Drug Index


Mechanism :

Vigabatrin is an irreversible inhibitor of gamma- aminobutyric acid transaminase (GABA-T), the enzyme responsible for the catabolism of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the brain. The mechanism of action of vigabatrin is attributed to irreversible enzyme inhibition of GABA-T, and consequent increased levels of the inhibitory neurotransmitter, GABA.

Indication :

  • Infantile spasm
  • Partial seizures with secondary GTC as adjunct if not controlled by other antiepileptic combination

Contraindications :

Contraindicated in pregnancy and lactation and in patients with a known hypersensitivity to vigabatrin or to any components of the product. Can exacerbate myoclonic and absence seizures. Caution in psychosis or behavioural problems. Cautionary use in children with pre-existing visual field defects. Formal assessment of visual fields (perimetry) should be undertaken in all children with a cognitive age of 9 years and above before the drug is started and every 6 months while receiving the drug. Reduce dose in renal failure.

Dosing :

Resistant partial epilepsy with or without secondary generalisation:
As an adjunct; Initially, 30-40 mg/kg daily, followed by the following maintenance dose:
10-15 kg: 0.5-1 g/day.
15-30 kg: 1-1.5 g/day.
30-50 kg: 1.5-3 g/day.
>50 kg: 2-3 g/day.
Doses to be administered once or twice daily.
Infantile spasms:
In children as monotherapy: 50 mg/kg daily, adjust according to response over 7 days. Maximum dose: 150 mg/kg daily in 1-2 divided doses.

Adverse Effect :

Dose dependent side-effects include somnolence, dizziness, headache, nervousness, depression, memory disturbances, hyperactivity, diplopia, aggression, irritability, hypo- or hypertonia. Chronic adverse effects include increased appetite and weight gain, peripheral constriction of visual fields.

Interaction :

May gradually reduce plasma phenytoin levels.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Give 50% of normal dose and titrate to response
10-20Give 50% of normal dose and titrate to response
<10Give 25% of normal dose and titrate to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as for GFR<10 mL/min
HDDialysed. Dose as for GFR<10 mL/min
HDF/High fluxDialysed. Dose as for GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as for GFR=10–20 mL/min

Hepatic Dose :

No dose adjustment recommended.
02/20/2021 09:17:42 Vigabatrin
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