From the FDA Drug Label
Each capsule contains 73 mg, 109 mg or 146 mg of valbenazine tosylate equivalent to 40 mg, 60 mg or 80 mg of valbenazine free base, respectively. The dose of Ingrezza (valbenazine) is 40 mg, 60 mg, or 80 mg of valbenazine free base, with corresponding doses of 73 mg, 109 mg, or 146 mg of valbenazine tosylate 1.
From the Research
Ingrezza (valbenazine) is typically initiated at 40 mg once daily for the first week, then increased to the recommended maintenance dose of 80 mg once daily, as supported by the most recent and highest quality study 2. The dosing regimen for Ingrezza is crucial for managing tardive dyskinesia effectively.
- The initial dose of 40 mg once daily for the first week allows for assessment of tolerability and efficacy.
- The maintenance dose of 80 mg once daily has been shown to provide significant improvement in symptoms, with a mean change from baseline to week 48 in AIMS total score of -11.0 2.
- For patients who may need additional symptom control and can tolerate the higher dose, it can be increased, but the evidence does not specify doses beyond 80 mg in the context of the most recent study 2. Key considerations for the use of Ingrezza include:
- Dose adjustments may be necessary for patients with hepatic impairment or those taking strong CYP3A4 inhibitors.
- Ingrezza works by selectively inhibiting VMAT2 (vesicular monoamine transporter 2), which helps regulate dopamine release in the brain, thereby reducing involuntary movements associated with tardive dyskinesia.
- The medication may take several weeks to show full effectiveness, and patients should continue taking it as prescribed even if they don't notice immediate improvement. Common side effects include somnolence, anticholinergic effects, balance disorders, and potential QT prolongation, as noted in various studies 3, 4, 2.