Ingrezza (valbenazine)
An approved treatment for Huntington Disease.
The same compound appears under different names depending on the context. Here is how to identify Valbenazine wherever you encounter it, plus the key facts at a glance.
- Generic name
- Valbenazine
- Brand name
- Ingrezza
- Development code
- NBI-98854
- Drug class
- VMAT2 inhibitor
- Manufacturer
- Neurocrine Biosciences
- How it's taken
- Taken by mouth once daily as a capsule, or as Ingrezza Sprinkle capsules that can be opened onto soft food.
A once-daily VMAT2 inhibitor approved for adults with chorea (involuntary movements) caused by Huntington disease. Its safety and effectiveness in children have not been established. Originally developed for tardive dyskinesia, Ingrezza is taken once a day, like Austedo XR, while tetrabenazine and regular Austedo are usually taken 2 or 3 times a day.
We'll email you when Ingrezza's FDA label changes, when the FDA acts on it, and when new trials for Huntington Disease open. Unsubscribe anytime.
Where Valbenazine fits
VMAT2 inhibitor FDA approved for both Huntington's disease chorea and tardive dyskinesia. Once-daily dosing may offer convenience advantages over tetrabenazine.
How Valbenazine works
Valbenazine selectively inhibits VMAT2, reducing the amount of dopamine packaged into vesicles for release at nerve terminals. With less dopamine available, the overactive brain circuits that cause chorea are calmed. Its high selectivity for VMAT2 (versus other monoamine transporters) may contribute to its tolerability profile.
Mechanism: Highly selective VMAT2 inhibitor that reduces dopamine release to control involuntary movements
Side effects and safety
Ingrezza carries a boxed warning: it can increase the risk of depression and suicidal thoughts and behavior in people with Huntington's disease, so mood must be watched closely. In the Huntington's chorea study, the most common side effects were sleepiness or sedation, hives, rash, and trouble sleeping. Other warnings include allergic reactions including angioedema, Parkinson-like symptoms, and QT prolongation. Neuroleptic malignant syndrome (NMS), a potentially fatal reaction, has been reported with VMAT2 inhibitors including Ingrezza; get emergency care for high fever, stiff muscles, confusion, or a fast or irregular heartbeat. Sleepiness can make it unsafe to drive or use machinery until you know how Ingrezza affects you.
This is not a complete list of side effects. Talk to your doctor or pharmacist about what to expect and when to seek medical attention.
Taking Valbenazine
Taken by mouth once daily as a capsule, or as Ingrezza Sprinkle capsules that can be opened onto soft food. For Huntington's chorea, the starting dose is 40 mg once daily, raised by 20 mg every 2 weeks to the recommended 80 mg once daily; 40 mg or 60 mg may be used depending on response and side effects. People who are known CYP2D6 poor metabolizers take 40 mg once daily.
Availability and cost
Only available as the brand-name product.
VMAT2 inhibitor with a once-daily dosing profile and primarily developed for tardive dyskinesia. Specialty pricing as a branded neuropsychiatry medication.
Help paying for Ingrezza
Pick your insurance to see which help fits. Drugmaker copay cards can't be used with Medicare, Medicaid or TRICARE; charity funds are the usual route there.
- Copay help
Eligible patients with commercial (non-government) insurance may pay $0 with the Ingrezza Savings Card.
For: private insurance · source - Free medicine program
Ingrezza Patient Assistance Program gives medicine at no cost to eligible patients with no insurance, no Ingrezza coverage, or qualifying financial need.
For: no insurance, underinsured · source - Other support
30-Day Free Trial: a free 1-month supply for new patients; your doctor submits the enrollment form.
The official page does not say who qualifies. Ask the program. · source
Good to know: Formerly called the INBRACE Support Program. Call Mon-Fri 8 AM-8 PM ET.
No charity fund for this condition is open right now. Funds reopen when they receive new donations; the foundations let you sign up to be told when one opens.
Clinical trial results
The 12-week KINECT-HD Phase 3 trial randomized 128 adults with Huntington's chorea. Chorea scores improved by 4.6 points on Ingrezza and 1.4 points on placebo, a statistically significant difference, and scores went back to baseline 2 weeks after patients stopped the drug.
Development history
Originally approved in April 2017 for tardive dyskinesia. The Huntington disease chorea indication was approved in August 2023 based on the KINECT-HD trial results. It is 1 of 2 once-daily VMAT2 inhibitors for HD chorea, along with Austedo XR.
