Ingrezza (valbenazine) is a prescription drug that’s used to treat certain movement disorders. Ingrezza comes as a capsule that you swallow.

Ingrezza is used in adults to treat:

To learn more about Ingrezza’s uses, see the “What is Ingrezza used for?” section below.

Ingrezza basics

Ingrezza contains the active ingredient valbenazine. (An active ingredient is what makes a drug work.)

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

Ingrezza is prescribed to treat the following conditions in adults:

About 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 atypical movements that you can’t control.

Usually, TD occurs as a side effect of certain medications. Below are some medications that may cause TD:

About chorea and Huntington’s disease

Like TD, chorea causes uncontrollable movements of your face, arms, or legs. These movements may be sudden and jerky and can resemble dancing or fidgeting.

Chorea may result from several conditions, including Huntington’s disease. This is a genetic (inherited) condition that causes nerve cells in the brain to break down.

Doctors may prescribe Ingrezza to treat chorea associated with Huntington’s disease. The drug is not prescribed to treat chorea due to other causes.

About Ingrezza for treating TD and chorea due to Huntington’s disease

TD and chorea may result from having too much of a chemical called dopamine in your brain. It’s not known exactly how Ingrezza works to treat these movement disorders. 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.

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

For more information on Ingrezza’s side effects, refer to this article. Your doctor or pharmacist can also tell you more about the potential side effects of this drug. And they can 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:

* 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:

* NMS was not reported in studies of Ingrezza. But it has been reported after the drug became available on the market.
† 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.

Boxed warning: Risk of depression and suicidal thoughts or behavior in people with Huntington’s disease

Ingrezza has a boxed warning about the risk of depression and suicidal thoughts or behavior 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 due to Huntington’s disease. This disease is a genetic (inherited) condition that causes nerve cells in the brain to break down. It may cause mood changes, such as depression, and can also lead to thoughts of or behaviors related to suicide. Ingrezza and similar drugs may worsen these symptoms of Huntington’s disease.

In certain studies, people taking the drug experienced depression and suicidal thoughts or behaviors. However, reports of these side effects were rare.

Symptoms of depression include:

  • feelings of sadness or hopelessness
  • lack of interest in activities a person used to enjoy
  • fatigue (low energy)
  • difficulty sleeping

Symptoms of suicidal thoughts or behaviors include:

  • frequent thoughts about dying or wishing life would end
  • avoiding or wanting to avoid other people
  • engaging in reckless behavior, such as drinking large amounts of alcohol
  • giving away possessions or saying goodbye to friends and family

What might help

Before starting treatment with Ingrezza, tell your doctor whether you have any mental health conditions, such as depression. Also, let them know whether you’ve ever had suicidal thoughts or behaviors. This will help your doctor determine whether Ingrezza is the right treatment option for you.

While you’re taking Ingrezza, your doctor will monitor you for new or worsening depression and suicidal thoughts or behavior. They may have you stop taking the drug if you develop either of these conditions.

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.

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Weight gain

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.

Dry mouth

Ingrezza can cause dry mouth. In fact, this medication can cause dryness throughout your body, which may result in symptoms such as:

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.

Allergic reaction

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. In fact, sudden swelling of the throat, lips, and face has been reported after taking Ingrezza. This reaction can occur after your first dose or after you’ve taken the drug for a while.

Call your doctor right away if you have an allergic reaction to Ingrezza. But if you think you’re having a medical emergency, such as severe swelling, 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.

For more information about Ingrezza’s dosage, refer to this article.

Form and strengths

Ingrezza comes as a capsule that you swallow. It comes in strengths of 40 milligrams (mg), 60 mg, and 80 mg.

Recommended dosages

Below is information on the dosages for the conditions Ingrezza is used to treat.

Dosage for tardive dyskinesia

To treat tardive dyskinesia (TD), you’ll take your prescribed dose of Ingrezza once daily. Your doctor will likely recommend a 40-mg starting dose of Ingrezza for the first week of treatment. After the first week, they will likely increase your dosage to 80 mg once daily.

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.

Dosage for chorea due to Huntington’s disease

To treat chorea due to Huntington’s disease, you’ll take your prescribed dose of Ingrezza once daily. Your doctor will typically recommend a 40-mg starting dose of Ingrezza for the first 2 weeks of treatment. After that, they’ll likely increase your dosage to 60 mg once daily for the next 2 weeks. Then they’ll increase your dosage to 80 mg once daily.

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. 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 TD or chorea 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.

For more about Ingrezza and cost, see this article. And be sure to check out this article to learn more about saving money on prescriptions.

