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What is Nitoman used for?

Nitoman is a brand-name prescription medication used to treat hyperkinetic movement disorders such as chorea (involuntary muscle movements) associated with Huntington’s disease, Senile Chorea, Hemiballismus, Tic in Gille’s de la Tourette Syndrome, and Tardive Dyskinesia (a condition caused by psychiatric medications that involve involuntary and abnormal movements).

Chorea is the most debilitating and common motor symptom of Huntington’s disease. It is believed that the jerky tics and movements are caused by the increased activity of a neurotransmitter known as dopamine.

Nitoman drug class

Nitoman contains the active ingredient tetrabenazine, which belongs to a class of drugs known as vesicular monoamine transporter 2 (VMAT2) inhibitors. This medication works in two ways.  

First, it binds to certain proteins to stop dopamine transportation of vesicles to be stored. The second way is by blocking the ability of dopamine to bind to the receiving nerve cells’ surface so it won’t be able to transmit electrical signals. Reducing the brain chemicals will calm down and reduce involuntary muscle movements in those with Huntington’s disease.

Nitoman dosage

Nitoman comes in a tablet form containing 25 mg of tetrabenazine.

Generally, the initial dose of Nitoman should be low, and the dosage should be titrated gradually based on the individual’s tolerance and responsiveness.

For most adult patients, the recommended initial starting dose is 12.5 mg, two to three times a day. This can be gradually increased by 12.5 mg per day every 3 to 5 days or at weekly intervals until the maximal effective and tolerated dose is attained for the individual.

For most cases, 25 mg three times a day is the maximally tolerated dose. In very rare cases, 200 mg is the maximum recommended dose.

If you notice that there is no improvement at the maximum tolerated dose within 7 days, it is unlikely that this medication will be beneficial to the patient, either by raising the dose or lengthening the duration of the treatment.

If you stopped taking Nitoman for more than 5 days and you want to resume taking it, this drug should be re-titrated. For treatment interruption of fewer than five days, you can resume Nitoman at the previous maintenance dose without titration.

Not enough controlled clinical studies have been performed on children.

Directions

Take Nitoman exactly as prescribed by your physician. Read carefully the medication guide and instruction sheet and follow the instructions on the prescription label.

This medication is for oral administration and is usually taken three times a day with or without food. 

Take this drug regularly and continuously to get the most benefit from it.

Do not increase your dose and frequency of taking this drug.

Caution

If you are allergic to Nitoman or to any of its components, do not take this medication.

This medication should not be given to patients with present episodes or a history of clinical depression.

Nitoman (tetrabenazine) should not be given together with an MAO inhibitor. There should be a 14-day gap between discontinuation of an MAOI and the beginning of Nitoman treatment, as well as between the discontinuation of Nitoman and the start of treatment using MAOI.

This medication may cause depression; therefore, you need to stop the use of this medication if you notice the first signs or symptoms of depression. You need to keep in mind that suicide is a possibility when depression is profound.

Nitoman (tetrabenazine) can cause symptoms of parkinsonism, especially in the elderly and at relatively low doses. This medicine is not used for the treatment of levodopa-induced dyskinetic/choreiform movements. This condition should be treated by reducing the dose of levodopa, not by administering Nitoman (tetrabenazine), since the latter can worsen the symptoms of parkinsonism.

Nitoman side effects

Like most medications, Nitoman may cause some unwanted side effects along with its needed effects.

Here are the common adverse reactions observed with Nitoman during clinical use of this medication: 

-Drowsiness 

-Unusual tiredness/fatigue 

-Weakness 

-Trouble sleeping (Insomnia) 

-Irritability 

-Dizziness 

-Depression 

-Restlessness 

-Akathisia 

-Excessive salivation or drooling 

-Anxiety or nervousness 

-Nausea, vomiting, diarrhea, or constipation 

-Parkinson-like syndrome 

If you start to experience suicidal thoughts or unusual changes in your mood or behavior, contact your doctor immediately. All your family members and other caregivers should also be alert for any of these signs.

How much does Nitoman cost in Canada? 

The cost of this drug varies depending on where you purchase the product. It can be very expensive but reasonable for its effectiveness. 

Check the top of this page to see our prices.

Frequently asked questions about Nitoman 

Can I drive while using Nitoman? 

Nitoman may cause drowsiness, weakness, or tiredness, so it is recommended not to drive or operate machinery while taking this medication until you know how it affects you.

What are the signs and symptoms of Nitoman overdose? 

The signs and symptoms of Nitoman overdose are sweating, drowsiness, hypothermia, and low blood pressure (hypotension). Also, acute dystonia, nausea and vomiting, sedation, confusion, diarrhea, hallucinations, rubor, tremors, and oculogyric crisis (prolonged involuntary upward deviation of the eyes) were reported.

Do I need a prescription to purchase Nitoman? 

Yes, you must present a valid prescription from your doctor regardless of whether you purchase it at your local pharmacy or online.

What other drugs could interact with Nitoman? 

Possible interactions with tetrabenazine are just some of the following drugs, alfuzosin, amantadine, amiodarone, antihistamines, antipsychotics, aripiprazole, azelastine, and baclofen. This is not a complete list, so check with your doctor before taking tetrabenazine. 

Avoid alcoholic drinks while taking tetrabenazine as it can increase dizziness and drowsiness.