Tiagabine is currently available in the United States, but not in Canada.

Known as

Gabitril

Uses

• Effective against partial seizures, including secondary generalized tonic-clonic seizures.
• Somewhat effective against primary generalized tonic-clonic seizures.
• Ineffective against or may worsen absence, myoclonic, and tonic or atonic seizures.
• Good for patients refractory to other drugs.
• A therapeutic range for tiagabine levels in the blood has not yet been established. The safety and efficacy in children younger than 12 years of age has not been established.

How to Use

Take tiagabine as prescribed by your doctor. It should be taken with food.

• Loading dose = 4 to 8 mg/d
• Maintenance dose = 32 to 56 mg/d, bidaily or quarter-daily.

Side Effects

Reactions may include cramps, nausea, vomiting, weight loss, diarrhea, increased appetite, mouth ulcers, dizziness, drowsiness, general weakness, nervousness, termors, difficulty concentrating depression, hostility, sore throat and difficulty swallowing, cough and skin rashes. Gastrointestinal upsets are decreased if taken with a meal.

Precautions

Tiagabine may generate new seizure types in patients with partial seizures. Do not stop taking tiagabine suddenly unless advised to do so by your doctor. You may have more frequent seizures. Do not drive or operate complex machinery until you have taken tiagabine long enough to gauge its effects on your mental and motor abilities.

Because of possible additive effects, be careful if taking tiagabine with other central nervous system (CNS) depressants. People with impaired liver function or liver disease may need to take a lower dosage of tiagabine.

During pregnancy, use tiagabine only if clearly needed. Tiagabine may be passed through breast milk. In laboratory tests, large doses of tiagabine have been implicated in birth defects in rats and rabbits and in the development of small cancers in the livers and testes of rats, and in structural chromosome aberrations.

Interactions

• Tiagabine causes a slight decerase in valproate levels.
• Valproate may significantly increase the tiagabine concentration.
• Carbamazepine phenobarbital and phenytoin may decrease the effect of tiagabine.
• Blood levels are unchanged by gabapentin, lamotrigine, topiramate, levetiracetam, oxcarbazepine and zonisamide.
• Effect of felbamate are unknown.

Missed Dose

Take as soon as you remember. Then resume medication schedule.

Storage

Store at room temperature between 15°C and 30°C away from children, heat, light and moisture.

Forms

Tablets

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