Vigabatrin is an important antiepileptic medication widely used in the treatment of infantile spasms and refractory complex partial seizures. It works by increasing the levels of gamma-aminobutyric acid (GABA) in the brain, making it effective for certain types of seizure disorders. Available in various forms including vigabatrin solution, vigabatrin suspension, vigabatrin powder, and vigabatrin sachet, this medicine is prescribed under multiple brand names such as Vigafyde, Sabril, and Vigadrone.
What is Vigabatrin?
Vigabatrin, also known as Sabril or Vigadrone, is a powerful anticonvulsant drug. Its mechanism of action (MOA) involves the irreversible inhibition of GABA transaminase, leading to increased GABA concentrations in the brain. This helps reduce abnormal brain activity associated with seizures.
Vigabatrin Uses and Indications
Vigabatrin is most commonly prescribed for:
Infantile spasms (IS) in children aged 1 month to 2 years
Refractory focal seizures in adults and pediatric patients who have failed to respond to other treatments
The Vigabatrin REMS (Risk Evaluation and Mitigation Strategy) program ensures the safe use of the drug, especially due to its potential side effects, which include visual field loss.
Forms of Vigabatrin Available
To make administration easier, especially for children, vigabatrin oral solution and vigabatrin suspension are commonly used. These liquid forms are easier to dose and swallow than tablets.
Here are the most common formulations:
Vigabatrin Powder
Available as vigabatrin powder for oral solution, this form is dissolved in water before administration.
Vigabatrin Liquid
Often called vigabatrin syrup or liquid vigabatrin, it is ideal for pediatric use. Brands like Vigafyde liquid and Sabril syrup fall into this category.
Vigabatrin Sachet
Pre-measured powder in sachet form offers convenience for accurate dosing.
Vigadrone Powder
Another popular powdered formulation, often prescribed in customized doses.
Vigabatrin Dose and Administration
The vigabatrin dose varies based on patient age, weight, and the condition being treated. For infantile spasms, the treatment usually begins with a low dose and increases gradually under medical supervision. It's crucial that parents or caregivers follow exact dosing instructions, especially when using powder vigabatrin or vigabatrin liquid formulations.
Stability and Storage of Vigabatrin
Vigabatrin stability is an important factor for ensuring efficacy. Once reconstituted, the oral solution or suspension should be stored according to the instructions—usually in a cool, dry place or refrigerated—and used within a specific time frame to maintain its potency.
Safety and the REMS Program
Due to the potential risk of permanent vision loss, all patients prescribed vigabatrin must be enrolled in the REMS vigabatrin program. Regular eye exams are required during treatment.
Conclusion
Vigabatrin remains a trusted treatment for infantile spasms and other difficult-to-treat seizures. Available in several patient-friendly forms—such as vigabatrin oral solution, vigabatrin syrup, vigabatrin vigabatrin sachet, and vigabatrin powder—it provides flexibility in dosing and administration. However, due to its safety profile, it must be used with care under a REMS program. Always consult a healthcare provider before starting or modifying any vigabatrin regimen.