| Huntington Disease
Ingrezza vs Xenazine
Side-by-side clinical, coverage, and cost comparison for huntington disease.Deep comparison between: Ingrezza vs Xenazine with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsXenazine has a higher rate of injection site reactions vs Ingrezza based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Xenazine but not Ingrezza, including UnitedHealthcare
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Category
Ingrezza
Xenazine
At A Glance
Oral
Once daily
VMAT2 inhibitor
Oral
Up to 3 times daily
VMAT2 inhibitor
Indications
- Tardive Dyskinesia
- Huntington Disease
- Huntington Disease
Dosing
Tardive Dyskinesia Initial dose 40 mg once daily; increase to recommended dose of 80 mg once daily after one week; 40 mg or 60 mg once daily may be considered based on response and tolerability.
Huntington Disease Initial dose 40 mg once daily; increase in 20 mg increments every two weeks to recommended dose of 80 mg once daily; 40 mg or 60 mg once daily may be considered based on response and tolerability.
Huntington Disease Start at 12.5 mg/day once in the morning; increase to 25 mg/day (12.5 mg twice daily) after 1 week, then titrate by 12.5 mg/day at weekly intervals; doses of 37.5-50 mg/day given in a three times daily regimen (max single dose 25 mg); doses above 50 mg/day require CYP2D6 genotyping -- EMs/IMs may titrate to max 100 mg/day (max single dose 37.5 mg), PMs must not exceed 50 mg/day (max single dose 25 mg); oral, without regard to food.
Contraindications
- History of hypersensitivity to valbenazine or any components of INGREZZA or INGREZZA SPRINKLE
- Active suicidality or untreated/inadequately treated depression
- Hepatic impairment
- Concurrent use of MAOIs or use within 14 days of MAOI discontinuation
- Concurrent use of reserpine (at least 20 days must elapse after stopping reserpine before starting XENAZINE)
- Concurrent use of deutetrabenazine or valbenazine
Adverse Reactions
Most common (>=2%) - Tardive Dyskinesia Somnolence/fatigue/sedation, anticholinergic effects, balance disorders/fall, headache, akathisia, vomiting, nausea, arthralgia
Most common (>=4%) - Huntington Disease chorea Somnolence/lethargy/sedation, fatigue, urticaria, rash, insomnia, akathisia, depression, diarrhea, nausea, back pain
Serious Depression and suicidal ideation (Huntington Disease), hypersensitivity reactions, somnolence and sedation, QT prolongation, neuroleptic malignant syndrome, parkinsonism
Postmarketing Hypersensitivity reactions including allergic dermatitis and pruritis
Most common (>=10%) Sedation/somnolence, fatigue, insomnia, depression, akathisia, anxiety, nausea
Serious Depression and suicidality, neuroleptic malignant syndrome, akathisia/restlessness/agitation, parkinsonism, sedation and somnolence, QTc prolongation, hypotension and orthostatic hypotension, hyperprolactinemia
Postmarketing Tremor, confusion, worsening aggression, pneumonia, hyperhidrosis, skin rash
Pharmacology
VMAT2 inhibitor; valbenazine reversibly inhibits vesicular monoamine transporter 2 (VMAT2), regulating monoamine uptake from the cytoplasm to the synaptic vesicle for storage and release, and is converted to active metabolite [+]-alpha-dihydrotetrabenazine ([+]-alpha-HTBZ), which also binds VMAT2 with high affinity (Ki ~3 nM).
VMAT2 inhibitor; tetrabenazine reversibly inhibits human vesicular monoamine transporter type 2 (VMAT2; Ki approximately 100 nM), depleting monoamines (dopamine, serotonin, norepinephrine, histamine) from nerve terminals, which is believed to underlie its anti-chorea effect in Huntington's disease.
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Most Common Insurance
Anthem BCBS
Ingrezza
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (2/12)
Xenazine
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (9/12)
UnitedHealthcare
Ingrezza
- Covered on 4 commercial plans
- PA (7/8) · Step Therapy (0/8) · Qty limit (7/8)
Xenazine
- Covered on 4 commercial plans
- PA (2/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Ingrezza
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Xenazine
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableHealthWell: Movement Disorders - Medicare Access
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
$10/momo
Xenazine Copay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
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IngrezzaView full Ingrezza profile
XenazineView full Xenazine profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.