth wasn’t a commonly reported side effect.
What might help
If you notice symptoms of dryness, including dry mouth, while taking Ingrezza, talk with your doctor. For dry mouth, your doctor may recommend an over-the-counter mouth rinse, mouth spray, or chewing gum to help ease this side effect. They may also recommend that you sip water more often to help prevent dry mouth and dryness in general.
Some people may have an allergic reaction to Ingrezza.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Ingrezza. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Your doctor will recommend the dosage of Ingrezza that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strengths
Ingrezza comes as a capsule that you swallow. It comes in strengths of 40 milligrams (mg), 60 mg, and 80 mg.
To treat tardive dyskinesia (TD), you’ll take your prescribed dose of Ingrezza once daily. Your doctor will likely recommend a lower starting dose of Ingrezza for the first week of treatment. After the first week, they will likely increase your dose.
In some cases, your doctor may recommend a lower dosage of Ingrezza. For example, having liver problems or taking other medications that may interact with Ingrezza may affect your dosage of Ingrezza.
Questions about Ingrezza’s dosage
Here are some answers to questions you may have about Ingrezza’s dosage.
- What if I miss a dose of Ingrezza? If you miss a dose of Ingrezza, talk with your doctor about when to take your next dose. In some cases, they may suggest that you take your dose as soon as you remember. But if it’s almost time for your next scheduled dose, they may recommend that you take your dose when you usually would.
- Will I need to take Ingrezza long term? Ingrezza is meant to be used as a long-term treatment for TD. If this medication works for you, your doctor will likely recommend that you take it long term.
- How long does Ingrezza take to work? Ingrezza starts working as soon as you take your first dose of medication. But it can take as long as 7 days for this medication to reach a steady level in your body. So you may not notice any changes right away. With continued treatment, you may notice a decrease in your tardive dyskinesia symptoms.
Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Ingrezza manufacturer’s website to see if it has support options.
And be sure to check out this article to learn more about saving money on prescriptions.
See this side-by-side comparison to learn how Ingrezza and Austedo (deutetrabenazine) are similar and different. To get more information about how these drugs compare, ask your doctor or pharmacist.
Find answers to some commonly asked questions about Ingrezza.
How does Ingrezza work?
Ingrezza is prescribed to treat adults with tardive dyskinesia (TD). But its mechanism of action (how it works) for treating this condition isn’t known for sure.
TD may result from having too much of a chemical called dopamine in your brain. It’s believed that Ingrezza stops a certain protein from working in your brain. By doing so, the drug may help decrease the messages that dopamine sends in your brain that cause involuntary movements.
For more information about how Ingrezza works, talk with your doctor or pharmacist.
How does Ingrezza compare with the drug Cogentin?
Ingrezza and Cogentin (benztropine) are both drugs that may be prescribed to treat side effects related to antipsychotic medications. These are medications for certain mental health disorders.
While Ingrezza is used to treat TD, Cogentin is used to treat extrapyramidal symptoms. Extrapyramidal symptoms tend to occur earlier than TD and may include symptoms such as muscle stiffness, restlessness, or tremors. Cogentin can also be used with other medications to treat parkinsonism. Cogentin isn’t used to treat TD and may actually make symptoms of TD worse.
Ingrezza only comes as a capsule that you swallow. Cogentin comes as an injection given into a vein or muscle. (Benztropine, the generic form of Cogentin, comes as a tablet and an injection.) These drugs have different dosage recommendations and may cause different side effects.
Whether your doctor recommends Ingrezza or Cogentin depends on your specific condition and other factors. For more information about the differences between Ingrezza and Cogentin, talk with your doctor.
Is Ingrezza a controlled substance?
No, Ingrezza isn’t a controlled substance. Controlled substances are drugs that are regulated by the United States government because they may cause dependence or misuse. Dependence occurs when your body needs a drug to function as it usually does. Misuse refers to taking a drug differently than how it was prescribed or that was prescribed to someone else.
