Xenazine (Tetrabenazine)

Name: Xenazine
Brand: Bausch Health
SKU: 6655
Availability: InStock

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Xenazine Tablet

Manufacturer: Bausch Health

Country: Canada

Dosage: 25 mg

Qty-Price (USD):

Type:

Product: Xenazine Tablet (New Zealand - Motetis)

Manufacturer: Douglas

Country: New Zealand

Dosage: 25 mg

Qty-Price (USD):

Generic Equivalent of Xenazine

Type

Product

Manufacturer

Country

Dosage

Qty-Price (USD)

Type:

Product: Tetrabenazine Tablet

Manufacturer: Generic

Country: Canada

Dosage: 25 mg

Qty-Price (USD):

Type:

Product: Tetrabenazine Tablet

Manufacturer: Generic

Country: India

Dosage: 25 mg

Qty-Price (USD):

Xenazine Information

medically reviewed by Carol Hou (BSc. Pharm) on July 22, 2025.

A licensed pharmacist (Licensed Community Pharmacies Directory | College of Pharmacists of British Columbia) with over 20 years of experience in medication management, specifically medication safety, she has reviewed the information for accuracy and completeness.

Xenazine and Tetrabenazine at CanadaPharmacyOnline.com

The medication tetrabenazine, originally developed and sold under the brand name Xenazine in some regions, is known as Nitoman in Canada and is manufactured and marketed by Bausch Health. In New Zealand, the same active ingredient, tetrabenazine, is manufactured by Douglas Pharmaceuticals under the brand name Motetis.

Generic tetrabenazine is sourced from manufacturers that meet applicable regulatory standards. The specific manufacturer of your dispensed medication may vary.

Important Information about Generic Xenazine:

Generic tetrabenazine contains the same active ingredient as the brand-name Xenazine and is required to meet the same safety, effectiveness, and quality standards as the brand-name product. This means it is designed to work in the same way as tetrabenazine, also known as Xenazine. Studies have demonstrated bioequivalence between generic and brand-name tetrabenazine, meaning they have comparable absorption rates and overall effects. However, individual responses to any medication can vary. If you have any questions about using generic tetrabenazine, talk to your doctor or pharmacist.

For more information about generic drug approval and bioequivalence, please visit Access to Generic Drugs in Canada | Canada.ca.

Dosage

Xenazine and generic tetrabenazine are available as oral tablets in 25 mg strengths (at this pharmacy).

Your doctor will determine the appropriate dose based on your individual needs and medical history.

Usage

Xenazine (tetrabenazine) is a prescription medication used to treat hyperkinetic movement disorders by affecting certain brain chemicals. Common uses include:
• Chorea Associated with Huntington's Disease: Treatment of the involuntary movements (chorea) characteristic of Huntington's disease.
• Tourette syndrome: Management of motor and vocal tics.
• Other Movement Disorders (off-label): Sometimes used off-label for conditions such as tardive dyskinesia (involuntary movements caused by long-term use of certain medications, typically antipsychotics), and hemiballismus (violent, flinging movements of a limb).

Mechanism of Action
Xenazine (tetrabenazine) exerts its therapeutic effects primarily by reversibly inhibiting vesicular monoamine transporter 2 (VMAT2). VMAT2 is responsible for transporting monoamine neurotransmitters, such as dopamine, serotonin, norepinephrine, and histamine, from the cytoplasm into synaptic vesicles for storage and subsequent release. By blocking VMAT2, tetrabenazine leads to a decrease in the uptake and storage of these monoamines within nerve terminals, resulting in their depletion from the nerve endings. This depletion, particularly of dopamine, is thought to reduce the excessive neuronal activity that contributes to involuntary movements.

Take Xenazine exactly as your doctor prescribes, following the instructions in the product monograph in Canada. Consult your doctor for personalized guidance and safe use.

The information below summarizes some, but not all, potential side effects, risks, and interactions. Before taking Xenazine, it is essential to discuss all possible side effects, risks, and interactions with your doctor or pharmacist.

Side Effects

The information below is a partial list of side effects; individual reactions can vary. Before starting Xenazine, it is crucial to discuss potential side effects and risks with your doctor or pharmacist.