Explore Huntington Disease trials
Other Huntington Disease treatments
Common questions about Valbenazine
▸What is Valbenazine (Ingrezza)?
A once-daily VMAT2 inhibitor approved for adults with chorea (involuntary movements) caused by Huntington disease. Its safety and effectiveness in children have not been established. Originally developed for tardive dyskinesia, Ingrezza is taken once a day, like Austedo XR, while tetrabenazine and regular Austedo are usually taken 2 or 3 times a day.
▸How does Valbenazine work?
Valbenazine selectively inhibits VMAT2, reducing the amount of dopamine packaged into vesicles for release at nerve terminals. With less dopamine available, the overactive brain circuits that cause chorea are calmed. Its high selectivity for VMAT2 (versus other monoamine transporters) may contribute to its tolerability profile.
▸What are the side effects of Valbenazine?
Ingrezza carries a boxed warning: it can increase the risk of depression and suicidal thoughts and behavior in people with Huntington's disease, so mood must be watched closely. In the Huntington's chorea study, the most common side effects were sleepiness or sedation, hives, rash, and trouble sleeping. Other warnings include allergic reactions including angioedema, Parkinson-like symptoms, and QT prolongation. Neuroleptic malignant syndrome (NMS), a potentially fatal reaction, has been reported with VMAT2 inhibitors including Ingrezza; get emergency care for high fever, stiff muscles, confusion, or a fast or irregular heartbeat. Sleepiness can make it unsafe to drive or use machinery until you know how Ingrezza affects you.
▸How is Valbenazine taken?
Taken by mouth once daily as a capsule, or as Ingrezza Sprinkle capsules that can be opened onto soft food. For Huntington's chorea, the starting dose is 40 mg once daily, raised by 20 mg every 2 weeks to the recommended 80 mg once daily; 40 mg or 60 mg may be used depending on response and side effects. People who are known CYP2D6 poor metabolizers take 40 mg once daily.
▸Is Valbenazine FDA approved?
Yes, Valbenazine (Ingrezza) is FDA approved (2023) for the treatment of Huntington Disease.
▸What is Ingrezza used for?
Ingrezza (valbenazine) is approved for adults with 2 movement disorders: tardive dyskinesia and chorea caused by Huntington's disease.
Tardive dyskinesia: Involuntary movement caused by long-term use of certain psychiatric medicines.
Huntington's chorea: Jerky, unpredictable movement that the person cannot control.
Forms: The same medicine is sold as regular Ingrezza capsules and as Ingrezza Sprinkle capsules that can be opened onto soft food.
Children: It has not been studied in children, so its effects in anyone under 18 are not established.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What is Ingrezza and who makes it?
Ingrezza is the brand name for valbenazine, a once-daily capsule in a drug class called VMAT2 inhibitors.
Maker: It is made by Neurocrine Biosciences, which developed it under the code NBI-98854.
Approval history: The FDA first approved it in April 2017 for tardive dyskinesia and added the Huntington's disease chorea use in August 2023.
Strengths: The capsules come in 40 mg, 60 mg, and 80 mg strengths.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸How does Ingrezza work?
Valbenazine blocks a protein in nerve cells called VMAT2, which packages dopamine and other chemical messengers into tiny storage sacs so they can be released.
Effect on movement: With less dopamine being loaded and released, the overactive brain circuits that drive involuntary movement quiet down.
What is known: The label says the exact way this reduces tardive dyskinesia and chorea is not fully understood, but the VMAT2 block is reversible and valbenazine does not bind to dopamine, serotonin, histamine, or muscarinic receptors themselves.
Why it matters: That selectivity may be part of why it is generally tolerated.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What are the side effects of valbenazine?
Sleepiness or sedation was the most common side effect in both the Huntington's disease and tardive dyskinesia trials.
Huntington's disease trial: The most common side effects on Ingrezza versus placebo were sleepiness or sedation (18.8% vs 3.2%), fatigue (14.1% vs 9.5%), hives (9.4% vs 0%), rash (7.8% vs 0%), restlessness called akathisia (6.3% vs 4.8%), trouble sleeping (6.3% vs 1.6%), depression or low mood (4.7% vs 1.6%), diarrhea (4.7% vs 1.6%), nausea (4.7% vs 0%), and back pain (4.7% vs 0%).
