VIGABATRIN

Dr C P Ravikumar

What is Vigabatrin ?

Vigabatrin is an anti-Seizure Agent chemically unrelated to other anti-seizure means that Vigabatrin works to treat seizures in a way that is different from other Anti-Seizure drugs.

What is Vigabatrin used for (Indications)?

How is Vigabatrin available?

How does Vigabatrin act (mechanism of action)?

Vigabatrin increases the levels of a neurotransmitter in the brain called GABA. GABA is like a natural “brake” for the brain, helping to calm down excessive electrical activity. In some people, the brain’s activity can be too high, which can lead to seizures or other problems. Vigabatrin stops an enzyme from breaking down GABA, allowing it to work more effectively and reduce those problems. Essentially, it helps the brain stay more balanced.

How much time does Vigabatrin take to act?

Vigabatrin typically starts to show effects within 1 – 2 hours after taking medicine, though it can take longer for some people to experience the full benefits. The exact time frame can vary depending on the individual and the condition being treated (e.g., Seizures or infantile spasms).

What is the ideal time to take Vigabatrin ?

The ideal time to take Vigabatrin is usually as prescribed by your doctor, often divided into two doses—morning and evening— about 12 hours apart. Taking it consistently at the same times each day helps maintain medication levels and better seizure control.

When should Vigabatrin be taken?

Vigabatrin can be taken either before or after food, depending on your preference or how your body reacts to it.

How should I give the medicine?

Powder for oral solution:

Add 1 sachet to 5ml of water (or more water depending on the number of sachets) and give to the child immediately. Don’t use any left-over prepared mixture.
To measure the right amount, use a medication spoon or an oral syringe. These are readily available at any local pharmacy.

A kitchen teaspoon will not provide the precise amount of the medication, so avoid using it.

Tablets:

The tablets have to be swallowed whole with water. Unless directed by a healthcare professional, avoid chewing, crushing, or breaking the tablets.

Is it possible for this medication to cause side effects in my child?

All medications have both benefits and potential side effects. While most people tolerate them well, it’s important to be aware that side effects can happen. Knowing what to watch for helps us respond quickly and manage any issues, allowing continued benefit from the treatment. Though rare, some individuals may experience serious side effects.

Side effects of Vigabatrin (Adverse reactions)

Does Vigabatrin cause weight gain?

Yes, weight gain is a possible side effect of Vigabatrin . If it becomes concerning, it’s best to talk to your healthcare provider for guidance.

Can Vigabatrin be taken alongside other commonly used medications?

Yes, other common medicines can usually be taken with Vigabatrin , but it is important to consult your healthcare provider or pharmacist first. Some medications may interact with Vigabatrin , affecting its effectiveness or increasing the risk of side effects.

What food to avoid while taking Vigabatrin ?

There are no specific foods that need to be avoided while taking Vigabatrin . However, it is always a good idea to maintain a balanced diet to support your overall health during treatment. If you have any concerns about interactions with food or if you’re on any other medications that require dietary restrictions, it is best to check with your healthcare provider.

Pregnancy and Lactation

There’s limited human data on Vigabatrin in pregnancy, and no clear link has been proven for major birth defects or miscarriage.
Animal studies, however, show potential fetal harm.
Vigabatrin does pass into breast milk, and because its effects on a nursing baby aren’t well understood, doctors will carefully weigh its importance for you against potential risks.
Please discuss with your doctor, if you are planning pregnancy.

Is there any risk if I conceive while taking Vigabatrin ?

If you conceive while taking Vigabatrin , there could be an increased risk of complications related to the medication’s potential effects.

It is important to discuss your plans with your doctor before trying to conceive so they can adjust your medication regimen if needed and help manage the risks. They will work with you to find the safest options for both you and your pregnancy.

Contraindication of Vigabatrin

Can I stop taking Vigabatrin ? (withdrawal)

Drug should not be discontinued abruptly because the possibility of increasing seizure frequency; therapy should be withdrawn gradually to minimize the potential of increased seizure frequency.

Monitoring Parameters

How to cope with side effects of Vigabatrin ?

Vision Problems: Vigabatrin can affect peripheral vision. Get regular eye examination and report any vision changes to your doctor right away.
Drowsiness/Fatigue: To manage tiredness, take the medication as prescribed, avoid alcohol or sedatives, and rest when needed.
Weight Gain: Vigabatrin can increase appetite, so keep an eye on your diet and exercise regularly to maintain a healthy weight.
Dizziness: Stand up slowly to avoid dizziness and be careful with sudden movements. Staying hydrated and eating regularly can help too.

Summary

Vigabatrin is a medicine used to treat certain hard-to-control seizures, including infantile spasms. It can work well, but it also has some important risks.

The biggest concern is vision problems, especially loss of side vision, which can sometimes be permanent. Other possible side effects include sleepiness, dizziness, tiredness, and weight gain.

People taking Vigabatrin need regular eye checkups. It’s important to follow your doctor’s instructions and report any side effects right away so the treatment can be adjusted if needed.

During pregnancy or breastfeeding, Vigabatrin should only be used if the benefits are greater than the risks. Always discuss concerns with your doctor and keep them updated while taking this medication.

Let us know if this information was useful!

References

1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020427s025%2C022006s026lbl.pdf
2. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/sabril- Vigabatrin
3. https://www.nice.org.uk/guidance/ng217/chapter/6-Treating-childhood-onset-epilepsies

Author:

Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU

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