tiagabine (Rx)

Brand and Other Names:Gabitril
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Dosing & Uses

AdultPediatricGeriatric

Dosing Forms & Strength

tablet

  • 2mg
  • 4mg
  • 12mg
  • 16mg

Partial Seizures (With Hepatic Enzyme-Inducing Anticonvulsants)

Initial: 4 mg/day PO for 1Week

Titrate weekly by 4-8 mg, not to exceed 56 mg/day divided q8-12hr

Partial Seizures (Without Hepatic Enzyme-Inducing Anticonvulsants)

12-22 mg/day PO divided q8-12hr

Other Information

Take with food

Monitor seizure frequency, CBC, renal funtion tests, liver function tests

Dosing Forms & Strength

tablet

  • 2mg
  • 4mg
  • 12mg
  • 16mg

Partial Seizures (With Hepatic Enzyme-Inducing Anticonvulsants)

<12 years

  • Not established

>12 years

  • Initial: 4 mg/day PO for one Week, THEN
  • 4 mg PO q12hr for one Week
  • Titrate weekly by 4-8 mg, not to exceed 32 mg/day divided q6-12hr

Partial Seizures (Without Hepatic Enzyme-Inducing Anticonvulsants)

<12 years: Not established

>12 years old: same as adult

Other Information

<12 years old: not recommended

Take with food

Partial seizures (with hepatic enzyme-inducing anticonvulsants)

Initial: 4 mg/day PO for 1Week

Titrate weekly by 4-8 mg, not to exceed 56 mg/day divided q8-12hr

Partial seizures (without hepatic enzyme-inducing anticonvulsants)

12-22 mg/day PO divided q8-12hr

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Interactions

Interaction Checker

and tiagabine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Dizziness (26-30%)

            Asthenia (16-20%)

            Somnolence (16-20%)

            Nausea (11-15%)

            1-10%

            Abdominal pain (6-10%)

            Diarrhea (6-10%)

            Vomiting (6-10%)

            Nervousness (6-10%)

            Pharyngitis (6-10%)

            Tremor (6-10%)

            Insomnia (6-10%)

            Rash (1-5%)

            Pruritis (1-5%)

            Ataxia (1-5%)

            Confusion (1-5%)

            Speech d/o (1-5%)

            Paresthesia (1-5%)

            Depr'n (1-5%)

            Pain (1-5%)

            Increased appetite (1-5%)

            Hostility (1-5%)

            Nystagmus (1-5%)

            Postmarketing Reports

            Bullous dermatitis

            Vision blurred

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            Warnings

            Contraindications

            Hypersensitivity

            Cautions

            Antiepileptic drugs (AED) increase risk of suicidal thoughts or behavior in patients taking them for any indication; patients treated with any AED for any indication should be monitored for emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior

            Risk of seizures if used in patients without epilepsy (when used off-label in psychiatric disorder); in nonepileptic patients who develop seizures while on therapy, discontinue therapy and evaluate patients for underlying seizure disorder

            Should not be abruptly discontinued because of possibility of increasing seizure frequency

            Use without enzyme-inducing antiepileptic drugs results in about twice the blood levels than what dosage recommendations are based on

            Because clearance of tiagabine is reduced in patients with liver disease, dosage reduction may be necessary in these patients

            Adverse events most often associated with therapy were related to central nervous system; the most significant of these can be classified into 2 general categories: 1) impaired concentration, speech or language problems, and confusion (effects on thought processes); and 2) somnolence and fatigue (effects on level of consciousness)

            Moderately severe to incapacitating generalized weakness reported; resolves after reduction in dose or discontinuation of thearpy

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Unknown; use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Blocks reuptake of gamma aminobutyric acid (GABA) by presynaptic neuron thereby enhancing its neurotransmitter inhibitory activity in the nervous system

            Pharmacokinetics

            Bioavailability: 90%

            Peak Plasma Time: 45 min

            Protein Bound: 96%

            Hepatic cytochrome P450 enzymes, mainly CYP3A4

            Metabolites: Inactive

            Half-Life: 7-9 hr; (with concomitant CYP3A4 inducers): 4-7 hr

            Total Body Clearance: 109 mL/min

            Excretion: Feces 63%; urine 25%

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.