Let's cut straight to the chase: Austedo (deutetrabenazine) can mix with alcohol, a handful of prescription meds, overthecounter drugs, supplements, and even some health conditions. Some combos are a big "nogo," while others just need a little extra watching.
Grab a pen, jot down every pill, herb, vitamin, and your drinking habits, then scroll down. We'll break down what's safe, what to avoid, and exactly what steps to take so you stay in control of your treatment.
What Are Interactions?
In the world of medicine, an "interaction" is simply what happens when two substances meet inside your body. They can change how a drug works, boost side effects, or sometimes even cancel each other out. With Austedo, the picture is a bit crowded: the druginteraction database lists about 448 known interactions 114 major, 332 moderate, and just a couple of minor ones.
Understanding this landscape matters because Austedo is powerful at easing chorea and tardive dyskinesia, but the same power can turn into unwanted drowsiness, heart rhythm quirks, or mood swings when paired with the wrong companion.
How Interactions Are Classified
Doctors sort interactions into three buckets so they can decide how to act:
- Major The risk outweighs any benefit. You should avoid the combination altogether.
- Moderate Generally best avoided, but sometimes a doctor might allow it with careful monitoring or dose tweaks.
- Minor Low clinical impact; usually just a headsup.
Interaction Classification Table
| Interaction Type | Example Drug | Clinical Effect | Management Tip |
|---|---|---|---|
| Major | MAOIs (phenelzine) | Reduced efficacy of both drugs | Stop MAOI 2weeks before starting Austedo |
| Moderate | SSRIs (sertraline) | Increased sideeffects, possible serotonin syndrome | Adjust dose or monitor closely |
| Minor | VitaminB12 | No known effect | No action needed |
Austedo and Alcohol
Why Alcohol Is Risky
Alcohol is the only foodrelated interaction on Austedo's label, and for a good reason. Both Austedo and alcohol depress the central nervous system, which can lead to a cocktail of dizziness, extreme drowsiness, and impaired judgment. In practical terms, that means a simple nightcap could turn a routine dose into a sleepy, unsafe evening.
Quick "Do I Need to Skip My Drink?" Checklist
- Are you on extendedrelease tablets? Same warning applies.
- Do you use prescription cough syrup that contains alcohol? Ask your pharmacist for an alcoholfree alternative.
- Do you ever have a glass of wine with dinner? Skip it while you're on Austedo.
Bottom line: most clinicians advise complete avoidance of alcohol while taking Austedo. If you're unsure, a quick call to your prescriber never hurts.
Major Drug Interactions
Contraindicated Drug Classes
These drug families should never be combined with Austedo. The reasons range from overlapping mechanisms that could cause severe sideeffects to metabolic roadblocks that boost Austedo levels to dangerous heights.
Contraindicated Drugs Table
| Drug Class | Why It's a Problem | Representative Drugs |
|---|---|---|
| Other VMAT2 inhibitors | Additive dopaminedepleting effect sideeffects | Tetrabenazine (Xenazine), Valbenazine (Ingrezza) |
| Monoamineoxidase inhibitors (MAOIs) | Opposite mechanisms reduced efficacy & safety | Phenelzine, Selegiline, Linezolid |
| Strong CYP2D6 inhibitors | Blocks Austedo metabolism toxicity risk | Bupropion (Wellbutrin) |
| Antiarrhythmics (QTprolonging) | Combined effect on heart rhythm | Amiodarone, Dofetilide |
When a doctor sees any of these on your list, they'll either switch the other drug, pause Austedo, or choose a completely different therapeutic path.
ModerateRisk Interactions (Common in Practice)
These aren't outright bans, but they can make your day feel "extra" weird if you ignore them.
- SSRIs (citalopram, fluoxetine, sertraline) May bump up serotoninrelated side effects.
- Benzodiazepines (alprazolam, diazepam) Double the drowsiness factor.
- Antihistamines (diphenhydramine, cetirizine) Sleepy plus a tiny heartrhythm nudge.
- Gabapentin Enhanced sedation, especially at night.
Sample Script to Use with Your Pharmacist
"I'm on Austedo 12mg daily and also take cetirizine for allergies. Is the combination safe, or should I switch to a nonsedating antihistamine?"
Supplements, Herbs & OTC
Herbs to Watch
Nature is great, but some botanicals can amplify Austedo's sleepy side effects.
- Valerian root Known for calming nerves; together they can turn a "relaxed" evening into a "donotdrive" scenario.
