vigabatrin (Sabril)

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Introduction

Restricted prescribing in U.S. to visual loss.

Indications

Contraindications

Pregnancy category: X

Dosage

  • start 1 g PO QD
  • adjust by 0.5 mg as tolerated
  • maximum dose 4 g/day
  • Pediatrics: 40 mg/kg/day, divide BID
  • reduce dosage in elderly

* no dosage adjustment in liver failure[3]

Dosage adjustment in renal failure

Pharmacokinetics

  • rapid absorption, not impaired by food
  • mimnal metabolism
  • elimination 1/2life 5-8 hours, up to 13 hours in elderly
    • 70% excreted unchanged in the urine

Monitor

Adverse effects

* peripheral vision loss may be irreversible[3]

Drug interactions

Mechanism of action

  • increases GABA levels by inhibiting GABA metabolism

Notes

More general terms

References

  1. UpToDate 13.3 http://www.utdol.com
  2. 2.0 2.1 Deprecated Reference
  3. 3.0 3.1 3.2 3.3 3.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018
  4. 4.0 4.1 4.2 Brooks M FDA Clears First Generic Version of Seizure Drug Sabril (Vigabatrin) Medscape - Jan 16, 2019. https://www.medscape.com/viewarticle/907809
    FDA News Release. Jan 16, 2019 FDA approves first generic version of Sabril to help treat seizures in adults and pediatric patients with epilepsy. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm629569.htm

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