Ingrezza isn’t believed to have an increased risk of dependence or misuse. But if you have any concerns about these risks and Ingrezza, talk with your doctor or pharmacist.
Does Ingrezza treat Tourette syndrome?
Ingrezza isn’t used to treat Tourette syndrome. At this time, Ingrezza is only used to treat TD. (To learn more, see the “What is Ingrezza used for?” section above.)
Like TD, Tourette syndrome is a condition that can cause involuntary movements affecting the face or other parts of the body. The difference between Tourette syndrome and TD is that TD occurs after taking a medication, such as an antipsychotic. The cause of Tourette syndrome is unknown.
Since TD and Tourette syndrome both cause involuntary movements, it was thought that Ingrezza may also help treat Tourette syndrome. But a study of people with Tourette syndrome who took Ingrezza didn’t find the drug to be effective for treating this condition. More studies are needed to see if Ingrezza may be a future treatment option for Tourette syndrome.
Is Ingrezza an antipsychotic drug?
No, Ingrezza is not an antipsychotic drug. Antipsychotics are medications used to treat certain mental health disorders.
Some antipsychotics may cause TD, the condition that Ingrezza is used to treat. (To learn more, see the “What is Ingrezza used for?” section above.)
If you have TD from taking an antipsychotic, your doctor may recommend that you take Ingrezza along with the antipsychotic to decrease TD symptoms.
Before you start taking Ingrezza, it’s important to talk with your doctor about other medications that you take. You should also tell your doctor about any other medical conditions that you have. Letting your doctor know about these factors will help them determine if Ingrezza may be a safe and effective treatment option for you.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before starting Ingrezza treatment, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Ingrezza.
Interactions with drugs or supplements
Ingrezza can interact with several kinds of drugs. These drugs include:
- certain antidepressant drugs, such as:
- monoamine oxidase inhibitors (MAOIs), including isocarboxazid (Marplan) or phenelzine (Nardil)
- paroxetine (Paxil)
- the antibiotic drug clarithromycin (Biaxin XL)
- the antifungal drugs ketoconazole and itraconazole (Sporanox)
- the seizure drugs carbamazepine (Tegretol) and phenytoin (Dilantin)
- the heart medications quinidine and digoxin (Lanoxin)
- the tuberculosis medication rifampin (Rimactane)
This list does not contain all kinds of drugs that may interact with Ingrezza. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Ingrezza.
Ingrezza may interact with the herbal supplement St. John’s wort. So it’s not recommended to take St. John’s wort while you’re taking Ingrezza. If you’re taking St. John’s Wort, talk with your doctor about the best treatment plan for your tardive dyskinesia (TD).
Ingrezza may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Ingrezza. Factors to consider include those in the list below.
- Heart problems, such as long QT syndrome. Ingrezza may cause certain heart rhythm problems. If you take other medications that may affect your heart or you have a heart problem, Ingrezza may increase your risk of long QT syndrome. Before starting Ingrezza treatment, talk with your doctor about any heart problems that you have. Your doctor can determine if Ingrezza may be a safe treatment option for you. In some cases, they may recommend a different medication to treat your TD.
- Allergic reaction. If you’ve had an allergic reaction to Ingrezza or any of its ingredients, your doctor will likely not prescribe Ingrezza. Ask your doctor what other medications are better options for you.
- Liver problems. Before you start taking Ingrezza, tell your doctor about any liver problems that you have. Your doctor may adjust your dose of Ingrezza depending on how serious your liver condition is. They may also monitor your liver function more often while you’re taking Ingrezza.
Ingrezza and alcohol
Drinking alcohol while taking Ingrezza may not be safe. Both Ingrezza and alcohol can cause very similar side effects. For example, Ingrezza and alcohol can both cause sleepiness, tiredness, nausea, or vomiting. So drinking alcohol during Ingrezza treatment may increase your risk of these side effects. (For more information about Ingrezza’s side effects, see the “What are Ingrezza’s side effects?” section above.)
