• Austedo, Austedo XR and Ingrezza are used to treat the movement disorder tardive dyskinesia.
• Austedo and Austedo XR also treat the movement disorder chorea which is associated with Huntington’s Disease.
• Austedo, Austedo XR and Ingrezza are from a group that are usually called VMAT2 inhibitors (inhibits vesicular monoamine transporter type 2).

How well does each medication work?

There have been separate Austedo (deutetrabenazine) clinical trials and Ingrezza (valbenazine) clinical trials to see how well they worked.

• Ingrezza 80mg dose had statistically significant improvement in tardive dyskinesia symptoms in 6 weeks.
• Austedo 36 mg had statistically significant improvement in tardive dyskinesia symptoms in 12 weeks.
• In the Ingrezza 40mg trial and the Austedo 24mg trial there was an improvement in scores but they were not clinically significant.
• In a clinical trial using Austedo for treatment of chorea there was a statistically significant improvement in chorea by 12 weeks, using a dose range 6mg to 48mg.
• Improvement in tardive dyskinesia is measured by the Abnormal Involuntary Movement Scale (AIMS) score. A negative score or decreasing score shows an improvement in tardive dyskinesia symptoms.
• Improvement in chorea movements is measured by the Total Maximal Chorea Score. A decreasing score or a negative score shows an improvement in chorea symptoms.

How easy are they to take?

Take Austedo

• twice daily with food, swallowed whole, do not crush, chew or break tablets.

Take Austedo XR

• daily with food, swallowed whole, do not crush, chew or break tablets.

Take Ingrezza

• once a day, with or without food

How safe are they?

Austedo and Austedo XR has a Boxed Warning, specifically warning people that taking Austedo and Austedo XR can increase the risk of developing depression, suicidal thoughts and behavior (suicidality) in patients with Huntington’s disease.

Ingrezza does not have a boxed warning.

What strengths are Austedo, Austedo XR and Ingrezza available as?

Austedo
Austedo XR extended-release tablets are available as 6mg extended-release tablets, 12mg extended-release tablets, and 24mg extended-release tablets
Austedo tablets are available as 6mg tablets, 9mg tablets, and 12 mg tablets.
Ingrezza
Ingrezza capsules are available as 40 mg capsules, 60 mg capsule, and 80mg capsules.

Who should not take these medications?

Some people should not take some medications if they have been or are on specific medications or have a particular health condition, these are called contraindications.

You should not take Austedo or Austedo XR if you:

• If you have Huntington's disease and you have depression that is not being treated or is being treated but you are still depressed, or if you are suicidal.
• have liver impairment.
• if you have been taking reserpine in the last 20 days.
• if you have been taking a medicine called a monoamine oxidase inhibitors (MAOI) in the last 14 days.
• if you are taking the medicine tetrabenazine (Xenazine) or vabenazine.

You should not take Ingrezza if you:

• Allergic or hypersensitive to Ingrezza or any of the ingredients in Ingrezza.

What serious side effects does each medicine have?

Austedo and Austedo XR: Depression and suicidality in patients with Huntington’s disease, QTc prolongation, neuroleptic malignant syndrome (NMS), akathisia, agitation, restlessness, parkinsonism, sedation, somnolence, hyperprolactinemia and binding to melanin-containing tissues.

Ingrezza: Hypersensitivity, somnolence, QT Prolongation and Parkinsonism.

Table Comparing Austedo and Ingrezza

Bottom Line:

• Both Austedo 36mg and Ingrezza 80mg provide statistically significant reduction in dyskinesia symptoms.
• Austedo (6mg-48mg) induces a statistically significant improvement in chorea.
• Individual patients' contraindications, other medications and medical conditions will determine which medication will suit them best.