VIGABATRIN

 (Sabril)

Standard Prescription

vigabatrin__mg PO Q__H (__mg/kg/24hr)

Dosages

Infantile Spasms:
Initial: 25 mg/kg/dose PO BID
Increment: 25 mg/kg/dose PO BID every 2-3 days to desired clinical response
Maximum: 75-100 mg/kg/dose PO BID

Refractory Focal Seizures (adjunct):
Children:
Initial:  20 mg/kg/dose PO BID (Max 250 mg/dose)
Increment: Increase by 125-250 mg/dose every 7 days to desired clinical response and tolerability.
Maximum: 50 mg/kg/dose PO BID
Adolescents > 16 years & Adults:
Initial: 500 mg/dose PO BID
Increment: 250-500 mg/24 hr PO every 7 days to desired clinical response and tolerability.
Maximum: 1500 mg/dose PO BID

Mechanism of Action

Anticonvulsant, irreversible mechanism-based inhibitor of gamma-aminobutyric acid aminotransferase (GABA-AT), resulting in increased levels of GABA in the brain.

Forms Supplied

tablet: 500 mg
(500 mg sachet is available but not stocked at BCCH)

Comments

A first line drug in the management of infantile spasms.

Adjust dose according to tablet increments.

Dose adjustment required in renal impairment.

May be taken with or without food.

Concerns have been raised over the occurrence of visual abnormalities which may be asymptomatic, and the outcome of which has been variable. Irreversible visual field loss may occur. The potential risks and benefits of therapy with vigabatrin should be discussed with the patient/caregiver. Ophthalmology consultation is suggested routinely before and during treatment.

References

32, 44

Last Edited

2022-09-12 01:01:23