Vigabatrin(vi gah ba’ trin)
Sabril
PREGNANCY CATEGORY C
Drug Classes
Antiepileptic
GABA transaminase inhibitor
Therapeutic Actions
Irreversibly inhibits GABA transaminase, the enzyme responsible for the metabolism of the inhibitory neurotransmitter GABA. Inhibiting the metabolism leads to increased levels of GABA in the nervous system and inhibition of neuronal activity.
Indications
Adjunct to treatment of refractory complex partial seizures in patients 10 yr and older who have not responded to alternative therapies (tablets)
Treatment of infantile spasms in children 1 mo—2 yr (oral solution)
Contraindications and Cautions
Contraindicated with history of serious hypersensitivity reactions to components of drug; breast-feeding.
Use cautiously with pregnancy, renal dysfunction.
Available Forms
Tablets—500 mg; powder—500 mg/packet
Dosages
Adults and pediatric patients older than 16 yr
500 mg PO bid; titrate to desired dose of 1.5 g bid. Taper when discontinuing.
Pediatric patients 10–16 yr
Refractory partial seizures: Initially, 250 mg PO bid; titrate to recommended dose of 1,000 mg PO bid. For patients weighing more than 60 kg, use adult dose.
Pediatric patients 1 mo–2 yr
Infantile spasms: 50 mg/kg/day PO in two divided doses; titrate every 3 days in 25- to 50-mg/kg increments to a maximum dose of 150 mg/kg/day.
Patients with renal impairment
CrCl of more than 50–80 mL/min, reduce dose by 25%; CrCl of more than 30 to 50 mL/min, reduce dose by 50%, CrCl of more than 10 to less than 30 mL/min, reduce dose by 75%.
Pharmacokinetics
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