Vigabatrin for epilepsy Sabril, Kigabeq
Vigabatrin will be prescribed for you by a specialist who will continue to monitor your progress.
If you experience any problems with your eyes or vision, you should contact your doctor as soon as possible.
You need to take vigabatrin regularly. Do not stop taking it unless your doctor tells you to.
|Type of medicine||An antiepileptic medicine|
|Used for||Epilepsy with partial seizures; infantile spasms in children with West's syndrome|
|Also called||Sabril®; Kigabeq®|
|Available as||Tablets, soluble tablets and sachets of granules|
Having epilepsy means that you have had more than one unexplained fit, or seizure. A seizure is a short episode of symptoms caused by a burst of abnormal electrical activity in your brain. With partial seizures (also called focal seizures), the burst of electrical activity is in one part of your brain and therefore you tend to have localised or 'focal' symptoms. Because different parts of the brain control different functions, your symptoms will depend on which part of your brain is affected. Partial seizures can sometimes develop into seizures which affect all of your brain. These are called secondary generalised seizures. Symptoms that may occur during a seizure can affect your muscles, sensations, behaviour, emotions, and consciousness, or a combination of these.
Vigabatrin works by increasing the amount of a chemical in your brain, called gamma-aminobutyric acid (GABA). This stabilises the electrical activity in your brain, which helps to prevent the seizures from occurring. Vigabatrin is prescribed by a specialist doctor for people whose symptoms are proving difficult to control with more commonly used antiepileptic medicines.
Vigabatrin is also helpful in West's syndrome which is a form of epilepsy occurring in infants and very young children.
Before taking vigabatrin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you (or your child if you are their carer) start taking vigabatrin it is important that your doctor knows:
- If you have any eyesight problems.
- If you have problems with the way your kidneys work.
- If you have ever had a mental health problem (such as psychosis or depression), or a behavioural disorder.
- If you are pregnant, trying for a baby or breastfeeding.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take vigabatrin
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about vigabatrin and will provide you with a full list of the side-effects which you may experience from taking it.
- Take vigabatrin exactly as your doctor tells you to. The dose of vigabatrin varies from one person to another depending on the other medicines also being taken (or body weight if it is for a child). Your dose will be printed on the label of the pack to remind you about what the doctor said. It is usual to start treatment on a low dose, and then for the dose to be increased gradually to a regular maintenance dose. You may be prescribed one dose to take each day at first, and then two doses every day once your dose has been increased.
- It is important you try to take your doses at the same times of day, each day. Having a routine will help you to remember to take your doses regularly.
- Swallow the tablet with about half a glassful of water. You can take vigabatrin either before or after a meal.
- If you have been given vigabatrin sachets of powder (Sabril®) for your child to take, each dose must be made up freshly. Stir the powder into half a glassful of water, milk or fruit juice to dissolve it, and then give it to your child to drink straightaway.
- If you have been given vigabatrin soluble tablets (Kigabeq®) for your child to take, dissolve the tablet fully in a small glass of water only, and then give it to your child to drink straightaway. There are two different strengths of soluble tablet, 100 mg and 500 mg; make sure you have been given the correct strength each time.
- If you forget to take a dose, take it as soon as you remember. If when you remember, it is nearly time for your next dose, take your next dose when it is due but leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- When you first start a new treatment for epilepsy there may be a change in the number or type of seizures you experience. Your doctor will advise you about this.
- Try to keep your regular appointments with your specialist or doctor. This is so your doctor can check on your progress. You will also need to have regular eye tests while you are on vigabatrin.
- While you are being treated for epilepsy there is a small risk that you may develop mood changes, distressing thoughts and feelings about suicide. If this happens, you must tell your doctor about it straightaway.
- People with epilepsy must stop driving at first. Your doctor will advise you about when it may be possible for you to start driving again. This will usually be after a year free of seizures.
- If you drink alcohol, ask your doctor for advice. Your doctor may advise you not to drink alcohol while you are on this medicine.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take with your antiepileptic medication.
- Many antiepileptic medicines can harm an unborn child. If you are a woman, make sure you have discussed with your doctor which types of contraception are suitable for you and your partner. If you want to have a family, discuss this with your doctor so that you can be given advice from a specialist before you become pregnant.
- You need to take vigabatrin regularly every day. Do not stop taking it unless your doctor tells you to stop. Stopping treatment suddenly can cause problems and your doctor will want you to reduce your dose gradually if this becomes necessary.
- Different formulations of some antiepileptic medicines can act in a slightly different way in your body. Because of this, your doctor may recommend that you continue to take vigabatrin from the same manufacturer each time you obtain a new supply. If so, each time you collect a prescription, check to make sure your supply looks the same and that the name is the same. If you are unsure, or if you have any questions about your prescription, please ask your pharmacist to advise you.
Can vigabatrin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with vigabatrin. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common vigabatrin side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Problems with eyesight (these affect about 1 in 3 people)||Let your doctor know about this as soon as possible. Your doctor may advise on eyesight tests during treatment with vigabatrin|
|Feeling sleepy or tired||Do not drive and do not use tools or machines. If the sleepiness becomes pronounced and affects your movements or consciousness, let your doctor know straightaway|
|Joint aches and pains||Ask your pharmacist to recommend a suitable painkiller|
|Common vigabatrin side-effects (these affect fewer than 1 in 10 people)||What can I do if I experience this?|
|Headache||Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know|
|Feeling sick (nausea) or being sick (vomiting), tummy (abdominal) pain||Stick to simple meals - avoid rich and spicy food|
|Increased weight, problems with speech, numbness or tingling sensations, feeling shaky, lack of concentration or co-ordination, difficulty sleeping, swollen feet or ankles, hair loss, mood changes such as feeling agitated or depressed, and in children over-excitement and movement disorders||Speak with your doctor for advice|
Important: your doctor will discuss with you the possibility that vigabatrin can cause an eyesight problem called visual field changes. This is a deterioration of sight from the edges of your field of vision. This problem occurs in about a third of people taking vigabatrin over a period of time. Because of this, you must let your doctor know straightaway if you notice any change in your vision so that your eyes can be checked. Your doctor may advise on eyesight tests during treatment with vigabatrin.
If you experience any other symptoms which you think may be due to vigabatrin, speak with your doctor or pharmacist for further advice.
How to store vigabatrin
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Sabril® Tablets 500 mg; Sanofi, The electronic Medicines Compendium. Dated March 2020.
Manufacturer's PIL, Sabril® Sachets 500 mg; Sanofi, The electronic Medicines Compendium. Dated November 2019.
Manufacturer's PIL, Kigabeq® 100 mg and 500 mg soluble tablets; Veriton Pharma Limited, The electronic Medicines Compendium. Dated August 2020.
British National Formulary, 80th Edition (Sep 2020); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.