Tardive dyskinesia trials: In the 3 trials, sleepiness was again the most common at 10.9% vs 4.2%, followed by dry mouth and similar anticholinergic effects (5.4% vs 4.9%), falls or balance problems (4.1% vs 2.2%), headache (3.4% vs 2.7%), akathisia (2.7% vs 0.5%), vomiting (2.6% vs 0.6%), and joint pain (2.3% vs 0.5%).
Driving: Because of the sleepiness, you should not drive or run dangerous machinery until you know how Ingrezza affects you.
Stopping for side effects: About 8% of Huntington's patients and 3% of tardive dyskinesia patients stopped the drug because of side effects.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What is the boxed warning on Ingrezza?
Ingrezza carries the FDA's strongest warning, a boxed warning, because VMAT2 inhibitors can increase depression and suicidal thoughts or actions in people with Huntington's disease, who already have a higher risk of both.
Trial numbers: In the 14-week trial, depression or depressed mood was reported in 4.7% of people on Ingrezza versus 1.6% on placebo. In the longer open-label extension of 125 patients, 7.2% reported suicidal thoughts and 2.4% made a suicide attempt.
What to do: People with a history of depression or suicide attempts need extra caution, and patients, family, and caregivers should report any mood change or unusual behavior to the prescriber right away.
Other warnings: The label also warns about serious allergic reactions including angioedema (swelling of the face, lips, or throat), QT prolongation (a heart rhythm change), neuroleptic malignant syndrome (a rare, potentially fatal reaction with high fever and stiff muscles), and Parkinson-like symptoms.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What is the starting dose of Ingrezza?
For both uses, Ingrezza starts at 40 mg once a day.
Tardive dyskinesia: The dose goes up to the recommended 80 mg once daily after 1 week.
Huntington's chorea: It is raised more slowly, by 20 mg every 2 weeks, until it reaches 80 mg once daily.
Lower doses: Your doctor may keep you at 40 mg or 60 mg instead if that works for you or if side effects appear at the higher dose.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸How do you take Ingrezza, and can the capsules be opened?
Take Ingrezza once a day, with or without food, and swallow the regular capsules whole.
Sprinkle capsules: They can be opened and the contents stirred into about 1 tablespoon of soft food like applesauce, yogurt, or pudding (not milk or water), eaten right away or within 2 hours, and followed by a glass of water.
Do not: Do not crush or chew Sprinkle capsules, and do not put the contents through a feeding tube because they can block it.
Who takes 40 mg: People with moderate or severe liver impairment, people who are known CYP2D6 poor metabolizers, and people taking a strong CYP3A4 or CYP2D6 inhibitor should take 40 mg once daily.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸Is there a generic for Ingrezza?
The FDA has approved generic valbenazine capsules, but as of October 2026 no generic valbenazine label is listed on DailyMed, which suggests a generic may not be in pharmacies yet.
FDA approvals: Lupin's generic valbenazine capsules were approved in April 2024, and a Zydus version approved in August 2024 is now listed as discontinued.
What DailyMed lists: The only valbenazine label there is brand-name Ingrezza and Ingrezza Sprinkle from Neurocrine Biosciences.
What to do: Ask your pharmacist whether a generic is actually available and whether your plan covers it.
Other VMAT2 inhibitors: Other VMAT2 inhibitors, such as tetrabenazine, do have generics, but they are different drugs with different dosing schedules.
▸How much does Ingrezza cost?
The FDA label does not list a price, and we do not publish one here because the amount you pay depends on your insurance, deductible, and pharmacy.
What to expect: Ingrezza is a branded specialty medicine for a neuropsychiatric condition, so list prices are high and most people get it through a specialty pharmacy with prior authorization.
What to do: Your prescriber's office or a pharmacist can run a benefits check to estimate your actual copay.
▸Is there an Ingrezza coupon or patient assistance program?
Yes, Neurocrine Access Support runs the Ingrezza savings and free-medicine programs, reachable at 1-844-647-3992 from 8 AM to 8 PM ET, Monday to Friday.
Savings card: Eligible patients with commercial insurance may pay $0 with the Ingrezza Savings Card.
Free medicine: The Ingrezza Patient Assistance Program gives the drug at no cost to eligible patients with no insurance, no Ingrezza coverage or financial need.
