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tiagabine (Gabitril)
Indications:
1) adjunctive treatment of partial seizures
2) OFF LABEL use for migraine, bilar disorder
Dosage:
1) start 4 mg PO QD
2) increase by increments of 4 mg
3) wait one week prior to 1st dose increase; thereafter may increase dose daily
4) maximum dose 32 mg
5) higher doses should be given in divided doses BID-QID
Tabs: 4, 12, 16, 20 mg
Pharmacokinetics:
1) protein binding 96%
2) 1/2life 6.7 hours
3) elimination: 25% in urine, 63% in feces
Adverse effects:
1) all dose-related
2) CNS: -dizziness, headache, somnolence, CNS depression, memory impairment, ataxia, seizures [2,3]
3) abnormal vision, deteriorating color vision
4) tremor
5) nausea
Laboratory:
- tiagabine in serum/plasma
- tiagabine/creatinine in urine
Mechanism of action:
- may inhibit reuptake of GABA by presynaptic terminals
Interactions
drug interactions
drug adverse effects of anticonvulsants
monitor with anticonvulsants
General
anticonvulsant
Database Correlations
PUBCHEM correlations
References
- Geriatric Dosage Handbook, 6th edition, Selma et al eds,
Lexi-Comp, Cleveland, 2001
- FDA Medwatch
http://www.fda.gov/medwatch/SAFETY/2005/safety05.htm#Gabitril
- Prescriber's Letter 12(4): 2005
FDA Public Health Advisory Seizures in Patients without
Epilepsy Being Treated with Gabitril (tiagabine)
Detail-Document#: 210406
(subscription needed) http://www.prescribersletter.com
- Medical Knowledge Self Assessment Program (MKSAP) 15,
American College of Physicians, Philadelphia 2009