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Home > Drug Category > Neurological Treatments > Nitoman and Equivalent

Nitoman Information

Nitoman (Tetrabenazine) is a vesicular monoamine transporter 2 (VMAT2) inhibitor used to manage movement disorders, conditions characterized by involuntary, uncontrollable body movements. It is used for movement disorders associated with neurological conditions such as Huntington's chorea (the jerky, irregular movements caused by Huntington's disease), hemiballismus (violent, flinging movements of the limbs), and severe tics associated with Tourette syndrome.

Tetrabenazine works by binding to and inhibiting VMAT2, a protein that transports and stores neurotransmitters such as dopamine, serotonin, and norepinephrine within nerve cells. By depleting these neurotransmitters, tetrabenazine helps reduce the overstimulation that causes involuntary, uncontrollable body movements. While it does not necessarily address the underlying neurodegeneration or the cognitive and psychological symptoms of the disease, it does help manage the most physically disruptive symptom of Huntington's, other movement disorders, offering some relief to patients.

Nitoman Side Effects

Some common side effects that may occur with the use of this medication include anxiety, difficulty starting movement, difficulty sleeping, dizziness, drooling, drowsiness, fatigue, increased appetite, nausea, orthostatic hypotension (dizziness when standing or sitting from a lying position), vomiting, weakness, and weight gain. Contact your doctor if you experience any of these side effects, as the dose may need to be adjusted.

However, seek immediate medical attention if you notice serious side effects such as:
• Allergic reactions such as breathing difficulties, hives, swelling of the face, lips, or throat;
• Difficulty swallowing;
• Heart problems such as QT prolongation (a dangerous alteration in the heart's electrical activity), dizziness, abnormal awareness of your heartbeat, rapid, pounding, or irregular heartbeat;
• Restlessness and inability to sit still (akathisia);
• Severely elevated blood pressure;
• Severe depression with suicidal thoughts and ideation;
• Severe tremor;
• Signs of neuroleptic malignant syndrome, such as high fever, neck stiffness, hallucinations, and confusion

Inform your doctor about any other side effects you notice that are not listed here.

Nitoman Precautions

Do not use this medication if you have:
• Allergy to tetrabenazine, the inactive ingredients in Nitoman, or any other medicine;
• Current use of other VMAT2 inhibitors (such as deutetrabenazine or valbenazine);
• Depression with suicidal thoughts and ideation that is difficult to treat;
• Liver disease (hepatic impairment);
• Parkinson's or related hypokinetic-rigid conditions

Before using this medication, ensure you inform your doctor about any medical conditions you previously or currently have, including the following:
• Depression, especially with a history of suicidal ideation or attempts;
• Difficulty swallowing;
• Heart disease, especially long QT syndrome or a history of abnormal heart rhythm;
• Hyperprolactinemia (high blood prolactin levels);
• Kidney disease;
• Low blood pressure, with severe dizziness with a change in posture;
• Neuroleptic malignant syndrome;
• Pheochromocytoma (tumor of the adrenal gland);
• Pituitary or breast tumor;
• Tardive dyskinesia (persistent, repetitive muscle movements usually affecting the face, mouth, or tongue that develop as a side effect of long-term antipsychotic medication use)

Avoid the intake of alcohol while taking this medication, as it can worsen the profound somnolence, dizziness, and psychomotor impairment caused by Nitoman. Taking tetrabenazine with monoamine oxidase inhibitors (MAOIs) such as phenelzine and selegiline can cause rapid accumulation of monoamine in the cells, causing a life-threatening hypertensive crisis. It is important to wait until 14 days after stopping MAOIs before starting tetrabenazine. Likewise, concomitant use of this medication with reserpine can cause dangerous depletion of monoamines, leading to profound parkinsonism or severe depression. Nitoman must also never be taken in combination with other VMAT2 inhibitors (e.g., deutetrabenazine or valbenazine), as this severely compounds the risk of profound monoamine depletion, extreme parkinsonism, and severe depression.

Therefore, these medications should not be used together with tetrabenazine. It is also important to inform your healthcare provider about all the medicines, including herbal supplements and drugs that prolong the QT interval (like certain antipsychotics or antibiotics), that you are taking before using tetrabenazine to prevent potential drug interactions.

Consult your doctor before using this medication during pregnancy. This medication should not be taken during pregnancy unless the clinical benefit to the mother absolutely outweighs the potential risks to the fetus, as human safety data is limited and animal studies have shown reproductive toxicity. Nitoman is not recommended for use in breastfeeding women as it can pass through breastmilk and affect the breastfed infant. Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do I need a prescription to order Nitoman?

Yes, a prescription is required from your physician to order Nitoman.