Ingrezza (valbenazine) has potential interactions with other medications and some supplements. For example, Ingrezza can interact with the drugs paroxetine and ketoconazole.
Ingrezza and Ingrezza Sprinkle are prescribed for adults to treat:
- tardive dyskinesia
- chorea resulting from Huntington’s disease
Both Ingrezza and Ingrezza Sprinkle come in capsules that you swallow. But you can also open the Ingrezza Sprinkle capsule, sprinkle and stir its contents into soft food, and then swallow the mixture. This article refers to both drugs as “Ingrezza,” but it notes whether any content is specific to Ingrezza Sprinkle.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ingrezza’s possible interactions. For a detailed overview of this drug, check out this in-depth Ingrezza article.
Before you start taking Ingrezza, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.
The following table lists drugs that may interact with Ingrezza. Keep in mind that this table does not include all drugs that may interact with Ingrezza. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| monoamine oxidase inhibitors (MAOIs) | • isocarboxazid (Marplan) • phenelzine (Nardil) | can increase the risk of side effects from MAOIs or can make Ingrezza less effective |
| drugs that slow the activity of the CYP3A4 enzyme | • ketoconazole • itraconazole (Sporanox, Tolsura) • others | can increase the risk of side effects from Ingrezza |
| drugs that slow the activity of the CYP2D6 enzyme | • paroxetine (Paxil, Brisdelle) • quinidine • others | can increase the risk of side effects from Ingrezza |
| drugs that speed up the activity of the CYP3A4 enzyme | • carbamazepine (Tegretol, others) • rifampin (Rimactane) • others | can make Ingrezza less effective |
| digoxin (Lanoxin) | — | can increase the risk of side effects from digoxin |
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
To learn whether Ingrezza interacts with herbs, vitamins, or supplements, see the “Are there other interactions with Ingrezza?” section.)
Certain health conditions or other factors could raise your risk of harm if you take Ingrezza. In such cases, your doctor may not prescribe Ingrezza for you. These are known as contraindications. Ingrezza has one contraindication, as described here:
If you’ve had an allergic reaction. If you’ve ever had an allergic reaction to Ingrezza or any of its ingredients, your doctor likely won’t prescribe Ingrezza. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
No interaction between Ingrezza and alcohol is known. But Ingrezza and alcohol can cause similar side effects, such as nausea and tiredness. Both Ingrezza and alcohol can also cause long QT syndrome, which can be serious.
Combining Ingrezza and alcohol can raise your risk of these side effects or could make them more severe.
If you drink alcohol, talk with your doctor about how much (if any) may be safe to consume during your Ingrezza treatment.
Learn more about certain drug interactions that can occur with Ingrezza.
Interaction with drugs that slow the activity of the CYP3A4 enzyme
Ingrezza interacts with drugs that slow the activity of the CYP3A4 enzyme (protein). This enzyme is responsible for breaking down certain drugs.
Examples of drugs that slow the activity of the CYP3A4 enzyme include:
- ketoconazole
- itraconazole (Sporanox, Tolsura)
- clarithromycin
- the HIV drugs ritonavir (Norvir) and cobicistat (Tybost)
What could happen
When you take a dose of Ingrezza, the CYP3A4 enzyme helps break down the drug and remove it from the body. If you also take a drug that slows the activity of this enzyme, Ingrezza won’t be broken down as quickly. This increases the amount of Ingrezza in the body, which raises your risk of side effects from the drug.
What you can do
If you need to take Ingrezza with a drug that slows the activity of the CYP3A4 enzyme, your doctor will likely prescribe a lower Ingrezza dosage for you. They may also monitor you closely for side effects during your treatment.
Interaction with drugs that slow the activity of the CYP2D6 enzyme
Ingrezza interacts with drugs that slow the activity of the CYP2D6 enzyme. This enzyme is responsible for breaking down certain drugs.
Examples of drugs that slow the activity of the CYP2D6 enzyme include:
- paroxetine (Paxil, Brisdelle)
- quinidine
- fluoxetine (Prozac)
- tipranavir (Aptivus)
What could happen
After you take a dose of Ingrezza, the CYP2D6 enzyme helps break down the drug and remove it from your body. If you also take a drug that slows the activity of this enzyme, your body doesn’t break down Ingrezza as quickly as it should. This can cause Ingrezza levels to build up in your body, which raises your risk of side effects from the drug.
What you can do
If you need to take Ingrezza with a drug that slows the activity of CYP2D6, your doctor will likely prescribe a lower dosage of Ingrezza for you. They may also monitor you closely for side effects while you’re taking Ingrezza.
Interaction with drugs that speed up the activity of the CYP3A4 enzyme
Ingrezza interacts with drugs that speed up the activity of the CYP3A4 enzyme. This enzyme helps your body break down certain drugs.
Examples of drugs that speed up the activity of CYP3A4 include:
- carbamazepine (Tegretol, others)
- rifampin (Rimactane)
- apalutamide (Erleada)
- primidone (Mysoline)
What could happen
After you take Ingrezza, the CYP3A4 enzyme helps break down the drug and clear it from your body. But if you also take a drug that speeds up the activity of CYP3A4, your body breaks down Ingrezza more quickly than usual. This causes the level of Ingrezza in your body to drop, and the drug may be less effective.
