Ingrezza, made simple.
Ingrezza is a once a day capsule that calms certain uncontrolled movements, the kind seen in tardive dyskinesia and in Huntington's disease. It is simple to start, with just one short step up in dose. This guide explains how it works and what to watch for. A Mississippi pharmacist wrote it for you, with care.
This guide is here to teach you. It is not medical advice, and it does not replace your doctor or pharmacist. Always do what your doctor tells you, and ask a pharmacist before you change how you take any medicine.
Print this guide for your fridgeWhat Ingrezza is and why your doctor gave it to you
Ingrezza is a once a day capsule. Its other name is valbenazine.
It is used for two kinds of uncontrolled movement. One is tardive dyskinesia, repetitive movements often of the face, tongue, or limbs that can develop after long-term use of certain psychiatric medicines. The other is the chorea, the involuntary movements, of Huntington's disease.
There is also a form called Ingrezza Sprinkle. It is the same medicine, but as granules you can sprinkle onto soft food, made for people who find capsules hard to swallow.
The simple version: Ingrezza helps quiet uncontrolled movements so they interfere less with daily life. It is once a day, and starting it is straightforward.
How Ingrezza works
Uncontrolled movements like these are linked to too much activity from a brain chemical called dopamine.
Ingrezza works by reducing how much dopamine is available to send those movement signals. It turns the volume down rather than off.
With less of that overactive signaling, the uncontrolled movements ease. Ingrezza is quite specific in how it works, which is part of why starting it is simpler than some similar medicines.
Your dose
Ingrezza is one capsule, once a day. You can take it with or without food. Take it at about the same time each day.
Starting Ingrezza is simple. For tardive dyskinesia, most people take a lower dose for the first week, then move to the regular dose. There is no long, multi-week dose climb. Your doctor picks your dose and your pharmacist checks it. This page will not tell you what dose to take.
If you use Ingrezza Sprinkle, open the capsule and sprinkle the granules onto a spoonful of soft food like applesauce, yogurt, or pudding. Use soft food, not milk or water, and swallow it right away. Do not crush or chew the granules, and do not give Ingrezza Sprinkle through a feeding tube.
Timing, and what to do if you miss a dose
Take Ingrezza once a day, at about the same time each day. Tie it to a daily habit so it is easy to remember.
If you miss a dose:
- If you miss a dose, take it as soon as you remember that day.
- If it is almost time for the next dose, skip the one you missed. Just take the next one.
- Never take two doses at once to catch up.
- If you have stopped for more than about a week, call your doctor before restarting.
Side effects, what is normal and what is not
Common, and often mild.
- Feeling sleepy or tired. This is the most common one.
- Dry mouth, or some constipation.
- A headache.
- Some people feel a little unsteady, so take care with balance.
Call your doctor if you notice:
- Sleepiness heavy enough to interfere with your day.
- New stiffness, slowness, or tremor, a parkinson-like feeling. This is worth reporting, especially in the first couple of weeks.
- Feeling unsteady, or a near fall.
- For a person with Huntington's disease, any new or worsening low mood. See the note in special situations.
Go to the emergency room right away if:
- You have swelling of the face, lips, tongue, or throat, or trouble breathing. This can be a serious allergic reaction. Stop Ingrezza and get care.
- You have a high fever, very stiff muscles, sweating, and confusion all together.
- If you have Huntington's disease and you have thoughts of harming yourself. You can also call or text 988 at any time.
What to be careful with
Ingrezza is handled by liver pathways that some common medicines share. The antidepressant fluoxetine, for example, can raise the level of Ingrezza, so if you take it, your doctor will likely use a lower Ingrezza dose. Some other medicines can change the level too.
If you take the heart medicine digoxin, Ingrezza can raise its level, so your doctor may want to check that.
The simple rule: before you start or stop any medicine or supplement, tell your pharmacist you take Ingrezza. Every single time. At Fairview, we check every new prescription against your list.
