Vigabatrin

Vigabatrin Brand Names

  • Sabril
  • VIGADRONE

What is Vigabatrin

Vigabatrin, an oral anticonvulsant, was synthesized in 1974 as a structural analog of gamma-aminobutyric acid (GABA) and was designed to inhibit the metabolism of GABA. Decreased concentrations of GABA have been associated with certain forms of epilepsy.

Vigabatrin has been investigated for the treatment of many seizure types but appears to be most effective in treating complex partial seizures and infantile spasms, particularly those associated with tuberous sclerosis complex (TSC).

Vigabatrin was the first drug to be FDA-approved for the treatment of infantile spasms, and it was the first real pharmacologic advancement in the treatment of this refractory seizure type since the introduction of ACTH in the late 1950s.

It has been used to treat patients with infantile spasms and refractory complex partial seizures in other countries for over 20 years and is available in over 50 countries worldwide.

The approval for the use of vigabatrin in the United States was delayed due to the FDA’s request for additional research on the visual field defects that are associated with vigabatrin use.

Due to the risk of permanent vision loss, vigabatrin is only available through a restricted distribution program.

Only prescribers and pharmacies registered with the program may prescribe and dispense vigabatrin.

Indications & Dosage

  • infantile spasms
  • partial seizures

For use as monotherapy in the treatment of infantile spasms in pediatric patients for whom the potential benefits outweigh the potential risk of vision loss

Side Effects

  1. abdominal pain
  2. abnormal magnetic resonance imaging (MRI) signal changes
  3. acne vulgaris
  4. agitation
  5. alopecia
  6. anemia
  7. angioedema
  8. anorexia
  9. anxiety
  10. appetite stimulation
  11. arthralgia
  12. asthenia
  13. back pain
  14. blurred vision
  15. candidiasis
  16. chest pain (unspecified)
  17. cholestasis
  18. confusion
  19. conjunctivitis
  20. constipation
  21. cough
  22. delirium
  23. dental pain
  24. depression
  25. diarrhea
  26. diplopia
  27. dizziness
  28. drowsiness
  29. dysarthria
  30. dyskinesia
  31. dysmenorrhea
  32. dyspepsia
  33. dystonic reaction
  34. edema
  35. encephalopathy
  36. esophagitis
  37. fatigue
  38. fever
  39. GI bleeding
  40. hallucinations
  41. headache
  42. hearing loss
  43. hepatitis
  44. hyperkinesis
  45. hyperreflexia
  46. hypertonia
  47. hypoesthesia
  48. hyporeflexia
  49. hypotonia
  50. impotence (erectile dysfunction)
  51. infection
  52. influenza
  53. insomnia
  54. irritability
  55. laryngeal edema
  56. lethargy
  57. maculopapular rash
  58. malaise
  59. malignant hyperthermia
  60. memory impairment
  61. muscle cramps
  62. myalgia
  63. myoclonia
  64. nasal congestion
  65. nausea
  66. nystagmus
  67. ocular pain
  68. optic neuritis
  69. paresthesias
  70. peripheral edema
  71. peripheral neuropathy
  72. pharyngitis
  73. polydipsia
  74. pruritus
  75. psychosis
  76. pulmonary embolism
  77. rash
  78. respiratory depression
  79. seizures
  80. sinusitis
  81. Stevens-Johnson syndrome
  82. suicidal ideation
  83. tinnitus
  84. toxic epidermal necrolysis
  85. tremor
  86. vertigo
  87. visual impairment
  88. vomiting
  89. weight gain

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • breast-feeding
  • children
  • depression
  • driving or operating machinery
  • geriatric
  • hepatic decompensation
  • hepatic disease
  • infants
  • laboratory test interference
  • neonates
  • pregnancy
  • renal impairment
  • requires an experienced clinician
  • substance abuse
  • suicidal ideation
  • visual impairment

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Alfentanil
  • Alprazolam
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amphetamines
  • Anxiolytics; Sedatives; and Hypnotics
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azathioprine
  • Azelastine; Fluticasone
  • Barbiturates
  • Beclomethasone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Betamethasone
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Budesonide
  • Budesonide; Formoterol
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Cannabidiol
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pyrilamine
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloral Hydrate
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chloroquine
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Ciclesonide
  • Clemastine
  • Clonazepam
  • Clorazepate
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Corticosteroids
  • Corticotropin, ACTH
  • Cortisone
  • Cyclizine
  • Cyproheptadine
  • Deferoxamine
  • Deflazacort
  • Deutetrabenazine
  • Dexamethasone
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Diazepam
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Droperidol
  • Esomeprazole; Naproxen
  • Estazolam
  • Eszopiclone
  • Ethambutol
  • Fentanyl
  • Fludrocortisone
  • Flunisolide
  • Flurazepam
  • Fluticasone
  • Fluticasone; Salmeterol
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Formoterol; Mometasone
  • Fosphenytoin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone
  • Hydromorphone
  • Hydroxychloroquine
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Interferons
  • Lansoprazole; Naproxen
  • Levorphanol
  • Lorazepam
  • Losartan
  • Loxapine
  • Maprotiline
  • Mecasermin rinfabate
  • Mecasermin, Recombinant, rh-IGF-1
  • Meclizine
  • Mefloquine
  • Meloxicam
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Methadone
  • Methohexital
  • Methylprednisolone
  • Midazolam
  • Mirtazapine
  • Molindone
  • Mometasone
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Opiate Agonists
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Pemoline
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Pentostatin
  • Phenobarbital
  • Phenothiazines
  • Phenytoin
  • Phosphodiesterase inhibitors
  • Prednisolone
  • Prednisone
  • Primidone
  • Propoxyphene
  • Quazepam
  • Ramelteon
  • Remifentanil
  • Secobarbital
  • Sedating H1-blockers
  • Sufentanil
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Temazepam
  • Thiopental
  • Thiothixene
  • Tramadol
  • Triamcinolone
  • Triazolam
  • Tricyclic antidepressants
  • Triprolidine
  • Warfarin
  • Zaleplon
  • Zolpidem
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