What you can do
Taking Ingrezza with a drug that speeds up the activity of CYP3A4 is not recommended. Instead, your doctor can suggest an alternative to Ingrezza or to the drug that speeds up CYP3A4.
Ingrezza may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. Note that the information presented here does not include all other interactions possible with Ingrezza.
Does Ingrezza interact with supplements?
Before you start taking Ingrezza, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ingrezza interactions with herbs
Ingrezza interacts with St. John’s wort. This herbal supplement is used to ease symptoms of depression and other conditions.
St. John’s wort speeds up the activity of the CYP3A4 enzyme (protein). If you take St. John’s wort with Ingrezza, your body breaks down Ingrezza more quickly than usual. This causes the level of Ingrezza in your system to drop, which could make the drug less effective. (To learn more about Ingrezza and CYP3A4, see the “Drug interactions explained” section.)
Before you begin treatment with Ingrezza, tell your doctor whether you take St. John’s wort. Your doctor will likely suggest that you don’t take the two together. They can recommend an alternative to St. John’s wort or Ingrezza.
Ingrezza and vitamins
Ingrezza currently has no reports of interacting with vitamins. But this doesn’t mean that interactions with vitamins won’t be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Ingrezza treatment.
Does Ingrezza interact with food?
Ingrezza interacts with grapefruit and grapefruit juice. Grapefruit and grapefruit juice can raise your risk of side effects from taking Ingrezza. This is because grapefruit products slow the activity of the CYP3A4 enzyme. This can raise the level of Ingrezza in your body, raising your risk of side effects.
Due to this interaction, your doctor may suggest that you do not consume grapefruit or grapefruit juice while you’re taking Ingrezza.
If you have other questions about Ingrezza and possible food interactions, talk with your doctor or pharmacist.
Does Ingrezza interact with vaccines or lab tests?
Ingrezza isn’t known to interact with any vaccines or lab tests.
Talk with your doctor or pharmacist if you have questions about receiving vaccines or having lab tests while taking Ingrezza.
Does Ingrezza interact with cannabis or CBD?Ingrezza currently has no reports of interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Ingrezza.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Ingrezza. Before taking Ingrezza, talk with your doctor about your health history. They’ll determine whether Ingrezza is right for you.
Health conditions or other factors that might interact with Ingrezza include:
Heart disease: Before taking Ingrezza, tell your doctor if you have heart disease, such as heart failure, or if you’ve had a heart attack. Having heart disease can raise your risk of long QT syndrome, a rare but serious side effect that Ingrezza may cause.
Irregular heart rhythm: If you have an irregular heart rhythm (including a heart arrhythmia), your doctor will determine whether Ingrezza is safe for you to take. Having an irregular heart rhythm raises your risk of long QT syndrome.
Liver condition: Before taking Ingrezza, it’s important to tell your doctor if you have a liver condition, such as fatty liver disease. Depending on how severe your liver problem is, your doctor may prescribe a lower dose of Ingrezza for you.
Pregnancy: It’s not known whether it’s safe to take Ingrezza or Ingrezza Sprinkle while pregnant. If you’re pregnant or planning a pregnancy, talk with your doctor to learn more about the risks and benefits of taking Ingrezza during pregnancy.
Breastfeeding: It’s recommended not to breastfeed during treatment with Ingrezza or Ingrezza Sprinkle. If you’re breastfeeding or planning to do so, talk with your doctor before starting Ingrezza treatment.
Allergic reaction: If you’ve ever had an allergic reaction to Ingrezza or any of its ingredients, your doctor likely won’t prescribe Ingrezza. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Is there a drug interaction checker for Ingrezza?
Doctors and pharmacists have access to resources that check interactions between drugs. These resources help them determine whether certain medications are safe to take during treatment with other medications. Some websites, such as PDR, also offer free tools to check for drug interactions.
If you’re uncertain whether some medications can be taken together, ask your pharmacist or doctor.
Is Ingrezza a controlled substance?
No, Ingrezza is not a controlled substance. Rather, it’s a type of inhibitor drug, which means it blocks certain actions in the body to treat your condition.
A controlled substance is a drug that the government regulates due to the risk of dependence or misuse. With dependence, your body needs the drug to function as usual. Misuse is taking a drug in a way other than how a doctor prescribes it.
Is Ingrezza used to treat parkinsonism?
No, Ingrezza is not approved to treat parkinsonism, which is a group of conditions that cause difficulty with movement.
Ingrezza is approved to treat tardive dyskinesia, which is a movement disorder. Tardive dyskinesia is similar in some ways to parkinsonism but is caused by long-term use of certain medications. Ingrezza is also approved to treat chorea resulting from Huntington’s disease.
If you have questions about parkinsonism or treatment options, it’s best to talk with your doctor.
Taking certain steps can help you avoid interactions with Ingrezza. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (Your doctor or pharmacist can help you fill out a
medication list .) - what to do if you start taking a new drug during your Ingrezza treatment
It’s also important to understand Ingrezza’s
If you did not get paperwork with Ingrezza, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can also help.
Taking Ingrezza exactly as prescribed can also help prevent interactions.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.