Alcohol is best avoided or kept minimal, because both alcohol and Ingrezza can make you sleepy and unsteady.
What it costs
The cost is different for every person, because every insurance plan is different.
Here is the honest way to find your price. If you pay cash, call Fairview and we will give you a price for your situation. If you have private insurance, there may be a coupon or a savings program from the maker of the drug that helps lower your cost, and we will check if one is available for you. The best step is to let a pharmacist look at your plan. We do this for every patient.
Do not let cost make you skip doses. Call us first. There is almost always something we can do.
There is also a generic version of many medicines. The generic is the same medicine. Ask your pharmacist if a generic is a good fit for you.
What should be checked
Ingrezza works best alongside some regular checks that keep you safe and confirm it is helping.
Your doctor should check, now and then:
- Whether the uncontrolled movements are improving.
- Any new stiffness, slowness, or tremor, especially early on.
- How sleepy you feel, and your balance.
- For a person with Huntington's disease, mood and emotional wellbeing.
Your pharmacist should, now and then:
- Check every new medicine and supplement against Ingrezza.
- If you use the sprinkle form, make sure you know how to take it.
- Help with cost and assistance programs.
- Keep your information private, always.
At Fairview, we keep an eye on our Ingrezza patients. If a refill is running late, we call you. Your care is handled discreetly and with respect.
Special situations
Mood, for people with Huntington's disease.
If Ingrezza is being used for the chorea of Huntington's disease, there is an important caution. In Huntington's disease, medicines of this kind can increase the risk of depression and thoughts of self-harm. This warning applies specifically to Huntington's disease, not to tardive dyskinesia. The patient, their family, and their caregivers should all be aware of this and should watch closely for low mood, hopelessness, or any thoughts of self-harm. If anything of concern appears, report it to the doctor right away, or call or text 988.
If you are treated for tardive dyskinesia.
If Ingrezza is for tardive dyskinesia rather than Huntington's disease, the depression and self-harm warning above does not apply to you in the same way. Still, tell your doctor about any change in mood, as you would with any medicine.
The sprinkle form.
Ingrezza Sprinkle is for people who find capsules hard to swallow. Open the capsule onto a spoonful of soft food such as applesauce or yogurt, not milk or water, and take it right away. It must not be given through a feeding tube. If swallowing is a problem, ask your doctor whether the sprinkle form is right for you.
A serious allergic reaction.
Rarely, Ingrezza can cause a serious allergic reaction with swelling of the face, lips, tongue, or throat. If that happens, stop the medicine and get emergency care. Tell your pharmacist about any past allergic reaction to it.
Cost should never be the reason you stop.
Ingrezza is expensive at full price, but most patients pay very little. There is a strong support program, and an assistance program that can provide the medicine at no cost for those who qualify. If cost is a worry, call Fairview before you ever skip a dose.
How Fairview helps Ingrezza patients
When you fill Ingrezza at Fairview, here is what you get. This is normal care for us, and it is always private.
At your first fill:
- We check all your medicines and supplements against Ingrezza.
- If you use the sprinkle form, we walk you through how to take it.
- We talk through cost and help you find any program you qualify for.
At every refill:
- We check your file for any new medicines.
- We ask how the medicine is working.
- We answer any new questions, privately.
On our own, without being asked:
- If a refill is running late, we call you.
- If we see a medicine that does not mix with Ingrezza, we call your doctor.
- We check your cost at every fill to keep it as low as possible.
- We keep your care discreet and respectful, always.
Questions people ask about Ingrezza
Ingrezza treats two kinds of uncontrolled movement: tardive dyskinesia, which can develop after long-term use of certain psychiatric medicines, and the chorea, the involuntary movements, of Huntington's disease.
Related guides
Have a question about your Ingrezza? Ask a pharmacist you can trust.
Uncontrolled movements can wear on a person, and a medicine that quiets them can give real relief. Fairview is here to support you and your family through it, privately and without judgment.