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Tiagabine

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Tiagabine, Gabitril

  • See Also
  1. Anticonvulsant
  2. Seizure Disorder
  3. Pregabalin
  4. Gabapentin
  • Mechanism
  1. Anticonvulsant
  2. GABA Reuptake Inhibitor
  • Indications
  • Adjunctive Therapy
  1. Simple Partial Seizure
  2. Complex Partial Seizure
  3. Bipolar Disorder (not FDA approved)
  • Adverse Effects
  1. Common (Dose related)
    1. Sedation
    2. Dizziness
    3. Lethargy
    4. Tremor
    5. Nervousness
    6. Irritability
    7. Abdominal Pain
    8. Cognitive Impairment
  2. Serious
    1. Status Epilepticus, New Seizueres, Nonconvulsive Status Epilepticus
      1. May occur when used in patients without Epilepsy
      2. Higher risk when combined with other agents that lower Seizure threshold
  • Precautions
  1. Adjust dose in hepatic disease
  • Dosing
  1. General
    1. Typically combined with enzyme-inducing anticonvulsants (e.g. Carbamazepine, Phenobarbital, Phenytoin, Primidone)
    2. Decrease starting dose and titration speed when NOT used with an enzyme-inducing anticonvulsant
  2. Adult
    1. Initial: 4 mg orally daily for first week
    2. Increase by 4 to 8 mg/day increments per day weekly (over 6 to 20 weeks)
    3. Divide dose 2 to 4 times daily after first week
    4. Maximum: 56 mg/day divided 2 to 4 times daily
  3. Child (age 12 to 18 years)
    1. Initial: 4 mg orally daily for first week
    2. Increase by 4 mg/day increments per day for first week, then up to 4 to 8 mg/day weekly thereafter (over 6 to 20 weeks)
    3. Divide dose 2 to 4 times daily after first week
    4. Maximum: 32 mg/day divided 2 to 4 times daily
  • Safety
  1. Pregnancy Category C
  2. Unknown Safety in Lactation
  • Resources
  1. Tiagabine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=cf97a72e-951e-a7db-a574-adac12a6b189
  • References
  1. (2022) Presc Lett, Resource #361206, Antiseizure Medications
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 56-7
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia