Valbenazine Guide: Uses, Side Effects, Dosage, and What Patients Should Know
Tardive dyskinesia and Huntington disease-associated chorea are neurological conditions that can cause uncontrollable body movements, affecting daily activities such as speaking, eating, walking, and social interaction. Over time, these symptoms may also affect emotional well-being, independence, and quality of life for both patients and caregivers.1-3
Treatment options for these movement disorders have evolved in recent years, including medications developed specifically to help manage involuntary movements. One such treatment is valbenazine, a medicine approved for adults with tardive dyskinesia and chorea associated with Huntington disease.4
What is Valbenazine?
Valbenazine, marketed under the brand name Ingrezza, is a prescription medication approved for the treatment of tardive dyskinesia in adults and chorea associated with Huntington disease.4
It belongs to a class of medicines called vesicle monoamine transporter 2 (VMAT2) inhibitors, which help regulate dopamine activity in the brain. By reducing abnormal signalling linked to involuntary movements, valbenazine may help improve movement control in some patients.4
What is Valbenazine Used For?
Valbenazine is approved for two major conditions:
- Tardive dyskinesia
Tardive dyskinesia is a hyperkinetic movement disorder associated with prolonged exposure to dopamine receptor blocking agents, particularly antipsychotic medications. Symptoms may include involuntary movements of the tongue, lips, face, and extremities.3
- Huntington disease-associated chorea
Huntington disease-associated chorea involves involuntary movements that may interfere with speech, eating, walking, balance, and daily functioning.1
Valbenazine helps reduce the severity of these movements in some patients.4
How Does Valbenazine Work?
Dopamine is a chemical messenger in the brain that helps control movement. In conditions such as tardive dyskinesia, changes in dopamine signalling may lead to unwanted involuntary movements.3
Valbenazine works by blocking a protein called VMAT2, which helps control how dopamine is stored and released in nerve cells. By reducing the amount of dopamine released, valbenazine can help lessen abnormal involuntary movements.3
Valbenazine For Tardive Dyskinesia
Tardive dyskinesia can have a major impact on daily functioning and quality of life. People with the disease may feel self-conscious or bothered by visible involuntary movements, which can make everyday activities more difficult.5
Clinical studies have shown that valbenazine can significantly reduce abnormal movements in adults with tardive dyskinesia. Some patients notice improvement within a few weeks, although response times can vary. Patients in clinical studies continued valbenazine treatment for up to 48 weeks under medical supervision.4,6
Valbenazine for Huntington Disease-associated Chorea
In people with Huntington disease, chorea can interfere with balance, swallowing, speech, and independence.1,2
Valbenazine may help reduce the intensity and frequency of these involuntary movements.4 Huntington disease is a complex neurological condition that can affect movement, thinking, and mood, so treatment plans are often tailored to each patient. During treatment, doctors may carefully monitor movement symptoms, mood, side effects, and overall functioning.7
What is Valbenazine Dosage?
Valbenazine is usually taken once daily, with or without food. The dose may differ depending on the condition being treated, liver function, and other medicines being taken.4
For tardive dyskinesia, treatment is typically started at 40 mg once daily for one week before increasing to the recommended dose of 80 mg once daily. For Huntington disease-associated chorea, treatment usually begins at 40 mg once daily, with gradual dose increases over time based on response and tolerability, up to a recommended dose of 80 mg daily.4
Some patients may require lower doses, including those with moderate or severe liver impairment or those taking certain medicines that affect how valbenazine is metabolized.4
Patients should always follow the exact dosing instructions provided by their healthcare provider.
How to Take Valbenazine Safely?
Here are some important safety tips for patients taking valbenazine4:
- It can usually be taken with or without food.
- Swallow capsules exactly as directed.
- Do not stop the medication suddenly without medical advice.
- Avoid driving or operating machinery until you know how the medicine affects you.
Because valbenazine may cause sleepiness in some people, caution is important during the first few days or weeks of treatment. If a dose is missed, the next dose should be taken at the usual scheduled time unless otherwise advised by a healthcare provider.4
What are the Common Side Effects?
Like all medications, valbenazine may cause side effects, although not everyone experiences them. In adults treated for tardive dyskinesia, the most common side effect is sleepiness or drowsiness (somnolence).4
In adults treated for Huntington disease-associated chorea, commonly reported side effects include4
- Sleepiness, sedation, or lethargy
- Rash
- Hives (urticaria)
- Difficulty sleeping (insomnia)
Some patients may also experience fatigue, balance problems, or dry mouth during treatment.4
Serious Side Effects and Warning Signs
Valbenazine may rarely cause serious side effects that require immediate medical attention.
