Ticstop

Ticstop25 mg

Tablet

Tetrabenazine

Square Pharmaceuticals PLC.

Product Code : 20307
MRP 350.00
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Medicine overview

Indications of Ticstop 25 mg

Ticstop 25 mg is indicated for the treatment of chorea associated with Huntington's disease,

Theropeutic Class

Atypical neuroleptic drugs

Pharmacology

Prolongation of the QTc interval has been observed at doses of 50 mg. In rats, it has been observed that Ticstop 25 mg or its metabolites bind to melanin-containing tissues such as the eyes and skin. After a single oral dose of radiolabeled Ticstop 25 mg, radioactivity was still detected in eye and fur at 21 days post dosing.Ticstop 25 mg is a reversible human vesicular monoamine transporter type 2 inhibitor (Ki = 100 nM). It acts within the basal ganglia and promotes depletion of monoamine neurotransmitters serotonin, norepinephrine, and dopamine from stores. It also decreases uptake into synaptic vesicles. Dopamine is required for fine motor movement, so the inhibition of its transmission is efficacious for hyperkinetic movement. Ticstop 25 mg exhibits weak in vitro binding affinity at the dopamine D2 receptor (Ki = 2100 nM).

Dosage & Administration of Ticstop 25 mg

General Dosing Considerations: The chronic daily dose of Ticstop 25 mg used to treat chorea associated with Huntington's disease (HD) is determined individually for each patient. When first prescribed, Ticstop 25 mg therapy should be titrated slowly over several weeks to identify a dose of XENAXINE that reduces chorea and is tolerated. Ticstop 25 mg can be administered without regard to food. Individualization Of Dose: Dosing Recommendations Up to 50 mg per day: The starting dose should be 12.5 mg per day given once in the morning. After one week, the dose should be increased to 25 mg per day given as 12.5 mg twice a day. Ticstop 25 mg should be titrated up slowly at weekly intervals by 12.5 mg daily, to allow the identification of a tolerated dose that reduces chorea. If a dose of 37.5 to 50 mg per day is needed, it should be given in a three times a day regimen. The maximum recommended single dose is 25 mg. If adverse reactions such as akathisia, restlessness, parkinsonism, depression, insomnia, anxiety or sedation occur, titration should be stopped and the dose should be reduced. If the adverse reaction does not resolve, consideration should be given to withdrawing Ticstop 25 mg treatment or initiating other specific treatment (e.g., antidepressants).Dosing Recommendations Above 50 mg per day: Patients who require doses of Ticstop 25 mg greater than 50 mg per day should be first tested and genotyped to determine if they are poor metabolizers (PMs) or extensive metabolizers (EMs) by their ability to express the drug metabolizing enzyme, CYP2D6. The dose of Ticstop 25 mg should then be individualized accordingly to their status as PMs or EMs Extensive and Intermediate CYP2D6 Metabolizers: Genotyped patients who are identified as extensive (EMs) or intermediate metabolizers (IMs) of CYP2D6, who need doses of Ticstop 25 mg above 50 mg per day, should be titrated up slowly at weekly intervals by 12.5 mg daily, to allow the identification of a tolerated dose that reduces chorea. Doses above 50 mg per day should be given in a three times a day regimen. The maximum recommended daily dose is 100 mg and the maximum recommended single dose is 37.5 mg. If adverse reactions such as akathisia, parkinsonism, depression, insomnia, anxiety or sedation occur, titration should be stopped and the dose should be reduced. If the adverse reaction does not resolve, consideration should be given to withdrawing Ticstop 25 mg treatment or initiating other specific treatment (e.g., antidepressants)

Dosage of Ticstop 25 mg

Recommended dosing for Ticstop 25 mg: Ticstop 25 mg can be taken with or without food. Individualization of dose with careful weekly titration is required. 1st week's starting dose: 12.5 mg daily. 2nd week: 25 mg (12.5 mg twice daily). Then slowly titrate at weekly intervals by 12.5 mg to a tolerated done that reduces chorea. Doses of 37.5 mg and up to 50 mg per day should be administered in three divided doses per day with a maximum recommended single dose not to exceed 25 mg. Patients requiring doses above 50 mg per day should be genotyped for the drug-metabolizing enzyme CYP2D6 to determine if the patient is a poor metabolizer or an extensive metabolizer. Maximum daily dose in poor metabolizers: 50 mg with a maximum single dose of 25 mg. Maximum daily dose in Extended and intermediate metabolizers: 100 mg with a maximum single dose of 37.5 mg. If serious adverse reactions occur, titration should be stopped and the dose should be reduced. If the adverse reactions do not resolve, consider withdrawal of Ticstop 25 mg. Pediatric & geriatric use: Safety and effectiveness in pediatric patients have not been established. The pharmacokinetics of Ticstop 25 mg and its primary metabolites have not been formally studied in geriatric subjects.

