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an anticonvulsant agent used orally as the hydrochloride salt as an adjunct in treatment of partial seizures.


(tye-a-ga-been) ,


(trade name)


Therapeutic: anticonvulsants
Pregnancy Category: C


Adjunctive treatment of partial seizures.


Enhances the activity of gamma-aminobutyric acid, an inhibitory neurotransmitter.

Therapeutic effects

Decreased frequency of seizures.


Absorption: 90% absorbed following oral administration.
Distribution: Unknown.
Protein Binding: 96%.
Metabolism and Excretion: Mostly metabolized by the liver; 2% excreted unchanged in urine.
Half-life: Without enzyme-inducing antiepileptic drugs—7–9 hr; with enzyme-inducing antiepileptic drugs—4–7 hr.

Time/action profile (blood levels)

POunknown45 minunknown


Contraindicated in: Hypersensitivity.
Use Cautiously in: All patients (may ↑ risk of suicidal thoughts/behaviors);Hepatic impairment (↓ dose/increased interval may be necessary);Patients receiving concurrent non–enzyme-inducing antiepileptic drug therapy such as valproates (may require lower doses and/or slower titration);Using tiagabine for off-label uses or other conditions leading to ↑ levels (may ↑ risk of new onset seizures); Obstetric / Lactation / Pediatric: Pregnancy, lactation, or children <12 yr (safety not established).

Adverse Reactions/Side Effects

Central nervous system

  • suicidal thoughts (life-threatening)
  • dizziness (most frequent)
  • drowsiness (most frequent)
  • nervousness (most frequent)
  • weakness (most frequent)
  • cognitive impairment
  • confusion
  • difficulty concentrating
  • hallucinations
  • headache
  • mental depression
  • personality disorder

Ear, Eye, Nose, Throat

  • abnormal vision
  • ear pain
  • tinnitus


  • dyspnea
  • epistaxis


  • chest pain
  • edema
  • hypertension
  • palpitations
  • syncope
  • tachycardia


  • abdominal pain
  • gingivitis
  • nausea
  • stomatitis


  • dysmenorrhea
  • dysuria
  • metrorrhagia
  • urinary incontinence


  • alopecia
  • dry skin
  • rash
  • sweating


  • weight gain
  • weight loss


  • arthralgia
  • neck pain


  • ataxia
  • tremors


  • allergic reactions
  • chills
  • lymphadenopathy


Drug-Drug interaction

Carbamazepine, phenytoin, primidone, and phenobarbital induce metabolism and ↓ blood levels; although concurrent therapy is usually necessary, adjustments may be required when altering regimens.


Oral (Adults >18 yr) 4 mg once daily initially for 1 wk; may ↑ by 4–8 mg/day at weekly intervals, up to 56 mg/day in 2–4 divided doses.
Oral (Children 12–18 yr) 4 mg once daily initially for 1 wk; may ↑ by 4 mg/day after 1 wk, then may ↑ by 4–8 mg/day at weekly intervals, up to 32 mg/day in 2–4 divided doses.

Availability (generic available)

Tablets: 2 mg, 4 mg, 12 mg, 16 mg

Nursing implications

Nursing assessment

  • Assess location, duration, and characteristics of seizure activity.
  • Assess mental status. May cause impaired concentration, speech or language problems, confusion, fatigue, and drowsiness. Symptoms may decrease with dose reduction or discontinuation.
  • Monitor closely for notable changes in behavior that could indicate the emergence or worsening of suicidal thoughts or behavior or depression.
  • Therapeutic serum levels have not been determined. However, levels may be monitored prior to and following changes in the therapeutic regimen.

Potential Nursing Diagnoses

Risk for injury (Side Effects)


  • Do not confuse tiagabine with tizanidine.
  • Oral: Administer with food.
    • Discontinue tiagabine gradually. Abrupt discontinuation may cause increase in seizure frequency.

