Tiagabine

Tiagabine is an anticonvulsant medication used, in addition to other medications, to treat partial epilepsy in adults.

Overview:

Tiagabine is an anticonvulsant medication used to treat epilepsy in adults. It is most commonly found under the brand name Gabitril.

Tiagabine's main mechanism of action is unknown. It is believed that Tiagabine works by binding to gamma aminobutyric acid - an inhibitory neurotransmitter in the central nervous system - which blocks gamma aminobutyric acid uptake in neurons, permitting gamma aminobutyric acid to more easily bind to the surfaces of post-synaptic cells.

Tiagabine was developed by Novo Nordisk in 1988 in Denmark. It was discovered along with research from Abbott Laboratories, with the two sharing original rights to the drug. The drug first became available and FDA-approved in the U.S. in 1998. In 2016, the patent on brand name versions of Tiagabine expired. It is widely available in the U.S., U.K., Canada, and Australia.

Condition(s) treated:

  • Epilepsy

Type of medicine:

  • Anticonvulsant

Side Effects:

Tiagabine has a number of different possible side effects. Some are more serious than others, and you should be aware of what side effects are common and less serious, and which should be brought to the attention of your doctor.

If you experience any of the following side effects, you should tell your doctor. If mild, they may not be serious, but if severe they could indicate that Tiagabine is not right for you. Even if any of the following symptoms are mild, you should discuss with your doctor whether experiencing these side effects may mean it is not appropriate for you. There may be other alternatives that allow you to live without certain side effects.

  • Dizziness
  • Fatigue or drowsiness
  • Lack of coordination or difficulty walking
  • Depression or mood changes
  • Hostility or anger
  • Difficulty concentrating
  • Increased appetite
  • Nausea
  • Stomach pain
  • Sleeping difficulties and insomnia
  • Abnormal itching
  • Abnormal bruising
  • Painful or frequent urination

Tiagabine may also cause some more serious and uncommon side effects. If you experience any of the following, you should alert a medical professional immediately.

  • Rash
  • Sores on the inside of the mouth, nose, eyes, or throat
  • Flu-like symptoms
  • Changes in vision
  • Extreme fatigue or weakness
  • Incontrollable shaking
  • Numbness, pain, burning, or other unusual sensations in the hands or feet
  • Seizures (new, more frequent, or worsening)

In addition to this list, if you experience any side effects that resemble an allergic reaction (such as rashes, fever, or swelling) you should also alert a doctor immediately. This may be a sign that you are allergic to Tiagabine and need a different medication.

This list is not exhaustive. If you experience any abnormal side effects while taking Tiagabine, you should always let your doctor know.

Dosage:

Tiagabine is taken orally, usually two to four times per day depending on what your doctor has prescribed. It is generally sold in strengths of 2 mg, 4 mg, 12 mg, and 16 mg. Depending on your particular needs and previous use of medications to control epilepsy, this dosage can vary. Generally, you should take no more than 56 mg per day, but should follow your doctor's recommendation. The medication should be taken with food and at about the same time each day.

Patients between the ages of 12 and 18 are generally advised to take one 4 mg dosage per day. This dosage is usually increased in increments of 4 mg or 8 mg, until the desired level of dosage is achieved. Once the patient is at the desired level, the dosage should be split into 2 to 4 dosages taken throughout the day. Generally, patients of this age should never take more than 32 mg per day.

Patients over the age of 18 are also advised to start by taking dosages of 4 mg per day, and also increase this dosage in intervals of 4 mg or 8 mg over the course of time until the proper dosage level is achieved. Once this level is achieved, these dosages should be broken into 2 to 4 separate dosages taken each day. The maximum daily recommended dose for adults is 56 mg.

Generally, when you start taking Tiagabine you will take a lower dose only once per day. Your doctor will slowly increase this dosage and frequency until you find a dosage that is suitable for you. You may need blood tests or to monitor the frequency and severity of seizures once you start taking Tiagabine. Depending on how you react to the medication, your doctor may lower or raise your dosage strength and frequency over time.

Never stop taking Tiagabine without medical direction. It is dangerous to suddenly stop Tiagabine and could trigger seizures or other withdrawal symptoms. If you feel sick, experience negative side effects, or don't feel that Tiagabine is right for you, talk to your doctor immediately. If you and your doctor decide that it is best to quit using Tiagabine, your doctor will help you to gradually lower your dosage until you are completely off it.

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose anyway, you should wait to take your next dose. Do not take two doses at once or too close to one another. Let your doctor know if you have missed a dose, and be careful not to miss doses often.