Common Side Effects - The following are some common side effects of Xenazine; other side effects may also occur. Contact your doctor promptly if any side effects are persistent, worsening, or concerning, or if you experience any other concerning symptoms.
• Agitation
• Anxiety
• Changes in muscle tone
• Constipation
• Depression (new or worsening)
• Diarrhea
• Dizziness
• Drowsiness/Sedation (somnolence)
• Dry mouth
• Fatigue/Weakness
• Headache
• Insomnia (difficulty sleeping)
• Nausea
• Parkinsonism (symptoms like tremor, slowness of movement, difficulty with balance, stiffness, excessive salivation)
• Restlessness (akathisia)
• Vomiting

Serious Side Effects - These are rare but potentially severe side effects. Seek immediate medical attention or call emergency services if you experience any of the following:
• Allergic reactions: Severe rash, hives, swelling of the face, lips, tongue, or throat, difficulty breathing, wheezing, itching.
• Cardiovascular effects:
• QT prolongation: Abnormal heart rhythm, which can lead to fainting, severe dizziness, or fast/irregular heartbeat.
• Orthostatic hypotension: Dizziness, lightheadedness, or fainting when getting up from a lying or sitting position.
• Depression and Suicidality: New or worsening depression, suicidal thoughts or behavior (including planning or attempting suicide), extreme worry, agitation, hostility, or unusual changes in behavior. This is a Black Box Warning for Xenazine.
• Difficulty swallowing (dysphagia): Can lead to aspiration pneumonia.
• Neuroleptic Malignant Syndrome (NMS): A rare but life-threatening reaction with symptoms like high fever, severe muscle stiffness, confusion, sweating, rapid heart rate, and blood pressure changes.
• Parkinsonism: Severe or worsening symptoms of Parkinson's disease, including unsteadiness, tremors, rigidity, or excessive salivation, especially if the dose is too high.

Contraindications

The following is not an exhaustive list of contraindications. Before starting Xenazine, it is crucial to discuss all your medical conditions, past and present, and all medications you are taking with your doctor or pharmacist.

Xenazine should not be used if:
• You are actively suicidal or have untreated or inadequately treated depression. This is a Black Box Warning for Xenazine.
• You are allergic to tetrabenazine or any other ingredient in Xenazine.
• You are taking a monoamine oxidase inhibitor (MAOI) or have taken one within the last 14 days (e.g., isocarboxazid, phenelzine, selegiline, tranylcypromine, linezolid, methylene blue injection). A dangerous drug interaction can occur.
• You have hepatic impairment (severe liver disease).

Tell your doctor about all of your medical conditions, past and present, before starting Xenazine. This is crucial because certain conditions affect whether Xenazine is right for you. These conditions may include, but are not limited to:
• Cardiac arrhythmias (especially prolonged QT interval or congenital long QT syndrome)
• Depression (history of)
• Dysphagia (difficulty swallowing)
• History of suicidal attempts or ideation
• Kidney impairment (dose adjustment may be needed)
• Liver impairment (mild to moderate)
• Parkinson's disease (may exacerbate symptoms)

Drug Interactions

Before taking Xenazine, it is essential to discuss all potential risks and interactions with your doctor or pharmacist. For complete and up-to-date information, please visit the Xenazine official product website USA at https://www.xenazineusa.com/

