vigabatrin

Generic name: Vigabatrin
Available as: Sabril: tablets 500mg, powder (sugar free) 500mg/sachet.

Adults

Average total daily dose: 2000mg – 3000mg daily divided into 1 or 2 doses.
Doses per day:  1 – 2
Treatment: Effective for focal seizures with or without secondarily generalised seizures where other treatment has not worked. Used for West syndrome with Tuberous Sclerosis. May worsen absence and myoclonic seizures. Not widely prescribed due to possible side effects.
Most common possible side effects include the following. Report severe reactions, such as a skin rash, to your doctor.
Nausea, abdominal pain, fluid retention, drowsiness, fatigue, agitation, dizziness, headache, nervousness, depression, aggression, impaired concentration or memory, tremor, and weight gain. Visual field defects have been reported in some adults: visual fields should be checked every six months. Talk to your GP or neurologist if you are concerned about this.

Children

Average total daily dose: Add-on therapy (from 1 month): 30 – 40mg/kg twice daily, (1 month – 2 years): up to 75mg/kg twice daily or (2 – 12 years): 1.5g twice daily. Monotherapy (1 month – 2 years): 40 – 50mg/kg twice daily, up to 75mg/kg twice daily.
Doses per day: 2
Treatment: Add-on therapy for focal seizures with or without secondary generalisation where other treatment has not worked. Monotherapy for infantile spasms. Particularly useful in Tuberous Sclerosis. May worsen absence and myoclonic seizures.
Most common possible side effects include the following. Report severe reactions, such as a skin rash, to your doctor.
Drowsiness, fatigue, nausea, behaviour and mood changes. Visual field defects have been reported in some adults: visual fields should be checked every six months.

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Please note:

• This information is a guide only, and lists the usual daily doses of anti-epileptic drugs (AEDs). The dose taken may be different to those listed above.
  
• Treatment of neonatal seizures (from birth to 28 days of age) is not covered.
  
• Most doses are listed as ‘mg/kg’: this means milligrams of AED per kg of the child’s weight.
  
• Children starting AED treatment at the age of 12 may start on adult doses. Some AEDs are only used for children aged 12 and over (including eslicarbazepine acetate, lacosamide, perampanel, pregabalin, retigabine and tiagabine).
  
• Some AED doses are listed as ‘twice daily’ (for example ‘5mg/kg twice daily’). This means that the dose listed is taken each time (and so the total daily dose will be double that listed).
  
• Some AED doses are listed as ‘divided into 2 (or 3) doses’ (for example ‘25 - 30mg/kg daily divided into 2 doses’). This means that the total amount listed is divided into two to give the dose taken each time.
  
• ‘Effective’ means the seizures it works for. ‘Monotherapy’ means the AED is taken on its own. ‘Add-on therapy’ means the AED is taken alongside other AEDs. ‘Tolerance’ means that a drug becomes less effective the longer you take it.
  
• Information for this page comes from sources including the British National Formulary (BNF), the British National Formulary for children (BNFC) and the electronic medicines Compendium (eMC). The side effects listed here are some of the most common possible side effects and may be worded differently in the patient information leaflet for the AED. Doctors may refer to the BNF/BNFC for starting doses and how to increase doses. For more details, and a complete list of side effects, visit www.medicines.org.uk/guides/epilepsy (opens new window).
  
• Every effort is made to ensure that all information is correct at time of publishing but information may change after publication. This information is not a substitute for advice from your doctor. Epilepsy Society is not responsible for any actions taken as a result of using this information.