Note: This document contains side effect information about vigabatrin. Some dosage forms listed on this page may not apply to the brand name Vigadrone.
Summary
Common side effects of Vigadrone include: arthralgia, blurred vision, confusion, depression, diplopia, fatigue, weight gain, abnormal gait, ataxia, cough, diarrhea, drowsiness, memory impairment, tremor, irritability, and pharyngolaryngeal pain. Other side effects include: status epilepticus, urinary tract infection, pulmonary congestion, abnormality in thinking, asthenia, depressed mood, dysmenorrhea, erectile dysfunction, eye pain, muscle twitching, paresthesia, peripheral edema, sinus headache, abnormal behavior, abnormal sensory symptoms, anemia, back pain, bronchitis, chest pain, constipation, fever, hypoesthesia, hyporeflexia, lethargy, myalgia, nervousness, nystagmus disorder, peripheral neuropathy, sedated state, toothache, upper abdominal pain, vertigo, malaise, abnormal dreams, bruise, and increased appetite. Continue reading for a comprehensive list of adverse effects.
Applies to vigabatrin: oral powder for oral solution, oral tablets.
Warning
-
Permanent Vision Loss
- Vigabatrin can cause permanent bilateral concentric visual field constriction, including tunnel vision that may result in disability.1 In some cases, vigabatrin also can damage the central retina and reduce visual acuity.1
- Risk of vision loss increases with increasing dosage and cumulative exposure; however, no dosage or exposure is known to be without risk.1
- Risk of new and worsening vision loss continues as long as vigabatrin is used and possibly after discontinuance.1
- Baseline and periodic vision assessment recommended in patients receiving vigabatrin.1 However, such vision assessment cannot always prevent vision damage.1 3 (See Permanent Vision Loss under Cautions.)
- Distribution of vigabatrin is restricted.1 71 (See Restricted Distribution Program under Dosage and Administration.)
REMS:
FDA approved a REMS for vigabatrin to ensure that the benefits outweigh the risks. The REMS may apply to one or more preparations of vigabatrin and consists of the following: elements to assure safe use and implementation system. See the FDA REMS page ([Web]). (See also Restricted Distribution Program under Dosage and Administration.)
Side effects include:
Causes permanent vision damage in a high percentage of patients. (See Permanent Vision Loss under Boxed Warning and also under Cautions.)
Adults (>16 years of age) with refractory complex partial seizures: Headache, fatigue, somnolence, dizziness, nystagmus, tremor, convulsion, nasopharyngitis, blurred vision, diplopia, memory impairment, insomnia, irritability, upper respiratory tract infection, abnormal coordination, pharyngolaryngeal pain, diarrhea, nausea, vomiting, constipation, upper abdominal pain, increased weight, dysmenorrhea, depression, confusional state, asthenia, peripheral edema, fever/pyrexia, influenza, arthralgia, back pain, pain in extremities, disturbance in attention, sensory disturbance, hyporeflexia, paresthesia.
Pediatric patients 10–16 years of age with refractory complex partial seizures: Increased weight, upper respiratory tract infection, fatigue, abnormal behavior, diarrhea, influenza, otitis media, somnolence, tremor, aggression, diplopia, nystagmus.
Pediatric patients with infantile spasms: Somnolence, bronchitis, ear infection, acute otitis media.
For Healthcare Professionals
Applies to vigabatrin: oral powder for reconstitution, oral tablet.
