II. Indications
- Complex Partial Seizures (adjunct in refractory cases)
III. Precautions
- Risk of Vision Loss (see Adverse Effects below)
- Restricted distribution of Vigabatrin in U.S.
- Must be part of monitoring program in U.S. to receive
- Not recommended in age <9 years due to greater difficulty in detecting Vision Loss
IV. Mechanism
VI. Dosing
- Adults (and children age >16 years, weight > 60 kg)
- Initial: 500 mg orally twice daily orally
- Titrate weekly at 500 mg/day/week
- Target: 1500 mg orally twice daily
- Children (age 10 to 16 years, weight 25 to 60 kg)
- Initial: 250 mg orally twice daily orally
- Titrate weekly at 500 mg/day/week
- Target: 1000 mg orally twice daily
- Infants with Infantile Spasms (age 1 month to 2 years)
- Initial: 50 mg/kg/day divided twice daily orally
- Titrate every 3 days by 25 to 50 mg/kg/day
- Maximum: 150 mg/kg/day divided twice daily orally
-
Renal Dosing
- Creatinine Clearance 50 to 80 ml/min: Decrease dose by 25%
- Creatinine Clearance 30 to 50 ml/min: Decrease dose by 50%
- Creatinine Clearance 10 to 30 ml/min: Decrease dose by 75%
VII. Adverse Effects
- Common
- Sedation
- Fatigue
- Weight gain
- Headache
- Dizziness, Ataxia or Vertigo
- Nervousness
- Abdominal Pain
- Constipation
- Serious
- Vision Loss (Retinal nerve atrophy)
- Onset may be at any time while taking medication, and irreversible once it occurs
- Obtain Visual Field testing at baseline, then every 3 months, and for 3 to 6 months after stopping medication
- Psychosis
- Vision Loss (Retinal nerve atrophy)
VIII. Pharmacokinetics
- Most (95%) is excreted unchanged in the urine
IX. Resources
- Vigabatrin (DailyMed)
- Vigabatrin (StatPearls)
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
| Definition (MSH) | An analogue of GAMMA-AMINOBUTYRIC ACID. It is an irreversible inhibitor of 4-AMINOBUTYRATE TRANSAMINASE, the enzyme responsible for the catabolism of GAMMA-AMINOBUTYRIC ACID. (From Martindale The Extra Pharmacopoeia, 31st ed) |
| Concepts | Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) |
| MSH | D020888 |
| SnomedCT | 310283001, 322976008 |
| LNC | LP20808-9, MTHU012453 |
| English | Vigabatrin, Vigabatrin - chemical (substance), Vigabatrin (substance), Vigabatrin - chemical, 4-Amino-5-hexenoic Acid, Acid, gamma-Vinyl-gamma-Aminobutyric, gamma Vinyl gamma Aminobutyric Acid, gamma-Vinyl-gamma-Aminobutyric Acid, gamma Vinyl GABA, gamma-Vinyl-GABA, vigabatrin, Vigabatrin [Chemical/Ingredient], VIGABATRIN, gamma vinyl gaba, gaba gamma vinyl, Vinyl Gamma-Aminobutyric Acid, 5-Hexenoic Acid, 4-Amino-, Gamma Vinyl Gaba, 4-Amino-5-Hexenoic Acid, Gamma-Vinyl Gaba, vigabatrin (medication), anticonvulsants vigabatrin, Vigabatrin product, Vigabatrin product (product), Vigabatrin product (substance), Gamma vinyl GABA, Gamma vinyl gamma aminobutyric acid |
| Swedish | Vigabatrin |
| Spanish | vigabatrina, producto, Ácido gamma-Vinil-gamma-Aminobutírico, vigabatrina (producto), gamma vinil GABA, vigabatrina (sustancia), vigabatrina, vigabatrin, vigabatrina - sustancia química (sustancia), vigabatrin, producto, producto con vigabatrina (producto), producto con vigabatrina, vigabatrina - sustancia química, vigabatrina, producto (producto), Vigabatrin |
| Czech | vigabatrin, kyselina gama-vinyl-gama-aminomáselná |
| Finnish | Vigabatriini |
| Russian | VIGABATRIN, ВИГАБАТРИН |
| Japanese | ビガバトリン |
| Polish | Wigabatryna |
| French | Gamma-vinyl GABA, Vigabatrine |
| German | Vigabatrin, Gamma-Vinyl-gamma-Aminobuttersäure |
| Italian | Vigabatrina |
| Portuguese | Ácido gama-Vinil-gama-Aminobutírico, Vigabatrina |
