Valbenazine Explained: A Practical Guide to Movement Disorder Treatment
Movement disorders can affect everyday activities in different ways, and understanding the available treatment options is often an important part of the care journey. If you or a loved one has been prescribed valbenazine or is exploring treatment options, this guide provides a simple overview of what the treatment is, how it may fit into a care plan, and what to know before getting started.
What Is Valbenazine?
Valbenazine is a prescription medicine approved by the FDA in 2017 for adults with tardive dyskinesia (TD), a condition that causes unwanted and repetitive body movements. Valbenazine is available as 40 mg and 80 mg capsules and belongs to a group of medicines called VMAT2 inhibitors.1
What Movement Disorders Is Valbenazine Used For?
Valbenazine is approved for the treatment of tardive dyskinesia (TD) in adults.
Before valbenazine became available, treatment approaches for TD often included medicines or supplements used for other conditions. One example is tetrabenazine, a medicine approved for chorea associated with Huntington's disease, which has shown positive results in some studies involving TD. Valbenazine was the first FDA-approved medicine specifically indicated for adults with TD.1
How Does Valbenazine Work?
To control movement, the brain uses chemical messengers called neurotransmitters. One of these messengers is dopamine, which plays an important role in how the body moves.
Valbenazine works by blocking a protein called VMAT2, which helps move and recycle these chemical messengers in the brain. By affecting this process, valbenazine helps reduce dopamine activity involved in abnormal movements.
VMAT2 is found mainly in the central nervous system, and valbenazine is designed to target this protein very specifically.1
What Is Tardive Dyskinesia?
Tardive dyskinesia (TD) is a movement disorder associated with the use of medicines called dopamine receptor blocking agents, most commonly antipsychotic medications. Among patients with schizophrenia who receive antipsychotic therapy, TD has a reported prevalence of up to 30%.1
People with TD may develop involuntary (uncontrolled) movements, especially involving the tongue, lips, face, and arms or legs. These movements are often described as athetoid or choreiform movements and may appear one to two years after starting treatment with dopamine receptor blockers.1
To help identify and monitor TD, healthcare professionals commonly use a tool called the Abnormal Involuntary Movement Scale (AIMS), which helps assess the presence and severity of abnormal movements.1
What Is Chorea Associated With Huntington’s Disease?
Chorea is a movement symptom that causes uncontrolled, sudden, and unpredictable body movements. These movements can affect the arms, legs, face, or other parts of the body and may look restless, fidgety, or even dance-like.2
One of the conditions most commonly linked with chorea is Huntington’s disease, an inherited condition that affects movement.2
The severity of chorea can vary from person to person. Some people may experience occasional small movements, while others may have more noticeable movements that affect walking, balance, or everyday activities. In some cases, chorea may occur alongside other movement symptoms that appear slower, twisting, or more forceful.2
Who May Be Prescribed Valbenazine?
Valbenazine is approved for the treatment of adults with tardive dyskinesia (TD).1
TD is most often associated with the use of antipsychotic medications, which are commonly used in conditions such as schizophrenia. Because many patients may require long-term antipsychotic treatment, some individuals may develop TD over time.1
Research has identified certain groups that may have a higher risk of developing TD, including:1
- Older adults
- Women
- African-Americans
Valbenazine Dosage: What Patients Should Know
Valbenazine is taken by mouth once daily and can be taken with or without food.
Treatment usually starts with a dose of 40 mg once daily for the first week. After that, the dose is increased to the recommended dose of 80 mg once daily.1
What To Expect After Starting Valbenazine
One can expect changes in involuntary movements over time and observed improvements after receiving valbenazine.
In a study, researchers followed 102 adults with TD for 6 weeks. Patients taking valbenazine showed greater improvement in movement symptoms than those taking a placebo. By the end of the study, people taking valbenazine had an average improvement of 3.6 points on a standard movement-rating scale, compared with 1.1 points in the placebo group.1
Similar results were seen in alarger study, which included 225 participants. After 6 weeks, patients taking valbenazine 80 mg once daily showed an average improvement of 3.2 points on the same movement-rating scale compared with placebo.1
Common Side Effects Of Valbenazine
In three 6-week clinical studies, 262 patients received 25 mg to 100 mg of valbenazine per day. Based on the combined results, the most commonly reported side effects were:1
- Sleepiness (somnolence) – 10.9%
- Anticholinergic effects – 5.4%
- Balance problems and falls – 4.1%
- Headache – 3.4%
- Akathisia (a feeling of restlessness or difficulty staying still) – 2.7%
- Vomiting – 2.6%
- Nausea – 2.3%
- Joint pain (arthralgia) – 2.3%
- The studies also reported dose-related increases in certain laboratory values, including prolactin, alkaline phosphatase, and bilirubin.1
Serious Precautions And Warning Signs
Before starting valbenazine, patients should discuss their overall health, including liver function, kidney function, pregnancy, and breastfeeding, with their healthcare provider.1
- Liver impairment: Patients with moderate or severe hepatic impairment are recommended a lower dose of 40 mg once daily.
