What to Do When You Can't Fill Your Austedo Prescription

If you've been prescribed Austedo (deutetrabenazine) and can't find it at a pharmacy — or can't afford it — you may be wondering what your options are. You're not stuck. There are alternative medications that work in similar ways, and your doctor can help you figure out the best path forward.

In this article, we'll explain what Austedo does, how it works, and walk through the most common alternatives available in 2026.

What Is Austedo?

Austedo is a brand-name prescription medication made by Teva Pharmaceuticals. Its generic name is deutetrabenazine. It belongs to a class of drugs called VMAT2 inhibitors — vesicular monoamine transporter 2 inhibitors.

Austedo is FDA-approved to treat:

• Tardive dyskinesia (TD) — repetitive, involuntary movements (often of the face, tongue, or limbs) caused by long-term use of certain medications, especially antipsychotics
• Chorea associated with Huntington's disease — uncontrolled, dance-like movements that occur with Huntington's disease

Austedo is available in two formulations: immediate-release tablets (taken twice daily with food) and Austedo XR (taken once daily). There is no generic version as of 2026, and it costs $7,000 to $10,000 per month without insurance.

For more details on Austedo itself, see our article on what Austedo is, its uses, and dosage.

How Does Austedo Work?

To understand the alternatives, it helps to know how Austedo works in the brain.

Austedo is a reversible VMAT2 inhibitor. VMAT2 is a protein that packages brain chemicals (called monoamines) — including dopamine, serotonin, norepinephrine, and histamine — into tiny storage containers in nerve cells. When VMAT2 is inhibited, less dopamine gets released.

Too much dopamine activity in certain parts of the brain is believed to cause the involuntary movements seen in tardive dyskinesia and Huntington's chorea. By reducing dopamine signaling, Austedo helps control these movements.

Austedo is a deuterated form of an older drug called tetrabenazine (Xenazine). The deuterium atoms slow down how quickly the body breaks the drug down, allowing it to last longer and be taken less frequently.

For a deeper explanation, check out how Austedo works: mechanism of action explained.

Alternative #1: Ingrezza (Valbenazine)

Ingrezza is the most direct alternative to Austedo for patients with tardive dyskinesia. Like Austedo, it's a VMAT2 inhibitor — meaning it works through the same mechanism of reducing dopamine release.

Key Facts About Ingrezza

• Generic name: Valbenazine
• FDA-approved for: Tardive dyskinesia (not Huntington's chorea)
• Dosing: Once daily (simpler than Austedo's twice-daily dosing for the immediate-release version)
• Manufacturer: Neurocrine Biosciences
• Cost: Similar to Austedo — also a high-cost specialty medication

How Ingrezza Compares to Austedo

Both medications are effective for tardive dyskinesia and are the only two VMAT2 inhibitors approved for this condition. The main differences:

• Ingrezza is taken once daily; Austedo (IR) is taken twice daily (though Austedo XR is also once daily)
• Ingrezza is not approved for Huntington's chorea — so if that's your condition, Ingrezza may not be an option
• Side effect profiles differ slightly. Common side effects of Ingrezza include sleepiness, balance problems, and headache
• You cannot take Ingrezza and Austedo at the same time — they are contraindicated together

If your doctor recommends switching from Austedo to Ingrezza, they will manage the transition carefully, including appropriate washout periods.

Alternative #2: Xenazine (Tetrabenazine)

Xenazine is the original VMAT2 inhibitor and the predecessor to Austedo. In fact, Austedo was developed as an improved version of Xenazine.

Key Facts About Xenazine

• Generic name: Tetrabenazine
• FDA-approved for: Chorea associated with Huntington's disease (not tardive dyskinesia)
• Dosing: Three times daily — more frequent than Austedo
• Generic available: Yes, generic tetrabenazine is available, which may make it more affordable

How Xenazine Compares to Austedo

• Xenazine requires more frequent dosing (three times daily vs. twice daily for Austedo or once daily for Austedo XR)
• It is only approved for Huntington's chorea, not tardive dyskinesia
• Xenazine may cause more side effects because it's metabolized faster, leading to bigger swings in drug levels
• A generic version of Xenazine is available, which can significantly reduce cost
• You cannot take Xenazine and Austedo at the same time

Xenazine may be a good alternative if you have Huntington's chorea and need a more affordable VMAT2 inhibitor.

Alternative #3: Adjusting the Causative Medication

For patients with tardive dyskinesia specifically, another approach is to work with your doctor to adjust or change the medication that's causing the involuntary movements in the first place.

Tardive dyskinesia is most commonly caused by long-term use of:

• Antipsychotics (both first-generation like haloperidol and second-generation like risperidone)
• Certain anti-nausea medications (like metoclopramide/Reglan)
• Some antidepressants

Your doctor may consider:

• Reducing the dose of the causative medication (if safe to do so)
• Switching to a different medication that is less likely to cause TD
• Discontinuing the causative medication (only if medically appropriate — never stop a medication on your own)

Important: Adjusting psychiatric medications is complex and must be done under close medical supervision. Stopping antipsychotics abruptly can cause serious problems. This approach works best in combination with a VMAT2 inhibitor, not necessarily as a replacement.

What About Other Movement Disorder Treatments?

Beyond VMAT2 inhibitors and medication adjustments, some doctors may consider other approaches depending on your specific situation:

• Benzodiazepines (like clonazepam) — sometimes used off-label for movement disorders, but carry risks of dependence and sedation
• Botulinum toxin injections — may help with localized involuntary movements (e.g., facial muscles)
• Deep brain stimulation (DBS) — a surgical option for severe cases that don't respond to medication

These are generally considered second-line or last-resort options. Talk to a movement disorder specialist to explore what's right for you.

How to Find Austedo Before Switching

Before exploring alternatives, make sure you've exhausted all options for finding Austedo itself. Sometimes the issue is availability or cost — not that Austedo isn't the right medication for you.

• Use Medfinder to search for pharmacies that have Austedo in stock near you
• Look into copay savings and patient assistance programs from Teva
• Ask about Austedo XR, which may have better availability

For more tips, see our guide on how to find Austedo in stock near you.

Final Thoughts

Not being able to fill your Austedo prescription is stressful, but you have options. Ingrezza is the closest alternative for tardive dyskinesia. Xenazine (with a generic available) may work for Huntington's chorea. And adjusting the medication causing your symptoms is always worth discussing with your doctor.

The most important thing is to never stop treatment on your own. Talk to your doctor before making any changes, and use tools like Medfinder to explore all your options.