Vigabatrin (Oral)

Vigabatrin, brand name Sabril, can be used in oral form to treat sufferers of epilepsy as well as babies who experience infantile spasms.

Overview

Low levels of gamma-aminobutyric acid or GABA can cause seizures. Vigabatrin increases GABA in the brain and reduces the chances that a seizure will occur. When other medications fail to minimize seizures, doctors may choose to prescribe this drug. It can be combined with other medications used to treat seizures or used alone. This drug can be used to treat children 10 years of age or older and adults. It can also be used to treat infantile spasms.

Condition(s) treated?

  • Infantile Spasms/West's Syndrome
  • Temporal Lobe Epilepsy
  • Complex Partial Seizures
  • Refractory Seizures
  • Secondarily Generalized Seizures
  • Simple Partial Seizures

Type of medicine?

  • Anticonvulsant

Side Effects

All medications have some sort of side effects, and some are more severe than others. You might be able to go through your day and deal with the milder side effects. But some side effects may be so serious that you have to make adjustments to your life to function while on Vigabatrin. You may experience these side effects while first starting the Vigabatrin treatment, and symptoms may ease up or completely subside during the duration of your treatment. If the side effects are too debilitating do not stop the medication, but do go see your doctor immediately. Your doctor may have to adjust the dosage or strength of the medicine to make it bearable for you. If you suddenly stop taking the medicine the seizures may come right back.

Half of all adult patients that take this drug experience central nervous symptom side effects such as sedation, drowsiness, fatigue, and impaired concentration. Children report excitation and agitation and some patients report an actual increase in the number of seizures that occur. Report any unusual or serious reactions immediately to your doctor.

One of the most severe side effects reported has been a complete loss of vision or the effect on the patient's vision. Partial blindness, blurred vision, trouble reading, and trouble seeing while driving were the most common. Visual field defects can occur months or years after the therapy is completed. Get frequent check-ups with an eye doctor during treatment and 4 times a year after treatment is complete. If you have myoclonus seizures there is an increased chance of more seizures.

The following side effects have been reported to occur while using the oral liquid, oral powder for solution and the oral tablet:

  • memory loss
  • agitation
  • vision changes
  • increase in seizures
  • eye pain
  • blue-yellow color blindness
  • constipation
  • agitation
  • burning, tingling, or prickly sensations
  • loss of balance
  • blurred or double vision
  • uncontrolled eye movement
  • diarrhea
  • dizziness
  • increased movement
  • stomache pain
  • trembling
  • can't sit still
  • pain in the joints
  • depression
  • drowsiness

Less common:

  • trouble sleeping
  • increased anger and aggression
  • speech issues
  • weakened muscles
  • more saliva
  • poor concentration
  • nausea
  • headache
  • gaining weight
  • vomiting

Psychosomatic side effects:

  • malaise
  • asthenia
  • thirst
  • fever
  • trouble speaking
  • irritability
  • depression
  • paranoia bad nerves
  • abnormal dreams
  • anger
  • lack of focus
  • bad nerves
  • mental impairment
  • hypomania
  • psyvhotic disorder
  • mania
  • suicide attempt
  • hallucination

Other serious side effects:

  • influenza
  • pneumonia
  • viral infection
  • pharyngeal Pain
  • nasopharyngitis pneumonia
  • espiratory tract infection
  • candidiasis

If you experience a loss of consciousness, this could be a sign of overdose, seek medical attention immediately.

If you experience any side effects that are not on this list consult your doctor. They may need to lower, raise, or adjust your dosage or the strength of your medicine to make the treatment effective for you.

Dosage

  • Available in powder or tablet form
  • Available through a restricted program called the SHARE program, contact your doctor for more information about the SHARE program
  • Take this medicine with or without food.

Oral liquid:

  • Open the medicine and pour contents of the packet into an empty cup.
  • Dissolve in 10 milliliters of cold or room temperature water.
  • Liquid should be clear, free of particles, and colorless; if not, don't use it.
  • Use the oral syringe provided to measure the dose.
  • Dispose of any unused medicine.

The dosage of any medication is on a case by case basis. It depends on the patient's weight, age, state of their health, the severity of their condition, underlying medical conditions, and any other medications they're currently taking. The doctor determines based on tests and an examination as well as medical history what your treatment will be. Failing to get a checkup and prescription from the doctor can have dire results. Anything you may take may make the condition worse or result in a whole new medical issue. Once you are seen, follow the strict instructions of your doctor and do not stop taking the medicine until the doctor advises you to stop.

Different patients are prescribed different strengths of Vigabatrin. The amount you receive depends on the strength of the drug, how many times you take it per day, the number of hours between doses, the severity of your condition and the amount of time you are being treated.

Oral dosage form (solution):

Infantile spasms:

  • Doses are determined strictly by the doctor and are based on body weight for children aged 1 month to 2 years old.
  • The starting dose is 50 milligrams (mg) per kilogram (kg) of body weight per day, divided and given twice per day.
  • The doctor adjusts the dosage as needed.
  • Usually not more than 150 mg per kg per day.
  • A doctor determines the dosage for children younger than 1 month of age.

Oral dosage forms (solution or tablets):

Seizures:

  • Adult doses start at 500 milligrams twice a day.
  • The doctor can increase or decrease the dosage as required. However, the dose is usually not more than 3000 mg per day.
  • Children aged 10 to 16 years - At first, 250 milligrams (mg) two times a day. Your doctor may adjust your dose as needed.
  • Usually not more than 2000 mg per day.
  • The doctor determines the dosage for children younger than 10 years of age.