In addition, the combination of alcohol and Ingrezza may slow down your breathing rate, which can be serious.
Talk with your doctor about how much alcohol, if any, is safe for you to drink with Ingrezza.
Pregnancy and breastfeeding
Ingrezza may cause harm to a developing fetus. At this time, no studies of Ingrezza have been done to determine if Ingrezza may be safe to take during pregnancy.
In addition, it’s not known if Ingrezza may pass into breast milk or what effects it may have on a child who is breastfed. Due to this risk, it is not recommended to breastfeed while taking Ingrezza or for at least 5 days after stopping treatment with Ingrezza.
If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor before starting Ingrezza. They may recommend a different treatment option for you.
Your doctor will explain how you should take Ingrezza. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions.
Ingrezza is a capsule that you swallow. You’ll take it once daily.
Accessible medication containers and labels
If it’s hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:
- have large print
- use braille
- contain a code you can scan with a smartphone to change the text into audio
Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn’t.
Also, if you’re having trouble opening your medication bottles, let your pharmacist know. They may be able to put Ingrezza in an easy-open container. Your pharmacist may also recommend tools to help make it simpler to open the drug’s container.
Taking Ingrezza with other drugs
Ingrezza is a medication that is prescribed to treat tardive dyskinesia (TD). TD usually occurs from taking another medication, such as an antipsychotic. (Antipsychotics are medications used to treat certain mental health disorders.)
If you have TD from taking medication, your doctor will likely recommend that you continue taking that medication even after starting Ingrezza. This is because Ingrezza only helps treat TD caused by your other medication. It does not treat the condition for which you’re taking the other medication.
But it’s possible that your doctor may change the other medication to one that causes fewer side effects. Talk with your doctor about the best treatments for your condition.
Questions about taking Ingrezza
Here are answers to a couple of questions you might have about taking Ingrezza.
- Can Ingrezza be chewed, crushed, or split? The manufacturer of Ingrezza doesn’t specify whether you can open or split Ingrezza capsules. You should try to swallow Ingrezza capsules whole. If you’re having difficulty swallowing your pills, see this article. You might also talk with your doctor about other medications that may treat your condition.
- Should I take Ingrezza with food? You can take Ingrezza with or without food.
Questions for your doctor
You may have questions about Ingrezza and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Ingrezza affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Don’t take more Ingrezza than your doctor prescribes. Taking more than this can lead to serious side effects.
What to do in case you take too much Ingrezza
Call your doctor if you think you’ve taken too much Ingrezza. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Before you start taking Ingrezza, ask your doctor or pharmacist any questions that you may have about the drug. Knowing more about a drug can help you decide whether you want to make it part of your treatment plan. Here are a few to get you started:
- How can I treat side effects that I have from Ingrezza?
- What should I do if I become pregnant while I’m taking Ingrezza?
- Can my dose be increased if Ingrezza isn’t working to treat my TD?
- What other treatment options are available for TD?
If you would like to learn more about treatment options for TD, see this article.
I’m taking the antidepressant Prozac. Will taking Ingrezza with this drug increase my risk of side effects?Anonymous
Yes, taking Prozac with Ingrezza will likely increase your risk of side effects. Fluoxetine, the active ingredient in Prozac, is an inhibitor of the CYP2D6 enzyme. This enzyme breaks down Ingrezza in your body. If you take Prozac with Ingrezza, the level of Ingrezza will increase in your body. This in turn increases your risk of side effects.
If your doctor prescribes a CYP2D6 inhibitor during Ingrezza treatment, they’ll decrease your dosage of Ingrezza to 40 milligrams (mg) once daily. Examples of CYP2D6 inhibitors besides Prozac include paroxetine (Paxil) and quinidine.
If you have more questions about taking Ingrezza with other medications, talk with your doctor or pharmacist.Melissa Badowski, PharmD, MPH, FCCPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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.