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# Deutetrabenazine

A deuterated form of tetrabenazine whose active metabolites last longer. Treats Huntington chorea and tardive dyskinesia.

Updated 2026-11-01

- Class: [VMAT2 inhibitors](https://durgical.com/en/pharmacology/classes/vmat2-inhibitors/)
- Transporter: Vesicular monoamine transporter 2 (VMAT2)
- ATC code: N07XX16

⇄**Vesicular monoamine transporter 2 (VMAT2)**Deutetrabenazine

ⓘ The figure shows tetrabenazine in human VMAT2; deutetrabenazine is the same molecule with some hydrogens replaced by deuterium and binds the same site.

**Target in 3D:** Vesicular monoamine transporter 2 (VMAT2). PDB structure 8JTA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8JTA) · Drag to rotate · pinch to zoom

## Mechanism of action

Deutetrabenazine is tetrabenazine with deuterium in place of some hydrogen atoms. The stronger carbon-deuterium bonds slow its metabolism (the kinetic isotope effect), so its active metabolites, which inhibit VMAT2, have longer half-lives. Dopamine stores are depleted and hyperkinetic movements decrease.

- Deuterium slows the breakdown of the active metabolites
- Metabolites block VMAT2 for longer
- Striatal dopamine release falls
- Chorea and tardive movements decrease

## Pharmacokinetics

**Metabolism**
Active deuterated metabolites with longer half-lives than those of tetrabenazine; CYP2D6 involved

## Indications

- Chorea of Huntington disease [Huntington disease →](https://durgical.com/en/conditions/huntington-disease/)
- Tardive dyskinesia [Antipsychotic-induced movement disorders (dystonia, akathisia, parkinsonism, tardive dyskinesia) →](https://durgical.com/en/conditions/antipsychotic-induced-movement-disorders/)

## Adverse effects

### Common

- Tiredness and somnolence
- Diarrhoea or constipation, dry mouth
- Insomnia
- Nasal congestion and sore throat

### Serious (rare, important)

- Depression and suicidal thoughts in Huntington disease (boxed warning)
- Parkinsonism, balance problems and falls
- QT prolongation and fainting
- Neuroleptic malignant syndrome

## Contraindications

- Liver disease
- MAO inhibitors (and within two weeks of stopping them)
- Tetrabenazine, valbenazine or reserpine
- Suicidal or untreated depressed patients with Huntington disease

## Key interactions

**Strong CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion, quinidine)**
Higher exposure; dose is limited

**QT-prolonging drugs**
Additive QT risk

**Alcohol and sedatives**
More drowsiness

## What is monitored

- Mood and suicidal thoughts
- Parkinsonism, gait and falls
- ECG and potassium and magnesium when QT risk exists

## Administration and safety

- Tablets are swallowed whole, not split, chewed or crushed
- Immediate-release and extended-release tablets are different products
- Increased gradually, at most weekly

## Nursing care

- Screen for depression and suicidal thoughts and involve the family
- Assess gait and fall risk
- Warn about drowsiness and alcohol

## Pregnancy and breastfeeding

Human data are lacking; pregnancy during treatment is discussed with the specialist.

## Memory aid

«DEUTErium = DUrable»: deuterium makes the tetrabenazine metabolites last longer.

## Test yourself

Think of the answer, then tap the question to see it.

## What does deuterium change in deutetrabenazine?

Stronger carbon-deuterium bonds slow metabolism, so the active VMAT2-inhibiting metabolites last longer.

## Which two movement disorders is deutetrabenazine used for?

Chorea of Huntington disease and tardive dyskinesia.

## Which psychiatric warning applies in Huntington disease?

Increased risk of depression and suicidal thoughts.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/deutetrabenazine/)

## Related drugs

- [Tetrabenazine](https://durgical.com/en/pharmacology/tetrabenazine/)
- [Valbenazine](https://durgical.com/en/pharmacology/valbenazine/)

## Related conditions

- [Huntington disease](https://durgical.com/en/conditions/huntington-disease/)
- [Antipsychotic-induced movement disorders (dystonia, akathisia, parkinsonism, tardive dyskinesia)](https://durgical.com/en/conditions/antipsychotic-induced-movement-disorders/)

[← Back to the class: VMAT2 inhibitors](https://durgical.com/en/pharmacology/classes/vmat2-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Deutetrabenazine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617022.html) (MedlinePlus (U.S. National Library of Medicine), 2024); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 21 (McGraw Hill, 2023); Farmacología básica y clínica (Katzung), 16.ª ed., cap. 28 (McGraw Hill, 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N07XX16) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/deutetrabenazine/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/deutetrabenazine/