Free trial: New patients can get a free 1-month supply when their doctor submits the enrollment form.
Source: Ingrezza savings and support, Neurocrine Biosciences
▸Is Ingrezza used for Huntington's disease?
Yes, Ingrezza is approved for the chorea (involuntary jerky movements) that comes with Huntington's disease in adults; it does not treat the disease itself or slow its progression.
Trial results: In the KINECT-HD trial of 128 patients, chorea scores on the Unified Huntington's Disease Rating Scale improved by 4.6 points on Ingrezza versus 1.4 points on placebo after 12 weeks, a difference of 3.2 points on a 28-point scale.
Ratings of improvement: Clinicians rated 43% of Ingrezza patients as much or very much improved versus 13% on placebo, and 53% of patients said the same about themselves versus 26% on placebo.
Dose used: More than 80% of trial patients were taking the 80 mg dose by the end of the study.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What is the difference between Ingrezza and Cogentin?
They work in opposite directions.
Ingrezza: Ingrezza (valbenazine) lowers dopamine release to calm the extra movements of tardive dyskinesia and Huntington's chorea.
Cogentin: Cogentin (benztropine) is an anticholinergic medicine used mainly for Parkinson's-type stiffness and tremor, including drug-induced parkinsonism; it is not an approved treatment for tardive dyskinesia or chorea.
Label details: The Ingrezza label even lists anticholinergic effects like dry mouth and constipation as a side effect of Ingrezza (5.4% vs 4.9% on placebo), and notes that Ingrezza itself can cause Parkinson-like symptoms in 3% of tardive dyskinesia patients and 4.7% of Huntington's patients.
Bottom line: The 2 drugs are not interchangeable, and the right choice depends on which movement problem you have.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸How soon does Ingrezza work, and what happens if you stop it?
The label does not give a day-by-day timeline for symptom relief.
Timing in trials: Valbenazine reaches a steady level in the blood within about 1 week, the tardive dyskinesia trials measured their main result at 6 weeks, and the Huntington's trial measured chorea at weeks 10 and 12, so most people are judged on at least a month or 2 of treatment.
If you stop: The benefit is not permanent: 2 weeks after Huntington's patients stopped the drug, their chorea scores went back to where they started, and tardive dyskinesia scores drifted back toward baseline after a 4-week break at the end of the long-term study.
What to do: Talk with your doctor before stopping.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What drugs interact with Ingrezza?
Do not take Ingrezza with an MAOI antidepressant or within 14 days of stopping one, because the combination could raise the risk of serotonin syndrome or make Ingrezza work less well.
CYP3A4 inducers: Strong CYP3A4 inducers such as rifampin lower valbenazine levels and are not recommended with it.
Strong inhibitors: Strong CYP3A4 inhibitors like ketoconazole and strong CYP2D6 inhibitors like paroxetine raise valbenazine levels, so the dose should be cut to 40 mg once daily.
Digoxin: Ingrezza also raises digoxin levels, so digoxin blood levels need monitoring and the digoxin dose may need to come down.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸Is CYP2D6 testing required for valbenazine?
No, the Ingrezza label does not require a CYP2D6 gene test before starting, unlike tetrabenazine (Xenazine), which requires it before doses above 50 mg a day.
Why it matters: CYP2D6 is a liver enzyme that helps clear the active form of valbenazine, and the roughly 7% of White, 2% of Asian, and 2% of African-American people who are poor metabolizers have about twice the usual blood level of that active metabolite.
Poor metabolizers: If you already know you are a CYP2D6 poor metabolizer, the recommended dose is 40 mg once daily, partly because higher levels can stretch the QT interval on an ECG.
Source: FDA label for Ingrezza, DailyMed, effective 2026-04-17
▸What is the advantage of once-daily Ingrezza over other VMAT2 inhibitors?
Ingrezza is taken once a day, as is Austedo XR, while tetrabenazine is usually taken 3 times a day and regular deutetrabenazine (Austedo) twice a day.
Why it matters: A simpler schedule is easier to stick with, which matters for people with Huntington's disease who may have memory or planning difficulties.
Swallowing: The Sprinkle capsule also helps people who have trouble swallowing pills, which is common as Huntington's disease progresses.
Limits: This is a convenience difference; the Ingrezza label does not compare its effectiveness with these drugs.
Source: FDA label for Ingrezza and FDA label for Austedo and Austedo XR