Do not take double doses. If you miss a dose of this medicine, take it as soon as possible. But if it's close to time for the next dose skip the one you missed and get right back on schedule. Skipping or missing doses may affect your treatment so create a schedule you can maintain during the duration of your treatment to receive the full benefit of the drug.

Interactions

Do not mix medications. Notify your doctor of any medications you may be taking before being prescribed Vigabatrin. The active ingredients in some medicine may prevent Vigabatrin if taken simultaneously. In addition, mixing medications may cause life-threatening and undesirable side effects and reactions.

Avoid street drugs and alcohol while on this medication. Mixing Vigabatrin with drugs and alcohol may result in life-threatening results. it may also cause increased cognitive issues and more intense lethargy, drowsiness, irritability, and partial blindness.

Do not take any other medication while being treated with Vigabatrin. This includes prescription and non-prescription medicine, vitamins, and herbal supplements. You don't know what mixing the medicines may do to the body or brain. It may cause undesirable and life-threatening results. The active ingredients in other medications may cancel out or offset the active ingredients in Vigabatrin and you will not receive the full benefits of the medicine.

Warnings

Take your first few doses of Vigabatrin at home, when you don't have anything to do. You don't know how you're going to feel once you take it, or what your side effects will be. Test the medication out to see how your body reacts and set your dosage schedule around that reaction. You may have to take it at night before bedtime or during the day when you are not moving around and busy. Discuss your schedule with your doctor to figure out the best regimen for you to maintain the most normal, active life as possible. You may have to try out a few options before you get the timing right. This drug can cause you to become weak, drowsy, and more lethargic than normal. Do not drive or operate machinery while taking this medication.

Do not stop taking Vigabatrin unless instructed by your doctor, or the treatment is complete. If the side effects are so severe they become unbearable consult with your doctor about possible causes and solutions. They may decide to change the dosage, wean you off the medicine over time, or offer an alternative treatment for your condition. If you suddenly stop using the medication, it's possible the seizures will immediately start again.

Notify any doctor you are seeing for any condition that you are on Vigabatrin. It can affect results of medical tests like MRIs. This includes the dentist, physical therapist, psychiatrist, psychologist, etc. - virtually any doctor that may prescribe you more medication or suggest lifestyle changes.

This medication may cause permanent loss of vision. You may not lose your vision right away, but the effect may occur months or years after treatment is complete. Follow up with an eye doctor 4 times a year to have your vision checked once treatment is complete. If you notice any issues with your vision during or after treatment consult with your doctor immediately to address the issue.

If you experience suicidal thoughts, agitation, increased irritability, depression, or any abnormal behaviors contact your doctor as soon as possible and make an appointment to be seen.

If you experience symptoms of peripheral neuropathy like painful sensations in the arms, legs, and feet, burning, tingling or numbness contact your doctor immediately. Make an appointment to be seen.

Notify your doctor if you gain too much weight too fast while on this drug or you experience swelling of the hands, feet, or ankles.

Storage

Keep all medications out of the reach of children and in a safe place. This drug should be stored in the container provided by the pharmacy in a cool dry place. Keep it out of moist areas and avoid humidity, extreme heat, and direct light.

You should take your prescribed medication until it's all gone. In the event that you have some left over, don't save any unused medication. Ask your doctor what is the safest way to discard of anything you have left, or find out where your local medication buyback is located in the community. Do not give your pills to other people. They may have an adverse reaction that can result in illness or death.

Summary

It's important that children, especially, check in with their doctor while being treated with this drug. Frequent checkups are mandatory while on Vigabatrin. Take your children to be seen monthly for check-ups while taking this medicine. Adults should be seen just as frequently. Any unusual reaction can be detected by the doctor more efficiently and quickly than by the patient. Don't attempt to self-diagnose. These are life-threatening conditions and you are not a doctor. If you think you're experiencing seizures or any other medical condition go to be seen by a licensed physician and get an official diagnosis.

Before attempting to take any medication, go get a prescription from your doctor. Vigabatrin is only available by prescription. Do not attempt to order it online or from a source other than your primary physician or specialist. Don't accept Vigabatrin from other patients because you think you may need the medication. Don't attempt to diagnose others; if a friend or loved one claims to be experiencing symptoms of seizures or any other medical condition refer them to their doctor and do not share your medications. A person taking this medication that may not need it, or in combination with other medications they may be on, could possibly result in death.

Once your treatment is complete it's important that you follow up with your doctor for frequent checkups every 3 months. Monitor any lingering side effects and keep a log of any recurring seizures. Report all information to your doctor at each visit so you have a record of the course of the disease and treatment. Attempt to make any lifestyle changes suggested by your doctor to combat your condition and a recurrence of that condition. Change your diet to help combat the seizures and eat healthily. Start a new fitness regimen like yoga, walking or any light exercise. Adjust your life to avoid the seizures as much as possible, do what you can, combined with the medication, to improve your quality of life. If the seizures come back, or you experience any other symptoms go see your doctor as soon as possible to develop a new course of action.

If the side effects, strict dosing schedule, or lifestyle changes are not working for you, you may not be a candidate for Vigabatrin. That's why a long, detailed consultation with your doctor is required. The doctor will go over all the possibilities and outcomes of treatment to help you determine if this drug is right for you. Be honest and truthful when giving information regarding your conditions and habits to your doctor. There may be alternatives to this medication that will work with your lifestyle or interact safely with your current medications. If you experience any of the signs of epilepsy or seizures of any kind, contact your doctor immediately.

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Last Reviewed:
December 23, 2017
Last Updated:
April 26, 2018
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