tiagabine hydrochloride monohydrate: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
tiagabine hydrochloride monohydrate: clinical details
Prescribing considerations
- Licensed only as adjunctive treatment for focal seizures in adults and adolescents older than 12 years.
- Confirm enzyme-inducing status and review treatment whenever relevant interacting therapy changes.
- Use caution in mild or moderate hepatic impairment because systemic exposure is increased.
Contraindications and cautions
- Hypersensitivity to tiagabine or any product excipient.
- Severely impaired hepatic function.
- Concomitant St John’s wort.
- Selected tablets contain lactose and are unsuitable for specified rare hereditary disorders of galactose metabolism or absorption.
Monitoring
- Review seizure control, adherence and central nervous system adverse effects.
- Monitor mood, behaviour and suicidal ideation.
- If spontaneous bruising occurs, obtain a full blood count including platelets.
- Refer new visual symptoms for ophthalmological assessment, including visual-field testing.
- Monitor closely for dizziness and tiredness in hepatic impairment.
Clinical pharmacology
A selective inhibitor of neuronal and glial GABA uptake, principally through GAT-1. It is rapidly and almost completely absorbed, highly protein-bound and eliminated mainly by hepatic metabolism; renal clearance is negligible and no active metabolites have been identified.
Formulation and product differences
- The selected product is a white, round, biconvex film-coated tablet marked “251”.
- It contains lactose and is supplied in child-resistant bottles containing a desiccant.
tiagabine hydrochloride monohydrate preparations and strengths
Tablet
Route: Oral
Strengths: 5 mg, 10 mg, 15 mg
tiagabine hydrochloride monohydrate interactions
Ask a prescriber or pharmacist to check all prescribed, non-prescription and herbal products.
St John’s wort
Contraindicated because it can increase tiagabine metabolism, lowering exposure and potentially reducing seizure control.
Phenytoin, carbamazepine, phenobarbital and primidone
These enzyme-inducing antiseizure treatments accelerate tiagabine metabolism. Starting, stopping or changing them requires clinical review.
Triazolam
Tiagabine may slightly prolong its central nervous system depressant effect, although the product information considers this unlikely to be clinically important.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.