- Severe kidney impairment: Valbenazine is not recommended for patients with severe renal impairment.
- Pregnancy: Limited information is available about valbenazine use during pregnancy. Animal studies reported delayed fetal development and increased rates of stillbirths and postnatal pup mortality at the maximum recommended human dose.
- Breastfeeding: Because valbenazine and its metabolite were found in animal milk, breastfeeding is not recommended during treatment and for 5 days after the final dose.
- Pediatric use: The safety and effectiveness of valbenazine have not been established in children.
Sleepiness, Driving, And Daily Safety
After starting valbenazine, doctors may monitor patients for how the medicine affects them, especially during the early stages of treatment.
One effect that has been associated with valbenazine is somnolence (sleepiness or drowsiness). Because of this, patients are advised to avoid activities that require full mental alertness, such as driving or operating heavy machinery, until they understand how the medicine affects them.1
Can Valbenazine Interact With Other Medicines?
Yes, valbenazine can interact with some medicines.1
- MAOIs: Taking valbenazine with MAO inhibitors may raise monoamine levels and increase the risk of serotonin syndrome or reduce treatment effect.
- Strong CYP3A4 inhibitors: These can increase valbenazine exposure, so the dose may need to be reduced.
- Strong CYP2D6 inhibitors: These can also increase exposure to valbenazine’s active metabolite, so dose reduction may be considered.
- Strong CYP3A4 inducers: These can lower valbenazine exposure and reduce effectiveness, so this combination is not recommended.
- Digoxin: Valbenazine may increase digoxin levels, so digoxin concentrations may need to be monitored.
- Patients should tell their doctor about all prescription medicines, over-the-counter medicines, and supplements before starting valbenazine.
Follow-Up Care During Movement Disorder Treatment
Regular follow-up appointments help doctors monitor how treatment is progressing and decide whether any additional checks are needed over time.
Valbenazine has been associated with QT prolongation, which is a change in the heart's electrical activity that can be measured using an electrocardiogram (ECG). In studies involving healthy volunteers, the average QT prolongation was 6.7 milliseconds, and 11.7 milliseconds in people who were poor CYP2D6 metabolizers or were taking strong CYP2D6 or CYP3A4 inhibitors.
Because of this, some patients may have an ECG before or during treatment, particularly if they have risk factors that may increase the likelihood of QT prolongation. Regular follow-up visits also provide an opportunity to discuss any changes, concerns, or questions that arise during treatment.1
What To Discuss With Your Doctor Before Starting Valbenazine
Before starting valbenazine, it can be helpful to have an open conversation with your doctor about your symptoms, treatment goals, and what to expect during treatment.
Some questions you may want to ask include:
- Why is valbenazine being recommended for me?
- What improvements should I realistically expect?
- How long might it take to notice changes?
- What side effects should I watch for?
- How will my progress be monitored?
- Will valbenazine affect any medicines I already take?
- What should I do if I miss a dose?
- How often will I need follow-up appointments?
- Are there any lifestyle or daily routine considerations I should know about?
- Who should I contact if I have questions or concerns during treatment?
Final Thoughts
Movement disorders such as tardive dyskinesia can have a meaningful impact on daily life, making it important for patients and caregivers to understand the available treatment options. Valbenazine was the first FDA-approved treatment specifically indicated for adults with tardive dyskinesia and works by targeting pathways involved in abnormal movements. From understanding how the medicine works and what side effects to watch for, to knowing the importance of follow-up care and medication reviews, being informed can help patients feel more confident and prepared throughout their treatment journey.¹
FAQs
- What is valbenazine used for?
Valbenazine is approved for the treatment of tardive dyskinesia (TD) in adults.¹
- Is valbenazine used for movement disorders?
Yes, valbenazine is used to treat tardive dyskinesia, a movement disorder characterized by involuntary movements.¹
- How does valbenazine work?
Valbenazine works by inhibiting VMAT2, a protein involved in the movement and recycling of neurotransmitters in the brain.¹
- What is tardive dyskinesia?
Tardive dyskinesia is a movement disorder associated with the use of dopamine receptor blocking medicines, often causing involuntary movements of the face and body.¹
- Can valbenazine treat tardive dyskinesia?
Yes, valbenazine is FDA-approved for the treatment of adults with tardive dyskinesia.¹
- Can valbenazine help with Huntington’s disease chorea?
Yes, valbenazine can help with Huntington’s disease chorea.¹˒²
References
- Uhlyar S, Rey JA. Valbenazine (Ingrezza): The First FDA-Approved Treatment for Tardive Dyskinesia. P T. 2018;43(6):328-331.
- Lui F, Merical B, Sánchez-Manso JC. Chorea. [Updated 2025 Jan 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430923/
Note:
The information provided is for education purpose only and is subjected to prescribing information of the drug and the guidance of your treating physician. Always consult your health care provider before making any medical decision for starting your treatment.
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