Drug Interaction Report

Deutetrabenazine and Tetrabenazine: Interaction Details

A pharmacist-reviewed analysis of the Deutetrabenazine and Tetrabenazine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Deutetrabenazine

Austedo Austedo XR® Austedo®
+

Tetrabenazine

Xenazine Xenazine®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Contraindicated
These should generally not be used together.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 262 documented Deutetrabenazine interactions, 29 are rated contraindicated — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Contraindicated

What happens

Depletion of monoamines in the central nervous system

Interaction Deep Dive

Concomitant use of deutetrabenazine and tetrabenazine is contraindicated2. Deutetrabenazine (deuterated tetrabenazine) is a vesicular monoamine transporter type 2 inhibitor structurally related to tetrabenazine that depletes monamines, including dopamine in the CNS 1. Deutetrabenazine may be initiated the day after discontinuation of tetrabenazine 2.

Why it happens (mechanism)

Additive inhibition of vesicular monoamine transporter 2 (VMAT2)

Common questions

Can I take Deutetrabenazine and Tetrabenazine together?

Depletion of monoamines in the central nervous system Always confirm with your pharmacist or prescriber before making any change.

How serious is the Deutetrabenazine and Tetrabenazine interaction?

It is rated contraindicated. These should generally not be used together.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Deutetrabenazine or Tetrabenazine need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Frank S, Testa CM, Stamler D, et al: Effect of deutetrabenazine on chorea among patients with Huntington disease: a randomized clinical trial. JAMA 2016; 316(1):40-50.
  2. Product Information: AUSTEDO(TM) oral tablets, deutetrabenazine oral tablets. Teva Pharmaceuticals USA Inc (per FDA), North Wales, PA, 2017. DailyMed
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Deutetrabenazine

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Tetrabenazine

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All Tetrabenazine interactions (58) Tetrabenazine drug information
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Deutetrabenazine + 1,4-butanediol Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Gamma-hydroxybutyrate (ghb) + 140 more
Tetrabenazine + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm Tragacanth + 9 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.