Vigabatrin

CLINICAL USE

Anti-epileptic agent

DOSE IN NORMAL RENAL FUNCTION

1–3 g daily in single or divided doses

PHARMACOKINETICS

Molecular weight : 129.2

%Protein binding : Negligible

%Excreted unchanged in urine : 60–80

Volume of distribution (L/kg) : 0.8

half-life – normal/ESRD (hrs) : 5–8/13–15

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Give 50% of normal dose and titrate to response

10 to 20 : Give 50% of normal dose and titrate to response

<10 : Give 25% of normal dose and titrate to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Unknown dialysability. Dose as for GFR <10 mL/min

HD : Dialysed. Dose as for GFR <10 mL/min

HDF/high flux : Dialysed. Dose as for GFR <10 mL/min

CAV/VVHD : Unknown dialysability. Dose as for GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antidepressants: anticonvulsant effect antagonised, convulsive threshold lowered

Anti-epileptics: concentration of phenytoin and possibly phenobarbital and primidone reduced

Antimalarials: mefloquine antagonises anticonvulsant effect; chloroquine and hydroxychloroquine occasionally reduce convulsive threshold

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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