Tetrabenazine

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Tetrabenazine
Systematic (IUPAC) name
(SS,RR)-3-Isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyrido[2,1-a]isoquinolin-2-one
Clinical data
Trade namesXenazine
AHFS/Drugs.comConsumer Drug Information
Pregnancy cat.C
Legal status℞-only (US)
RoutesOral (tablets, 25 mg)
Pharmacokinetic data
BioavailabilityLow, extensive first pass effect
Protein binding82–85%
MetabolismHepatic (CYP2D6-mediated)
ExcretionRenal and fecal
Identifiers
CAS number58-46-8 YesY
ATC codeN07XX06
PubChemCID 6018
DrugBankDB04844
ChemSpider5796 YesY
UNIIZ9O08YRN8O YesY
KEGGD08575 YesY
ChEMBLCHEMBL117785 YesY
SynonymsRo-1-9569
Chemical data
FormulaC19H27NO3 
Mol. mass317.427 g/mol
 YesY (what is this?)  (verify)
 
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Tetrabenazine
Systematic (IUPAC) name
(SS,RR)-3-Isobutyl-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-pyrido[2,1-a]isoquinolin-2-one
Clinical data
Trade namesXenazine
AHFS/Drugs.comConsumer Drug Information
Pregnancy cat.C
Legal status℞-only (US)
RoutesOral (tablets, 25 mg)
Pharmacokinetic data
BioavailabilityLow, extensive first pass effect
Protein binding82–85%
MetabolismHepatic (CYP2D6-mediated)
ExcretionRenal and fecal
Identifiers
CAS number58-46-8 YesY
ATC codeN07XX06
PubChemCID 6018
DrugBankDB04844
ChemSpider5796 YesY
UNIIZ9O08YRN8O YesY
KEGGD08575 YesY
ChEMBLCHEMBL117785 YesY
SynonymsRo-1-9569
Chemical data
FormulaC19H27NO3 
Mol. mass317.427 g/mol
 YesY (what is this?)  (verify)

Tetrabenazine is a drug for the symptomatic treatment of hyperkinetic movement disorder and is marketed under the trade names Nitoman in Canada and Xenazine in New Zealand and some parts of Europe, and is also available in the USA as an orphan drug. On August 15, 2008 the U.S. Food and Drug Administration (FDA) approved the use of tetrabenazine to treat chorea associated with Huntington's disease (HD), the first in the US.[1] The compound has been known since the 1950s.

Pharmacology[edit]

Tetrabenazine works mainly as a VMAT-inhibitor[2] and as such promotes the early metabolic degradation of monoamines, in particular the neurotransmitter dopamine.

Uses[edit]

Tetrabenazine is used as a treatment, but not a cure for hyperkinetic disorders[3][4] such as:

Side effects[edit]

Because tetrabenazine is closely related to antipsychotics, many of its side effects are similar. Some of these include:[6]

Unlike many antipsychotics, tetrabenazine is not known to cause tardive dyskinesia.

Warnings[edit]

References[edit]

  1. ^ 1st US drug for Huntington's disease wins approval[dead link]
  2. ^ Zheng G, Dwoskin LP, Crooks PA (2006). "Vesicular monoamine transporter 2: role as a novel target for drug development". AAPS J 8 (4): E682–92. doi:10.1208/aapsj080478. PMC 2751365. PMID 17233532. 
  3. ^ Jankovic J, Beach J (1997). "Long-term effects of tetrabenazine in hyperkinetic movement disorders". Neurology 48 (2): 358–62. PMID 9040721. 
  4. ^ Kenney C, Hunter C, Jankovic J (January 2007). "Long-term tolerability of tetrabenazine in the treatment of hyperkinetic movement disorders". Mov. Disord. 22 (2): 193–7. doi:10.1002/mds.21222. PMID 17133512. 
  5. ^ Ondo WG, Hanna PA, Jankovic J (August 1999). "Tetrabenazine treatment for tardive dyskinesia: assessment by randomized videotape protocol". Am J Psychiatry 156 (8): 1279–81. PMID 10450276. 
  6. ^ Robertson MM (March 2000). "Tourette syndrome, associated conditions and the complexities of treatment". Brain. 123 123 (3): 425–62. doi:10.1093/brain/123.3.425. PMID 10686169. 

External links[edit]