- Cannabis / CBD Emerging reports suggest an added drowsy feeling; better to discuss dosage with your clinician (Medical News Today).
Vitamins & Minerals
The good news? No solid evidence shows vitamins clash with Austedo. However, if you have a heartrhythm concern, keep an eye on magnesium and potassium levels because they subtly influence cardiac electrical activity.
CheckList for Patients
- Write down every supplement (including "energy drinks").
- Highlight anything with a known sedative effect.
- Bring the list to your next appointment your doctor will thank you.
HealthConditionBased Contraindications
Key Conditions to Flag
Even if the drug list looks clean, certain medical histories can make Austedo a risky choice.
ConditionBased Contraindications Table
| Condition | Why It Matters | Typical Provider Action |
|---|---|---|
| Liver dysfunction | Impaired metabolism higher drug levels | Consider dose reduction or avoid |
| Depression / suicidal ideation | Boxed warning for increased suicidality | Often not prescribed; seek alternatives |
| QTprolongation / irregular heart rhythm | Potential exacerbation of rhythm issues | ECG monitoring; avoid certain combos |
| Pregnancy / breastfeeding | Limited safety data | Riskbenefit discussion; possibly switch |
| Parkinsoniantype disorders | Too much dopamine depletion | May opt for a different class |
Talking to Your Doctor
Use simple, direct language. For example: "I have mild liver enzyme elevation is Austedo safe for me?" Your doctor will know which labs to run or whether to tweak the dose.
Practical Tools & How to Prevent Interactions
Personal Medication List (Downloadable Template)
Creating a living document of everything you take is the single most effective safety net. Include columns for:
- Medication name (prescription, OTC, supplement)
- Dosage & timing
- Reason for use
- Any recent changes
Keep it on your phone or printed on the fridge you'll thank yourself before each pharmacy visit.
Use an Online Interaction Checker
Websites like Drugs.com let you type in "Austedo" and a second medication to see the interaction grade instantly. The steps are simple:
- Enter "Austedo" as the primary drug.
- Add the second medication.
- Read the colorcoded result (red=major, yellow=moderate, green=minor).
- Follow the suggested action or call your prescriber for clarification.
When to Call Your Healthcare Team
Don't wait for a problem to snowball. Reach out if any of these happen:
- You add a new prescription or overthecounter product.
- You start or stop drinking alcohol or using cannabis.
- Sudden, unexplained drowsiness, heart palpitations, or mood changes appear.
- Your lab results (especially liver enzymes) shift.
Sample Emergency Script
"I've started a new nighttime antihistamine and now feel unusually sleepy after my Austedo dose. Should I stop the antihistamine or adjust my Austedo?"
Conclusion
In a nutshell, Austedo can be a gamechanger for movement disorders, but its strength comes with a web of interactions that you need to navigate. By avoiding alcohol, steering clear of contraindicated drugs (especially other VMAT2 inhibitors, MAOIs, and strong CYP2D6 blockers), watching moderaterisk combos, and flagging health conditions like liver disease or depression, you set yourself up for success.
Take the printable medication list, run your current regimen through a trusted interaction checker, and schedule a quick medicationreview appointment. That proactive approach is the safest way to keep the benefits of Austedo rolling while minimizing surprises.
FAQs
Can I drink alcohol while taking Austedo?
No. Alcohol can intensify the central nervous system‑depressing effects of Austedo, leading to excessive drowsiness and impaired judgment. Complete avoidance is recommended.
What drug classes are absolutely contraindicated with Austedo?
Other VMAT‑2 inhibitors (e.g., tetrabenazine), monoamine‑oxidase inhibitors, strong CYP2D6 inhibitors (e.g., bupropion), and QT‑prolonging anti‑arrhythmics should never be combined with Austedo.
Are over‑the‑counter antihistamines safe with Austedo?
Many antihistamines (like diphenhydramine) can increase sedation. Non‑sedating options such as loratadine are generally preferred, but always check with your pharmacist.
Do supplements like vitamins interfere with Austedo?
There is no solid evidence that standard vitamins clash with Austedo. However, herbs with sedative properties (e.g., valerian) and high‑dose magnesium/potassium should be discussed with your provider.
What health conditions make Austedo risky?
Liver dysfunction, depression or suicidal ideation, QT‑prolongation, pregnancy/breastfeeding, and Parkinsonian‑type disorders increase the risk of serious side‑effects and may require dose adjustments or alternative therapies.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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