[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [VMAT2 inhibitors](https://durgical.com/en/pharmacology/classes/vmat2-inhibitors/) › Valbenazine

[Pharmacology](https://durgical.com/en/pharmacology/) · [VMAT2 inhibitors](https://durgical.com/en/pharmacology/classes/vmat2-inhibitors/)

# Valbenazine

A selective VMAT2 inhibitor for tardive dyskinesia and Huntington chorea. Watch for sleepiness, QT prolongation and MAO inhibitor interactions.

Updated 2026-11-01

- Class: [VMAT2 inhibitors](https://durgical.com/en/pharmacology/classes/vmat2-inhibitors/)
- Transporter: Vesicular monoamine transporter 2 (VMAT2)
- ATC code: N07XX13

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

ⓘ The figure shows valbenazine bound to human VMAT2 (cryo-EM structure).

**Target in 3D:** Vesicular monoamine transporter 2 (VMAT2). PDB structure 9KQ8 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/9KQ8) · Drag to rotate · pinch to zoom

## Mechanism of action

Valbenazine is converted to an active metabolite that selectively and reversibly inhibits VMAT2. Less dopamine is loaded into vesicles and released onto supersensitive striatal receptors, so the involuntary movements of tardive dyskinesia decrease.

- Valbenazine becomes an active VMAT2-blocking metabolite
- Less dopamine is stored in vesicles
- Supersensitive striatal receptors get less stimulation
- Tardive movements of mouth, face and limbs decrease

## Pharmacokinetics

**Metabolism**
Converted to an active metabolite; CYP3A4 and CYP2D6 are involved

## Indications

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

## Adverse effects

### Common

- Sleepiness and tiredness
- Restlessness (akathisia)
- Anticholinergic-type effects: dry mouth, constipation, blurred vision, difficulty urinating
- Balance problems and falls, headache, nausea

### Serious (rare, important)

- Depression and suicidal thoughts, especially in Huntington disease
- QT prolongation and arrhythmias
- Parkinsonism
- Neuroleptic malignant syndrome; allergic reactions with angioedema

## Contraindications

- Hypersensitivity to valbenazine
- MAO inhibitors (avoided, including within two weeks)
- Caution: long QT syndrome, recent heart attack, heart failure, liver disease

## Key interactions

**MAO inhibitors (including rasagiline, safinamide, selegiline)**
Excess monoamines; avoided

**Strong CYP2D6 inhibitors (paroxetine, fluoxetine) or CYP3A4 inhibitors**
Higher exposure; dose is reduced

**St John's wort**
May interact; checked before use

**Alcohol and sedatives**
More drowsiness

## What is monitored

- Involuntary movement scale over time
- Mood and suicidal thoughts
- ECG when QT risk factors are present
- Sleepiness, gait and falls

## Administration and safety

- Capsules are given once a day; sprinkle capsules can be mixed with a spoonful of soft food
- Breastfeeding is avoided during treatment and for some days after the last dose
- Look-alike names with other «-benazine» drugs

## Nursing care

- Teach not to drive until sleepiness is known; avoid alcohol
- Ask about low mood and suicidal thoughts
- Report palpitations, fainting or swelling of the face
- Ask about grapefruit and new medicines that may interact

## Pregnancy and breastfeeding

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

## Memory aid

«VALbenazine VALues a calm tongue»: tardive dyskinesia of mouth and tongue settles.

## Test yourself

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

## What is the main indication of valbenazine?

Tardive dyskinesia in adults; it is also used for Huntington chorea.

## Which cardiac risk is monitored with valbenazine?

QT prolongation, especially with CYP2D6 or CYP3A4 inhibitors or long QT syndrome.

## Which drug group must not be combined with valbenazine?

MAO inhibitors, including the MAO-B inhibitors used in Parkinson disease.

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

## Related drugs

- [Tetrabenazine](https://durgical.com/en/pharmacology/tetrabenazine/)
- [Deutetrabenazine](https://durgical.com/en/pharmacology/deutetrabenazine/)

## Related conditions

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

[← 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: [Valbenazine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617023.html) (MedlinePlus (U.S. National Library of Medicine), 2025); 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=N07XX13) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/valbenazine/
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