Provide your doctor with a complete list of all your medications, including prescriptions, over-the-counter (OTC) drugs, vitamins, and herbal supplements. It is also essential to inform your doctor about any herbal teas, recreational drugs, or significant dietary changes you are making, as these could potentially interact with Xenazine. Xenazine may interact with other medicines, but is not limited to:
• Anticoagulants (blood thinners, e.g., warfarin): Potential for interaction, though pharmacokinetic interaction is unlikely. Monitor closely.
• Antidepressants (e.g., fluoxetine, paroxetine): Strong CYP2D6 inhibitors like fluoxetine and paroxetine can significantly increase the exposure to tetrabenazine's active metabolites, potentially increasing the risk of side effects. Dose limits for tetrabenazine may apply (e.g., maximum daily dose of 50 mg, single dose of 25 mg).
• Anti-emetics (e.g., metoclopramide): Dopamine antagonists, such as metoclopramide, may counteract the effects of tetrabenazine or increase the risk of Parkinson's disease symptoms.
• Antihypertensives (blood pressure medications): Xenazine may potentiate the action of antihypertensive drugs, increasing the risk of hypotension.
• Antipsychotics (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone) and other dopamine antagonists: May increase the risk of Parkinsonism, NMS, and akathisia. Some (e.g., chlorpromazine, haloperidol, thioridazine, ziprasidone) also increase the risk of QT-interval prolongation; concomitant use should be avoided.
• CNS Depressants (e.g., benzodiazepines, opioids, sedatives, hypnotics): May cause additive CNS depression, leading to increased drowsiness, dizziness, and impaired coordination.
• Levodopa: Xenazine may reduce the therapeutic effects of levodopa and can exacerbate Parkinson's disease symptoms.
• Monoamine Oxidase Inhibitors (MAOIs) (e.g., phenelzine, selegiline): Contraindicated. Concomitant use or use within 14 days of discontinuing an MAOI can lead to severe, potentially fatal reactions including CNS excitation and hypertension.
• QT-prolonging drugs (e.g., certain antiarrhythmics like amiodarone, procainamide, quinidine, sotalol; some antibiotics like moxifloxacin; certain antipsychotics): Increased risk of QT-interval prolongation. Concomitant use should generally be avoided.
• Reserpine: Contraindicated. Concomitant use may result in elevated catecholamine levels; a washout period of at least 20 days is required when switching from reserpine to tetrabenazine.
• VMAT2 inhibitors (e.g., deutetrabenazine, valbenazine): Contraindicated. Avoid alcohol use while taking Xenazine. Concomitant use with alcohol may worsen sedation and somnolence (drowsiness).

Pregnancy and Breastfeeding

Xenazine is generally not recommended during pregnancy unless the potential benefit outweighs the potential risk to the fetus, as animal studies have shown evidence of fetal harm (e.g., increased stillbirths, hypothermia, mortality, delayed development). There are no adequate and well-controlled studies in pregnant humans. If you are pregnant or planning to become pregnant, discuss this with your doctor. Tetrabenazine is excreted into human milk. Due to the potential for severe adverse reactions in the infant, a decision should be made whether to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. Consult your doctor for personalized advice.

Use in the Elderly

Elderly patients taking Xenazine should be monitored closely for side effects such as sedation, Parkinsonism, and orthostatic hypotension, as they may be more susceptible to these effects and potential falls.

Use in Children

Health Canada approves Xenazine for the treatment of chorea associated with Huntington's disease. In Canada, it is also approved for the treatment of Tourette syndrome in children and adolescents. The safety and effectiveness of Xenazine in pediatric patients for all potential indications have not been fully established, and dosage must be carefully determined by a physician based on individual needs and response. Children and adolescents may be at increased risk of depression and suicidality, and should be closely monitored.

Frequently Asked Questions about Xenazine at Canada Pharmacy Online:

Why is Xenazine more affordable in Canada than in the United States?

Prescription drug prices, including Xenazine, are generally lower in Canada than in the US due to a combination of factors, primarily government price regulations, differing market dynamics, and other economic considerations. In Canada, provincial and federal governments negotiate drug prices with pharmaceutical companies, which often results in lower costs compared to the US, where market forces play a more significant role. For more information, see the FAQs on Prescription Drug Importation from the Kaiser Family Foundation (KFF): https://www.kff.org/health-costs/issue-brief/faqs-on-prescription-drug-importation/

How much is the shipping?

Our shipping fee is a flat rate of $10.00 per order. Our pharmacy is dedicated to providing you with the lowest prices on high-quality products.

How do I place an order with your pharmacy?

Ordering from us is very simple. You can purchase online or call Customer Service at 1866.920.3784; for more information or to learn about the ordering process, visit our How to Order page.

Is there a limit on the number of tablets I can order at one time?

CanadaPharmacyOnline.com can only dispense a maximum of a three-month supply of Xenazine at a time, as per your doctor's prescription.

Can I buy over the counter from you?

No, Xenazine requires a valid prescription from your doctor. We do not sell this product without a valid prescription.

Do you ship to the United States?

Yes, we do. It usually takes 7 to 18 business days to receive your order from our pharmacy.

What is the best time to take Xenazine?

Xenazine is typically taken two or three times a day, with or without food. Taking it with food may help reduce stomach discomfort. It's essential to spread the doses throughout the day, as instructed by your doctor, to maintain consistent levels and minimize side effects. Your doctor will provide specific instructions on the timing of your dose.

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The information on this page is sourced from independent third parties contracted by CanadaPharmacyOnline. While we cannot guarantee its medical accuracy, we strongly recommend consulting a healthcare professional for personalized advice regarding medications or medical conditions.

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