Patient/Family Teaching

  • Instruct patient to take medication as directed. Take missed doses as soon as possible unless almost time for next dose. Do not double doses. Do not discontinue abruptly; may cause increase in frequency of seizures. Instruct patient to read the Medication Guide before starting and with each Rx refill, changes may occur.
  • Advise patient to notify health care professional immediately if frequency of seizures increases.
  • May cause dizziness. Caution patient to avoid driving or activities requiring alertness until response to medication is known. Do not resume driving until physician gives clearance based on control of seizure disorder.
  • Advise patient and family to notify health care professional if thoughts about suicide or dying, attempts to commit suicide; new or worse depression; new or worse anxiety; feeling very agitated or restless; panic attacks; trouble sleeping; new or worse irritability; acting aggressive; being angry or violent; acting on dangerous impulses; an extreme increase in activity and talking, other unusual changes in behavior or mood occur.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
  • Instruct patient to notify health care professional of medication regimen prior to treatment or surgery.
  • Advise patient to carry identification describing disease process and medication regimen at all times.
  • Advise patient to notify health care professional if pregnancy is planned or suspected or if breast feeding.

Evaluation/Desired Outcomes

  • Decrease in the frequency or cessation of seizures.


/ti·ag·a·bine/ (ti-ag´ah-bēn) an anticonvulsant agent used as the hydrochloride salt as an adjunct in the treatment of partial seizures.


an anticonvulsant.
indication It is used as an adjunct treatment for partial seizures.
contraindication Known hypersensitivity to this prohibits its use.
adverse effects Adverse effects include dizziness, anxiety, somnolence, ataxia, amnesia, unsteady gait, depression, vasodilation, nausea, vomiting, diarrhea, pruritus, rash, pharyngitis, and coughing. Abrupt discontinuation of this drug can cause sudden onset of seizures. Simultaneous use of the herb ginkgo may decrease anticonvulsant effectiveness.
References in periodicals archive ?
Postmarketing reports have shown that GABITRIL use has been associated with new onset seizures and status epilepticus in patients without epilepsy.
In clinical trials, the most common adverse events for GABITRIL in combination with other anticonvulsants were dizziness/lightheadedness, asthenia/lack of energy, somnolence, nausea, nervousness/irritability, tremor, abdominal pain, and thinking abnormal/difficulty with concentration or attention.
Additional information on GABITRIL is available at www.
In the case of Gabitril, which had been approved for use for epilepsy, Cephalon told the sales force to visit not just neurologists, but also psychiatrists, and to promote the drug for anxiety and other psychiatric indications.
Gabitril is indicated as adjunctive therapy in adults and children 12 years and older in the treatment of partial seizures.
The effectiveness of Gabitril when added to an existing regimen of at least one other antiepilepsy drug (adjunctive therapy) was examined in three multi-center, double-blind, placebo-controlled, parallel group clinical trials in 769 patients with refractory partial seizures, as well as two placebo-controlled cross-over studies in 90 patients.
a pharmaceutical company based in Frazer, Pennsylvania, will pay the federal government and numerous states a total of $375 million to settle four "qui tam" (whistleblower) lawsuits alleging Medicare and Medicaid fraud involving the sales and marketing of Actiq, Gabitril and Provigil between 2001 and 2006.
The government's investigation found that more than 80 percent of the sales of Provigil, Gabitril and Actiq were for off-label uses.
A new bolded warning is being added to labeling for Gabitril (tiagabine) to notify physicians of the risk of seizures in patients without epilepsy who are being treated with this drug, the Food and Drug Administration has announced.
The company currently markets three proprietary products in the United States: PROVIGIL (modafinil) Tablets [C-IV], GABITRIL (tiagabine hydrochloride) and ACTIQ (oral transmucosal fentanyl citrate) [C-II] , and more than 20 products internationally.
The company's proprietary products in the United States include: TREANDA (bendamustine hydrochloride) for injection, AMRIX (Cyclobenzaprine Hydrochloride Extended-Release Capsules), PROVIGIL (modafinil) Tablets (C-IV), FENTORA, TRISENOX (arsenic trioxide) injection, VIVITROL (naltrexone for extended-release injectable suspension), GABITRIL (tiagabine hydrochloride), NUVIGIL (armodafinil) Tablets (C-IV) and ACTIQ (oral transmucosal fentanyl citrate) (C-II).
officials have finalized an agreement that penalizes Cephalon for marketing its painkiller Actiq, epilepsy drug Gabitril and sleep drug Provigil for unapproved uses.