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Pharmacologic class: Nipecotic acid derivative
Therapeutic class: Anticonvulsant
Pregnancy risk category C
Unknown. Thought to raise seizure threshold by enhancing activity of gamma-aminobutyric acid (a major inhibitory neurotransmitter in CNS).
Tablets: 2 mg, 4 mg, 12 mg, 16 mg, 20 mg
Indications and dosages
➣ Adjunctive treatment of partial seizures
Adults older than age 18: Initially, 4 mg P.O. once daily for 1 week; may increase as needed by 4 to 8 mg/day at weekly intervals, up to 56 mg/day in two to four divided doses
Adolescents ages 12 to 18: Initially, 4 mg P.O. once daily. May increase total daily dosage by 4 mg at start of week 2; thereafter, may increase by 4 to 8 mg q week until clinical response occurs or patient is receiving up to 32 mg/day. Give total daily dosage in two to four divided doses.
• Hepatic impairment
• Hypersensitivity to drug or its components
Use cautiously in:
• hepatic impairment
• pregnant or breastfeeding patients
• children younger than age 12 (safety not established).
Don't stop drug suddenly. Dosage must be tapered.
• Be aware that concomitant anticonvulsant therapy need not be modified unless indicated.
CNS: dizziness, insomnia, drowsiness, nervousness, asthenia, confusion, poor concentration, impaired memory, depression, emotional lability, hostility, agitation, ataxia, abnormal gait, tremors, paresthesia, speech disorder, language problems
EENT: nystagmus, epistaxis, pharyngitis
GI: nausea, vomiting, diarrhea, abdominal pain, mouth ulcers
Respiratory: increased cough
Skin: rash, pruritus
Other: increased appetite, weight changes, pain, allergic reaction
Drug-drug. Carbamazepine, phenobarbital, phenytoin, primidone: increased tiagabine clearance, decreased blood level
Watch for signs or symptoms of depression and suicidal ideation.
• Assess vital signs and cardiovascular status.
• Monitor closely for severe generalized weakness. If present, consult prescriber regarding possible dosage reduction.
• Tell patient to take on regular schedule with food.
Caution patient not to stop therapy suddenly. Dosage must be tapered.
• Instruct patient to report signs or symptoms of depression.
Advise patient to report neurologic reactions. Tell him to contact prescriber immediately if severe overall weakness or severe depression occurs.
• Advise female patient to tell prescriber if she suspects she is pregnant.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.