Interaction of Ticstop 25 mg

With medicine: Strong CYP2D6 Inhibitors: A reduction in Ticstop 25 mg dose may be necessary when adding a strong CYP2D6 inhibitor (e.g., fluoxetine, paroxetine, quinidine) in patients maintained on a stable dose of Ticstop 25 mg. Reserpine: Reserpine binds irreversibly to VMAT2, and the duration of its effect is several days. At least 20 days should elapse after stopping reserpine before starting Ticstop 25 mg, Ticstop 25 mg and Reserpine should not be used concomitantly. With food & others: No interaction with food, can be taken with or without food.

Contraindications

Ticstop 25 mg is contraindicated in: Actively suicidal, or who have depression which is untreated or undertreated Hepatic impairment. Concurrent use of monoamine oxidase inhibitors (MAOIs) or reserpine. Concurrent use of deuTicstop 25 mg or valbenazine.

Side Effects of Ticstop 25 mg

Common: Most common adverse reactions (>10% and at least 5% greater than placebo) were-Sedation/somnolence, fatigue, insomnia, depression, akathisia, anxiety/anxiety aggravated & nausea.Rare: Suicidal thoughts, neuroleptic malignant syndrome, a reaction characterized by fever, muscle rigidity and confusion & pneumonia.

Pregnancy & Lactation

Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Ticstop 25 mg should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Nursing Mothers: It is not known whether Ticstop 25 mg or its metabolites are excreted in human milk. Since many drugs are excreted into human milk and because of the potential for serious adverse reactions in nursing infants from Ticstop 25 mg, a decision should be made whether to discontinue nursing or to discontinue Ticstop 25 mg, taking into account the importance of the drug to the mother.

Precautions & Warnings

The benefit and potential for adverse effects such as worsening mood, cognition, rigidity, and functional capacity should be periodically re-evaluated. The maximum daily dose should not exceed 50 mg/day and the maximum single dose should not exceed 25 mg if administered in conjunction with a strong CYP2D6 inhibitor (e,g., fluoxetine, paroxetine). In case of Neuroleptic Malignant Syndrome, the treatment should be discontinued. The dose should be reduced or discontinued if patient experience restlessness, agitation, akathisia and parkinsonism, The treatment may impair patient's ability to drive or operate complex machinery, Tetrabenzine is not recommended in combination with other drugs that prolong QTc.

Overdose Effects of Ticstop 25 mg

Signs and symptoms of overdosage of Ticstop 25 mg may include drowsiness, sweating and hypothermia.

Storage Conditions

Store in a cool & dry place. protect from light & moisture. Keep all medicines out of the reach of the children.

Use In Special Populations

Pediatric Use: The safety and efficacy of Ticstop 25 mg in pediatric patients have not been established.Geriatric Use: The pharmacokinetics of Ticstop 25 mg and its primary metabolites have not been formally studied in geriatric subjects.Hepatic Impairment: Because the safety and efficacy of the increased exposure to Ticstop 25 mg and other circulating metabolites are unknown, it is not possible to adjust the dosage of Ticstop 25 mg in hepatic impairment to ensure safe use. The use of Ticstop 25 mg in patients with hepatic impairment is contraindicated

Drug Classes

Atypical neuroleptic drugs

Mode Of Action

Ticstop 25 mg is a drug formerly used as an antipsychotic but now used primarily in the symptomatic treatment of various hyperkinetic disorders, It is a vesicular monoamine transporter-2 (VMAT-2) inhibitor that used as symptomatic treatment of chorea associated with Huntington's disease.

Pregnancy

There are no adequate data on the developmental risk associated with the use of Ticstop 25 mg in pregnant women. There are no data on the presence of Ticstop 25 mg or its metabolites in human milk.
Disclaimer

The information provided is accurate to our best practices, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy. The absence of specific information about a drug should not be seen as an endorsement. We are not responsible for any consequences resulting from this information, so consult a healthcare professional for any concerns or questions.