Drug Index

Vigabatrin

 
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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 :

PO

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.


07/17/2019 10:39:39 Vigabatrin
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