General
The more commonly reported adverse reactions have included headache, somnolence, fatigue, dizziness, weight gain, tremor and visual field defects. This drug can cause permanent vision loss.[Ref]
Ocular
Based on adult studies, 30 percent or more of patients can be affected with bilateral concentric visual field constriction ranging in severity from mild to severe. Severe cases may be characterized by tunnel vision to within 10 degrees of visual fixation, which can result in disability. In some cases, damage can occur to the central retina and may decrease visual acuity.[Ref]
Very common (10% or more): Visual field defect (30% or more), nystagmus (up to 19%), blurred vision (up to 16%), diplopia (up to 16%)
Common (1% to 10%): Asthenopia, eye pain, strabismus, conjunctivitis
Rare (0.01% to 0.1%): Retinal disorder (such as peripheral retinal atrophy)
Very rare (less than 0.01%): Optic neuritis, optic atrophy[Ref]
Nervous system
Very common (10% or more): Headache (up to 33%), somnolence (up to 26%), dizziness (up to 26%), tremor (up to 16%), memory impairment (up to 16%), abnormal coordination (up to 16%)
Common (1% to 10%): Speech disorder, sensory disturbance, paresthesia, movement disorder (including dystonia, dyskinesia, and hypertonia), either alone or in association with abnormalities in MRI, hyperreflexia, hyporeflexia, hyperesthesia, hypoesthesia, status epilepticus, dysarthria, postical state, sensory loss
Uncommon (0.1% to 1%): Coordination abnormal (ataxia)
Rare (0.01% to 0.1%): Encephalopathy (e.g., sedation, stupor, confusion)
Frequency not reported: Increase in seizure frequency
Postmarketing reports: Dystonia, encephalopathy, hypertonia, hypotonia, muscle spasticity, myoclonus, optic neuritis, dyskinesia[Ref]
Magnetic Resonance Imaging (MRI) Abnormalities in Infants:
-Abnormal MRI signal changes characterized by increased T2 signal and restricted diffusion in a symmetric pattern involving the thalamus, basal ganglia, brain stem, and cerebellum have been observed in some infants treated with this drug for infantile spasms. Some infants exhibited coincident motor abnormalities, but no causal relationship has been established.[Ref]
Dermatologic
Common (1% to 10%): Acne
Uncommon (0.1% to 1%): Rash
Rare (less than 0.1%): Angioedema, urticaria
Postmarketing reports: Facial edema, angioedema, maculo-papular rash, pruritus, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), alopecia[Ref]
Psychiatric
Very common (10% or more): Excitation (children), agitation (children)
Common (1% to 10%): Agitation, aggression, nervousness, depression, paranoid reaction, irritability, asthenia, fever, thirst, malaise, expressive language disorder, abnormal dreams, mental impairment (thought disturbance), lethargy, disturbance in attention
Uncommon (0.1% to 1%): Hypomania, mania, psychotic disorder
Rare (0.01% to 0.1%): Suicide attempt
Very rare (less than 0.01%): Hallucination
Postmarketing reports: Acute psychosis, apathy, delirium, hypomania, neonatal agitation, psychotic disorder[Ref]
Metabolic
Very common (10% or more): Weight gain (up to 14%)
Common (1% to 10%): Increased appetite[Ref]
Other
Very common (10% or more): Fatigue (up to 40%), gait disturbance (up to 12%)
Common (1% to 10%): Edema, tinnitus, vertigo, peripheral edema
Postmarketing reports: Deafness, malignant hyperthermia, multi-organ failure[Ref]
Hematologic
Common (1% to 10%): Anemia[Ref]
Endocrine
The following birth defects have been reported during the postmarketing period: congenital cardiac defects, congenital external ear anomaly, congenital hemangioma, congenital hydronephrosis, congenital male genital malformation, congenital oral malformation, congenital vesicoureteric reflux, dentofacial anomaly, dysmorphism, fetal anticonvulsant syndrome, hamartomas, hip dysplasia, limb malformation, limb reduction defect, low set ears, renal aplasia, retinitis pigmentosa, supernumerary nipple, and talipes.
Postmarketing reports: Birth Defects, delayed puberty, developmental delay
Gastrointestinal
Very common (10% or more): Diarrhea (up to 16%), nausea (up to 10%)
Common (1% to 10%): Vomiting, abdominal pain, upper abdominal pain, constipation, dyspepsia, stomach discomfort, toothache, abdominal distention, thirst
Postmarketing reports: Gastrointestinal hemorrhage, esophagitis[Ref]
Genitourinary
Common (1% to 10%): Urinary tract infection, dysmenorrhea, erectile dysfunction[Ref]
Hepatic
Very rare (less than 0.01%): Hepatitis
Frequency not reported: Decreases in ALT and AST
Postmarketing reports: Cholestasis[Ref]
Musculoskeletal
Very common (10% or more): Arthralgia
Common (1% to 10%): Joint sprain, muscle strain, back pain, pain in extremity, myalgia, muscle twitching, muscle spasms[Ref]
Respiratory
Very common (10% or more): Upper respiratory tract infection (up to 51%) Nasopharyngitis (up to 14%), pharyngeal pain (up to 14%), cough (up to 14%)
Common (1% to 10%): Bronchitis, pulmonary congestion, sinus headache
Postmarketing reports: Laryngeal edema, pulmonary embolism, respiratory failure, stridor[Ref]
Cardiovascular
Common (1% to 10%): Chest pain[Ref]
Immunologic
Very common (10% or more): Viral infection (up to 20%), pneumonia (up to 13%)
Common (1% to 10%): Influenza
Uncommon (0.1% to 1%): Candidiasis, ear infection, croup infectious[Ref]