Deutetrabenazine IV Formulation
No, there is currently no intravenous (IV) formulation of deutetrabenazine available. Deutetrabenazine is only available as an oral tablet formulation.
Available Formulation Information
Deutetrabenazine is a vesicular monoamine transporter type 2 (VMAT2) inhibitor that is FDA-approved for the treatment of chorea associated with Huntington's disease and tardive dyskinesia 1, 2, 3. The medication is administered orally in tablet form with the following characteristics:
- Starting dose: 6 mg twice daily (BID) for tardive dyskinesia 1
- Dose titration: Can be increased at weekly intervals in increments of 6 mg/day 1
- Maximum recommended dose: 24 mg BID 1
- Administration requirement: Should be taken with food 1
Pharmacokinetic Considerations
The absence of an IV formulation is consistent with deutetrabenazine's pharmacokinetic profile:
- Deutetrabenazine is a deuterated form of tetrabenazine 2, 4
- The deuteration allows for a longer half-life and less frequent daily dosing compared to tetrabenazine 4
- The medication is metabolized by the liver 4
- The pharmacokinetic advantages of deutetrabenazine are specifically designed for oral administration
Alternative Administration Routes
For patients who cannot take oral medications, limited evidence suggests:
- Crushing deutetrabenazine tablets may be an option for administration via feeding tubes in patients with severe orofacial dyskinesia who cannot swallow 5
- A case report documented successful treatment of tardive dyskinesia using crushed deutetrabenazine administered via percutaneous endoscopic gastrostomy (PEG) tube 5
Clinical Implications
The lack of an IV formulation has important clinical implications:
- For patients requiring parenteral medication administration, deutetrabenazine would not be an appropriate choice
- Alternative VMAT2 inhibitors or other medication classes may need to be considered for patients unable to take oral medications
- When transitioning between care settings, patients on deutetrabenazine will need to continue the oral formulation
Medication Safety
The absence of an IV formulation may actually enhance medication safety:
- Unlike medications that have both oral and IV formulations (which can lead to dosing errors), deutetrabenazine's single formulation eliminates this potential confusion
- This is particularly important given that medication errors involving IV administration can have more immediate and severe consequences than oral administration errors
When treating conditions for which deutetrabenazine is indicated but IV administration is required, clinicians should consult with specialists to identify appropriate alternative medications that are available in IV formulations.