Ingrezza and Austedo (deutetrabenazine) are prescribed to treat tardive dyskinesia (TD) and chorea due to Huntington’s disease in adults. Ingrezza comes as a capsule that you swallow. Austedo comes as a tablet or extended-release tablet* that you swallow. The latter is available under the name Austedo XR.

See this side-by-side comparison to learn how Ingrezza and Austedo are similar and different. To get more information about how these drugs compare, ask your doctor or pharmacist.

* An extended-release tablet releases its drug slowly into your body over a long period of time.

Find answers to some commonly asked questions about Ingrezza.

How does Ingrezza work?

Ingrezza is prescribed to treat adults with tardive dyskinesia (TD) and chorea due to Huntington’s disease. But its mechanism of action (how it works) for treating these conditions isn’t known for sure.

TD and chorea 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?

Like Ingrezza, Cogentin (benztropine) was a drug that may be prescribed to treat side effects related to antipsychotic medications. (These are medications for certain mental health disorders.) Currently, Cogentin is discontinued. But generic benztropine is still available for prescription.

While Ingrezza is used to treat TD and chorea due to Huntington’s disease, benztropine is used to treat extrapyramidal symptoms. Extrapyramidal symptoms tend to occur earlier than TD or chorea and may include symptoms such as muscle stiffness, restlessness, and tremors. Benztropine can also be used with other medications to treat parkinsonism.

Benztropine isn’t used to treat TD or chorea. It may actually make symptoms of TD worse, while its effects on chorea are unknown.

Ingrezza only comes as a capsule that you swallow. Benztropine comes as a tablet and an injection given into a vein or muscle. These drugs have different dosage recommendations and may cause different side effects.

Whether your doctor recommends Ingrezza or benztropine depends on your specific condition and other factors. For more information about the differences between Ingrezza and benztropine, 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 and chorea due to Huntington’s disease. (To learn more, see the “What is Ingrezza used for?” section above.)

Like TD and chorea, Tourette syndrome is a condition that can cause involuntary movements affecting the face or other parts of the body. But there are differences between these conditions. TD occurs after taking a medication, such as an antipsychotic. The chorea that Ingrezza treats results from Huntington’s disease, a genetic (inherited) condition that causes nerve cells in the brain to break down. The cause of Tourette syndrome is unknown.

Since TD, chorea, and Tourette syndrome all 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 whether 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, one of the conditions 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.

Antipsychotics are thought to help ease symptoms of chorea. (Doctors prescribe Ingrezza to treat chorea due to Huntington’s disease.) If you’re interested in learning more about antipsychotics for chorea, talk with your doctor.

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 whether Ingrezza may be a safe and effective treatment option for you.

Interactions

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.

To learn more about Ingrezza’s interactions, refer to this article.

Interactions with drugs or supplements

Ingrezza can interact with several kinds of drugs. These drugs include:

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.

Other interactions

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) or chorea due to Huntington’s disease.

Ingrezza can also interact with grapefruit and products containing it, such as grapefruit juice. Due to this interaction, your doctor may suggest that you do not consume grapefruit or grapefruit juice while you’re taking Ingrezza.

Boxed warnings

Ingrezza has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Risk of depression and suicidal thoughts or behavior in people with Huntington’s disease. Ingrezza is prescribed to treat chorea due to Huntington’s disease. This disease is a genetic (inherited) condition that causes nerve cells in the brain to break down. It may cause mood changes, such as depression, and can also lead to thoughts of or behaviors related to suicide. Ingrezza and similar drugs may worsen these symptoms of Huntington’s disease.

For more information, see the “What are Ingrezza’s side effects?” section above.

Other warnings

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 whether Ingrezza may be a safe treatment option for you. In some cases, they may recommend a different medication to treat your TD or chorea due to Huntington’s disease.
  • 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.
  • Neuroleptic malignant syndrome (NMS). Ingrezza may cause NMS. If you develop NMS from taking Ingrezza, your doctor will have you stop taking the drug to treat this side effect. However, restarting Ingrezza treatment may cause NMS to occur again. In this case, your doctor will monitor you closely for NMS if you start taking Ingrezza again.

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 whether Ingrezza may be safe to take during pregnancy.

In addition, it’s not known whether 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.

Taking Ingrezza

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

One of the conditions doctors prescribe Ingrezza to treat is 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 America’s Poison 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 TD?
  • What other treatment options are available for chorea due to Huntington’s disease?

To learn more about Ingrezza, 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.

Q:

I’m taking the antidepressant Prozac. Will taking Ingrezza with this drug increase my risk of side effects?

Anonymous

A:

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.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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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.

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