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| Both sides previous revision Previous revision Next revision | Previous revisionLast revisionBoth sides next revision | ||
| content:vigabatrin [2020/02/23 18:14] – [Main disadvantages] icna | content:vigabatrin [2020/02/23 18:46] – [Adverse drug reactions] icna | ||
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| ===== Dosage and titration ===== | ===== Dosage and titration ===== | ||
| - | **Adults:** start treatment with 500 mg/day and titrate in increments of 500 mg/day every week. Typical adult maintenance dose is 1000–3000 mg/day given in two equally divided doses. | + | **Adults:** start treatment with 500 mg/day and titrate in increments of 500 mg/day every week. Typical adult maintenance dose is 1000–3000 mg/day given in two equally divided doses.Because the excretion is mainly renal, the dose should be reduced in patients with renal insufficiency and creatinine clearance |
| - | + | ||
| - | Because the excretion is mainly renal, the dose should be reduced in patients with renal insufficiency and creatinine clearance | + | |
| **Children with infantile spasms:** start treatment with 50 mg/kg/day and adjust according to the response over 7 days, up to a total of 150–200 mg/kg/day. | **Children with infantile spasms:** start treatment with 50 mg/kg/day and adjust according to the response over 7 days, up to a total of 150–200 mg/kg/day. | ||
| - | Dosing: despite its short half-life (5–7 hours), vigabatrin may be given once or twice daily, because inhibition of GABA-T results in a relatively long duration of action, and GABA levels in the CSF can remain elevated for up to 120 hours after a single oral dose. | + | **Dosing:** despite its short half-life (5–7 hours), vigabatrin may be given once or twice daily, because inhibition of GABA-T results in a relatively long duration of action, and GABA levels in the CSF can remain elevated for up to 120 hours after a single oral dose. |
| **TDM:** unnecessary; | **TDM:** unnecessary; | ||
| - | Reference range: 6–278 μmol/l, which is irrelevant in clinical practice. | + | **Reference range:** 6–278 μmol/l, which is irrelevant in clinical practice. |
| ===== Adverse drug reactions ===== | ===== Adverse drug reactions ===== | ||
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| * the mechanism of vigabatrin-induced visual field defects are probably due to reversible oedema of the myelin in the optic nerves, retinal cone system dysfunction or both. | * the mechanism of vigabatrin-induced visual field defects are probably due to reversible oedema of the myelin in the optic nerves, retinal cone system dysfunction or both. | ||
| * Other ADRs include sedation, dizziness, headache, ataxia, paraesthesiae, | * Other ADRs include sedation, dizziness, headache, ataxia, paraesthesiae, | ||
| - | * there is no evidence of idiosyncratic ADRs. | + | * there is no evidence of idiosyncratic ADRs |
| + | * movement disorders including dystonia, dyskinesia, and hypertonia have been reported in patients treated for infantile spasms. | ||
| ===== Mechanism of action ===== | ===== Mechanism of action ===== | ||