One of the most important warnings involves patients with Huntington disease. Valbenazine may increase the risk of depression, suicidal thoughts, or unusual changes in behaviour in some individuals. Caregivers and family members should watch for mood changes or worsening depression and report these symptoms promptly.4
Although these reactions are uncommon, medical attention should be sought immediately if they occur.
Who Should Speak to a Doctor Before Taking Valbenazine?
Before starting valbenazine, patients should discuss their complete medical history with their doctor, especially if they have4
- Depression or a history of suicidal thoughts
- Huntington disease with psychiatric symptoms
- Liver disease or heart rhythm problems
Doctors may recommend closer monitoring in some patients, particularly those with underlying mental health conditions.
Can Valbenazine Interact with Other Medicines?
Yes. Valbenazine can interact with certain medications, which may affect how well treatment works or increase the risk of side effects. Before starting treatment, patients should tell their doctor about all prescription medicines, over-the-counter products, vitamins, and herbal supplements they take. It is also important to inform all healthcare providers about ongoing valbenazine treatment.4
What to Ask Your Doctor Before Starting Valbenazine?
Before beginning treatment, patients may find it helpful to ask the following:
- What benefits should I expect from this medication?
- How long will it take to work?
- What side effects should I watch for?
- Will this interact with my current medications?
- How often will I need follow-up visits?
- What should I do if I miss a dose?
- Is this medicine safe with my medical history?
Open communication can help patients feel more confident and prepared during treatment.
Accessing Valbenazine in India Through the Named Patient Program
Valbenazine is approved in several countries for the treatment of tardive dyskinesia and Huntington disease-associated chorea. However, availability may vary across India. In situations where appropriate treatment options are limited, eligible patients may be able to access valbenazine through the Named Patient Program (NPP)8 with approval from a treating doctor and supporting medical documentation.
The process may involve regulatory review and coordinated import before the medicine is supplied to the treating hospital or healthcare centre. Support services such as Rx4U may assist patients and caregivers with documentation, coordination with healthcare providers, and managing import and delivery logistics.
Final Takeaway
- Valbenazine is used to treat tardive dyskinesia and Huntington disease-associated chorea in adults.
- It helps reduce involuntary movements by regulating dopamine activity in the brain.
- Treatment is usually taken once daily.
- In India, access may be possible through the NPP with physician approval.
Frequently Asked Questions
1. Can valbenazine cause drowsiness?
Yes. Sleepiness or drowsiness is a commonly reported side effect.4
2. Can valbenazine be used during pregnancy?
Patients who are pregnant or planning pregnancy should speak with their doctor before starting treatment.4
3. Can patients breastfeed while taking valbenazine?
Breastfeeding is not recommended during treatment and for 5 days after the last dose.4
Medical Disclaimer
This information is provided for educational purposes only and is not a substitute for professional medical advice. Ingrezza (valbenazine) should only be taken under the guidance of a qualified healthcare provider. Patients should always consult their doctor or pharmacist for advice on diagnosis, treatment, and medication use, and should not make changes to their prescribed therapy without medical supervision.
References
1. Lui F, Merical B, Sánchez-Manso JC. Chorea. In: StatPearls. StatPearls Publishing; 2026 Jan-. Updated January 21, 2025. Accessed May 18, 2026. https://www.ncbi.nlm.nih.gov/books/NBK430923/
2. Thorley EM, Iyer RG, Wicks P, et al. Understanding how chorea affects health-related quality of life in Huntington disease: an online survey of patients and caregivers in the United States. Patient. 2018;11(5):547-559. doi:10.1007/s40271-018-0312-x
3. Uhlyar S, Rey JA. Valbenazine (Ingrezza): the first FDA-approved treatment for tardive dyskinesia. P T. 2018;43(6):328-331.
4. Prescribing information. Neurocrine Biosciences Inc. 2026. Accessed May 18, 2026. https://pi.neurocrine.com/ingrezza/INGREZZA-Full-Prescribing-Information.pdf
5. Farrar M, Lundt L, Franey E, Yonan C. Patient perspective of tardive dyskinesia: results from a social media listening study. BMC Psychiatry. 2021;21(1):94. doi:10.1186/s12888-021-03074-9
6.Hauser RA, Factor SA, Marder SR, et al. KINECT 3: A phase 3 randomized, double-blind, placebo-controlled trial of valbenazine for tardive dyskinesia. Am J Psychiatry. 2017;174(5):476-484. doi:10.1176/appi.ajp.2017.16091037
7. Olmedo-Saura G, Bernardi E, Bojtos L, et al. Update on the symptomatic treatment of Huntington's disease: from pathophysiology to clinical practice. Int J Mol Sci. 2025;26(13):6220. doi:10.3390/ijms26136220
8. Patil S. Early access programs: benefits, challenges, and key considerations for successful implementation. Perspect Clin Res. 2016;7(1):4-8. doi:10.4103/2229-3485.173779
