Formulary
Tiagabine: Indications, Dosing, Side Effects and Interactions
Tiagabine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Tiagabine: Indications, Dosing, Side Effects and Interactions
Tiagabine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Adjunctive treatment**
- **Child** (By Mouth): for focal seizures with or without secondary generalisation that are not satisfactorily controlled by other antiepileptics (without enzyme-inducing drugs) 12-17 years Initially 5-10 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg/24 hours every week; maintenance 15-30 mg daily in 2-3 divided doses.
- **Adult** (By Mouth): Initially 5-10 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg/24 hours every week; maintenance 15-30 mg daily in 2-3 divided doses.
**Adjunctive treatment for focal seizures with or without secondary generalisation that are not satisfactorily controlled by other antiepileptics (with enzyme-inducing drugs) for tiagabine**
- **Child 12-17 years** (By mouth): Initially 5-10 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg/24 hours every week; maintenance 30-45 mg daily in 2-3 divided doses.
**Adjunctive treatment for focal seizures with or without secondary generalisation that are not satisfactorily controlled by other antiepileptics (without enzyme-inducing drugs) for tiagabine**
- **Child 12-17 years** (By mouth): Initially 5-10 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg/24 hours every week; maintenance 15-30 mg daily in 2-3 divided doses.
Cautions
Avoid in Acute porphyrias ; seizures (may be exacerbated) Cautions, further information Seizure exacerbation Tiagabine may exacerbate seizures in patients with absence or myoclonic seizures (including juvenile myoclonic epilepsy), tonic or atonic seizures, Dravet syndrome, and Lennox-Gastaut syndrome. A
Side effects
Common or very common Abdominal pain; behaviour abnormal; concentration impaired; depression; diarrhoea; dizziness; emotional lability; fatigue; gait abnormal; insomnia; nausea; nervousness; speech disorder; tremor; vision disorders; vomiting Uncommon Drowsiness; psychosis; skin reactions Rare or very rare Delusions; hallucination Frequency not known Suicidal behaviours
Interactions
**Severe interactions:**
- Possible toxicity with phenytoin on stopping primidone); stiripentol, tiagabine, valproic acid, zonisamide.
**Other interactions (2):**
- Antiemetics: aprepitant Antiepileptics: clobazam, clonazepam, ethosuximide, lamotrigine, eslicarbazepine, oxcarbazepine, primidone, tiagabine, topiramate, valproic acid, zonisamide.
- Combinations requiring precautions - Midazolam, triazolam, alprazolam Increased plasma benzodiazepine levels may occur via decreased hepatic metabolism leading to excessive sedation.
Pregnancy
Important safety information For tiagabine MHRA/CHM advice: Antiepileptics: risk of suicidal thoughts and behaviour (August 2008) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs: updated advice on switching between different manufacturers' products (November 2017) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review (January 2021) See Epilepsy .
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment (risk of increased exposure); avoid in severe impairment. Dose adjustments Manufacturer advises dose reduction and/or longer dose interval with careful titration in mild to moderate impairment.
Medicinal forms
Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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