From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
When taking deutetrabenazine, baseline electrocardiogram (ECG), liver function tests (AST, ALT, bilirubin), complete blood count (CBC), and CYP2D6 genotyping are necessary for safe use, as well as regular monitoring of these parameters and assessment of movement disorders, depression, and suicidality, as supported by the most recent study 1. The recommended diagnostic tests and laboratory evaluations are necessary to assess the potential risks associated with deutetrabenazine, including QT prolongation, hepatotoxicity, and depression.
- Baseline ECG is necessary to assess QT interval, as deutetrabenazine can cause QT prolongation, although a recent study found that deutetrabenazine does not have a clinically relevant effect on QT prolongation at maximum recommended doses 2.
- Liver function tests are required since the medication is metabolized by the liver and may cause hepatotoxicity.
- Complete blood count (CBC) should be performed to establish baseline values.
- CYP2D6 genotyping is recommended as deutetrabenazine is metabolized by this enzyme, and poor metabolizers may require dose adjustments.
- Patients should also undergo baseline assessment of depression and suicidal ideation using standardized scales, as the medication carries a boxed warning for these risks. During treatment, regular monitoring includes:
- Periodic ECGs (especially when reaching maintenance doses)
- Liver function tests every 3-6 months
- Ongoing assessment of movement disorders, depression, and suicidality These tests are crucial because deutetrabenazine, used for chorea in Huntington's disease and tardive dyskinesia, works by inhibiting vesicular monoamine transporter type 2 (VMAT2), affecting neurotransmitter storage and potentially causing various systemic effects requiring careful monitoring, as reported in a real-world adverse event analysis 1.