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Ingrezza mechanism of action: How does it work?

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 28, 2023.

Official answer

by drugclasses.com

Experts aren’t sure exactly how Ingrezza works but suggest it blocks a protein transporter called vesicular monoamine transporter 2 (VMAT2), which is responsible for regulating the uptake of neurotransmitters such as dopamine. The abnormal functioning of dopamine is thought to be a cause of tardive dyskinesia (TD) and chorea associated with Huntington's disease (HD). By blocking VMAT2, Ingrezza reduces the uptake of dopamine, causing a decrease in symptoms of TD and chorea.

Ingrezza may also regulate the uptake of other neurotransmitters, such as noradrenaline and serotonin. All these neurotransmitters have various functions within the body but dopamine, in particular, plays a role in movement as well as pleasure, motivation, and learning.

Ingrezza may be used to treat adults with tardive dyskinesia (TD) or with chorea associated with HD. Although some reduction in symptoms of TD and chorea may be noticed within a week or two, it can take a few months for the full effects to be seen. Side effects include fatigue, sleepiness, a rash, changes in balance, and a dry mouth.

References
  • The cause of tardive dyskinesia (TD) and how INGREZZA works Ingrezza.com https://www.ingrezza.com/how-ingrezza-can-help
  • Ingrezza (valbenazine) 08/2022 Neurocrine Biosciences, Inc. https://www.drugclasses.com/pro/ingrezza.html
  • Touma KTB, Scarff JR. Valbenazine and Deutetrabenazine for Tardive Dyskinesia. Innov Clin Neurosci. 2018;15(5-6):13‐16.
    Huntington's Disease. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/huntingtons-disease#:~:text=People%20living%20with%20HD%20develop,movements%20are%20signs%20of%20chorea
  • Earnst D. Ingrezza Gains Approval for Huntington Disease Chorea. August 21, 2023. Medical Professionals Reference. https://www.empr.com/home/news/ingrezza-gains-approval-for-huntington-disease-chorea/
  • Neurocrine Biosciences Announces FDA Approval of INGREZZA® (valbenazine) Capsules for the Treatment of Chorea Associated With Huntington's Disease.
    Neurocrine Biosciences. 18 August 2023. https://neurocrine.gcs-web.com/news-releases/news-release-details/neurocrine-biosciences-announces-fda-approval-ingrezzar

Read next

How much does Ingrezza cost and will insurance cover it?

Ingrezza costs approximately $7,921 for 28 capsules of the 40mg strength and $8,702 for 28 capsules of the 80mg strength, or an annual cost of $102,973 to $113,126 per year; however, most people do not pay this amount. People with commercial insurance may qualify for a $0 copay for each Ingrezza prescription through the INBRACE Support Program and approximately 46% of Medicare Part D and Medicare Advantage plans cover Ingrezza. For people with Medicaid, most states require prior authorization for Ingrezza and the satisfaction of certain criteria before it can be funded. Continue reading

Which pharmacies can dispense Ingrezza?

A specialty pharmacy will dispense your Ingrezza or Ingrezza Sprinkle and will mail it directly to you via overnight mail. Your doctor will send your prescription to the appropriate pharmacy, and they will contact you to verify the information. Continue reading

Does Ingrezza cause weight gain?

Weight gain has been reported in a 6-week clinical study with Ingrezza, but it is not a common side effect. Of 151 patients taking either the 40 mg/day or 80 mg/day dose, 3 patients had weight gain (2%) compared to zero patients (0%) in the placebo (inactive treatment) group. Continue reading

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