Interactions:

Tiagabine can have negative reactions with other medications and foods. You should tell your doctor about all medications and dietary supplements you take before beginning Tiagabine.

Tiagabine should never be taken with idelalisib or ivacaftor.

Many other medications may interact with Tiagabine in different ways. You should tell your doctor if you take or are planning to take any of the following:

  • Diet pills
  • Medication for psychiatric disorders
  • ADHD medication
  • Narcotics
  • Other medications that make you drowsy
  • Carbamazepine
  • Phenobarbital
  • Divalproex
  • Phenytoin
  • Primidone
  • Valproic acid

You should be careful about drinking grapefruit juice while on Tiagabine, as it could have a negative reaction. Talk to your doctor about this before drinking grapefruit juice.

Warnings:

It is possible to overdose on Tiagabine. Signs of overdose include lethargy, seizures, tremors, dizziness, vomiting, agitation, depression, and hallucinations, among other things. Overdose of Tiagabine can be lethal, as it can depress the respiratory system. If you or someone you know has overdosed on Tiagabine, you should alert medical professionals immediately. Though there is no antidote for Tiagabine overdose, medical supervision and care can help overdose victims to heal or reduce the chances of long-term damage.

Tiagabine may make you drowsy or affect you in unexpected ways. Usually, you will be able to tell how the medication affects you after you have taken it for a while. When you first start Tiagabine, do not drive or operate heavy machinery. Also be careful when increasing or lowering doses, as you do not know how different amounts of Tiagabine may affect you. Alcohol may worsen these effects if taken with Tiagabine. You should consult with your doctor before drinking alcohol while using Tiagabine, and be careful to see how it affects you.

Though rare, Tiagabine has also shown to affect patients' mental health. When you begin Tiagabine, you should watch out for increased anxiety, depression, panic attacks, or suicidal thoughts. If you experience any of these mental disorders, you should alert someone immediately. Tiagabine may not be right for you, or you may need to have your dosage and prescription adjusted.

It is not always safe to take Tiagabine when pregnant. Tell your doctor if you are, may be, or are planning to become pregnant before taking Tiagabine. You should also tell your doctor if you are breastfeeding or planning to breastfeed. Although there are no conclusive studies on how Tiagabine may affect unborn babies or nursing babies, your doctor may want to monitor you.

You should always tell a medical professional that you take Tiagabine before any surgeries or dental work. To be safe, it is also a good idea to wear a medical bracelet or carry information stating that you use Tiagabine in case of an emergency.

Those who do not have epilepsy or are not prescribed Tiagabine should not take it. Taking Tiagabine when not necessary can induce seizures and be extremely harmful.

Storage:

Tiagabine should be stored in its original container, tightly sealed. It should come with a child safety lock, which you should ensure is always tightly in place and that the bottle is out of the reach of children. Tiagabine should be stored at room temperature, somewhere that is not susceptible to moisture or intense heat. If your Tiagabine is damaged, you should try to get a new prescription or refill as soon as possible.

When done with a prescription of Tiagabine, you should scratch off any personal details from the bottle and throw it away in your household garbage. Do not throw Tiagabine pills away in the garbage. If you need to dispose of Tiagabine, you should find a certified medicine take-back program, which you can do by consulting the FDA's website on drug disposal. You can talk to your doctor about any special disposal options. Also be sure to dispose of any medications that are outdated or not needed. If your prescription expires and you need more, you should talk to your doctor or get a new prescription refill. To avoid this, you should always monitor your supplies and request a new prescription or refill before you run out.

Summary:

Tiagabine is an anticonvulsant medication used to treat partial epilepsy in adults, commonly sold under the brand name Gabitril.

Tiagabine can have a number of side effects, both serious and common. Tiagabine is most commonly known for making patients drowsy or fatigued. You should always tell your doctor if you experience severe side effects or think you may be allergic to Tiagabine.

Tiagabine is generally taken in doses two to four times per day. It is sold in tablets of various strengths, and generally starts with a dosage of 4 mg per day, gradually increased as prescribed by a doctor. Tiagabine should always be taken with food, and at about the same times each day. Tiagabine should never be abruptly stopped. Only stop taking Tiagabine under the guidance of a medical professional, who will gradually decrease your dosage.

It is possible to overdose on Tiagabine. Never take two doses at once or take more than prescribed. You should also check with your doctor about taking Tiagabine with other medications or before any type of surgery. It is always a good idea to wear a medical bracelet or carry medical information stating that you take Tiagabine, so that medical professionals are aware in case of an emergency.

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Last Reviewed:
December 24, 2017
Last Updated:
December 22, 2017
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