- Refractory complex partial seizures in patients in whom several seizure treatments have failed and for whom the potential benefits outweigh the risk of vision loss:
- Adults and >16 years:
- Initially PO 500mg BD, then increase by 500-mg increments weekly to target dose of 1.5g BD
- Initially PO 500mg BD, then increase by 500-mg increments weekly to target dose of 1.5g BD
- Adults and >16 years:
-
- 2-16 years:
- 10-15 kg: Initially PO 175mg BD, then increase by weekly intervals to total maintenance dose of 525mg BD
- 2-16 years:
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- >15-20 kg: Initially PO 225mg BD, then increase by weekly intervals to total maintenance dose of 650mg BD
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- >20-25 kg: Initially PO 250mg BD, then increase by weekly intervals to total maintenance dose of 750mg BD
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- >25-60 kg: Initially PO 250mg BD, then increase by weekly intervals to total maintenance dose of 1000mg BD
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- >60 kg: Initially PO 500mg BD, then increase by 500-mg increments weekly to target dose of 1.5g BD
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- Infantile spasms:
- 1 month to 2 years: Initially PO 50mg/kg/day divided BD
- If needed, may increase dose by 25-50mg/kg/day increments every 3 days
- Max 150mg/kg/day
- 1 month to 2 years: Initially PO 50mg/kg/day divided BD
Sachet: 500mg/packet
- Dissolve powder content from each 500 mg packet in 10 mL cold or room temp water (final concentration 50 mg/mL)
- Prepare immediately before use
- Taken without regards to food
Anticonvulsant
It irreversibly inhibits GABA metabolism, increasing GABA activity in the CNS and central GABA release
- Vision loss
- Headache
- Dizziness
- Fatigue
- Somnolence
- MRI abnormalities (patients <6 years)
- Weight gain
- Tremor
- Nystagmus
- Blurred vision
- Seizures
- Diarrhea
- Nausea
- Vomiting
- Arthralgia
- Dysmenorrhea
- Depression
- Constipation
- Irritability
- Nasopharyngitis
- URI
- Impaired memory
- Impaired coordination
- Diplopia
- Paresthesia
- Insomnia
- Peripheral neuropathy
- Edema
- Visual field defect
- Fever
- Rash
- Abrupt withdrawal
- < 2 years
WARNING
- It can cause permanent bilateral concentric visual field constriction, including tunnel vision that can result in disability
- In some cases, can damage the central retina and may decrease visual acuity
- Amifampridine
- Bupropion
- Dalfampridine
- Metoclopramide
Drug Status
| Availability | Prescription only |
| Pregnancy | Weigh risk vs benefit |
| Breastfeeding | Weigh risk vs benefit |
| Schedule | Controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Sabril | 500mg | Sachet | 50’s | Sanofi | Surgipharm Ltd |