Possible Benefit of Sabril

The possible benefit of treatment with Sabril (vigabatrin) is reducing spasm frequency in infants with infantile spasms (IS). The effectiveness of Sabril as a treatment for IS was established in 2 clinical trials reviewed by the FDA. Sabril is 1 of only 2 medicines approved by the Food and Drug Administration (FDA) for the treatment of infantile spasms (IS).

Some infants taking Sabril were spasm free or had a reduction in daily spasm frequency.

In Study 11

Some infants with IS taking Sabril were spasm free

Study 1 looked at the number of infants with IS who were spasm free for 7 days in a row beginning within the first 14 days of Sabril therapy.

The number of infants who were spasm free

Among infants taking Sabril at a dose of 18 to 36 mg/kg/day:8 of 114
Among infants taking Sabril at a dose of 100 to 148 mg/kg/day:17 of 107

In Study 21

Some infants with IS taking Sabril had a reduction in daily spasm frequency

Study 2 looked at the decrease over 5 days in daily spasm frequency in 40 infants with IS. Twenty infants took placebo (no medicine), and 20 took Sabril. While there was no change in the number of spasms counted each day between groups using a 2-hour timeframe, the 24-hour timeframe did find that the number of spasms counted each day was reduced in the infants taking Sabril, compared to those who took no medicine (placebo).

Average reduction in daily spasm frequency in infants with Sabril, compared with placebo

with Sabril*69%
with placebo* (no medicine)17%

*Results over the last 2 days of the study.

  • If your infant does not show an improvement within 2 to 4 weeks or sooner, your doctor should slowly stop the medicine because of the risk of permanent vision loss
  • Because of the risk of permanent vision loss, your infant’s response to and continued need for Sabril should be periodically checked by your doctor

Most Common Side Effects

The most common side effects of Sabril in babies include:

  • Sleepiness - Sabril may cause your baby to be sleepy. Sleepy babies may have a harder time suckling and feeding, or may be irritable
  • Swelling in the bronchial tubes (bronchitis)
  • Ear infection
  • Irritability

Learn more about Sabril for Infantile Spasms

Learn about Sabril for refractory CPS

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SABRIL ® (vigabatrin) Tablets and Powder for Oral Solution

Use

SABRIL (vigabatrin) is a prescription medicine used with other treatments in adults and children 10 years of age and older with refractory complex partial seizures (CPS) who have not responded well enough to several other treatments and if the possible benefits outweigh the risk of vision loss. SABRIL should not be the first medicine used to treat CPS.

SABRIL (vigabatrin) is a prescription medicine used in babies, 1month to 2 years old, with infantile spasms (IS), if the possible benefits outweigh the possible risk of vision loss.


Important Safety Information

WARNING: PERMANENT VISION LOSS
See Medication Guide and full Prescribing Information for complete information.


All people who take SABRIL:
  • You are at risk for vision loss with any amount of SABRIL.
  • Your risk of vision loss may be higher the more SABRIL you take daily and the longer you take it.
  • It is not possible for your healthcare provider to know when vision loss will happen. It could happen soon after starting SABRIL or any time during treatment. It may even happen after treatment has stopped.
  • Because SABRIL might cause permanent vision loss, it is available to healthcare providers and patients only under a special program called the SABRIL Risk Evaluation and Mitigation Strategy (REMS) Program. Your healthcare provider will explain the details of this Program to you.
  • SABRIL can damage the vision of anyone who takes it. People who take SABRIL do not lose all of their vision, but some people can have severe loss particularly to their ability to see to the side when looking straight ahead (peripheral vision). With severe vision loss, you may only be able to see things straight in front of you (sometimes called “tunnel vision”). You may also have blurry vision. If this happens, it will not get better.
  • Tell your healthcare provider right away if you (or your child): might not be seeing as well as before starting SABRIL; start to trip, bump into things, or are more clumsy than usual; are surprised by people or things coming in front of you that seem to come out of nowhere; or if your baby is acting differently than normal. These changes can mean that vision damage has occurred.
  • It is recommended that your healthcare provider test your (or your child’s) vision before or within 4 weeks after starting SABRIL, and at least every 3 months during treatment until SABRIL is stopped. It is also recommended that vision be tested about 3 to 6 months after SABRIL is stopped. It is difficult to test vision in babies, but to the extent possible, all babies should have their vision tested. Your healthcare provider will determine if testing can be done. Regular vision testing is important because damage can happen before any changes are noticed.
  • Vision tests cannot prevent the vision damage that can happen with SABRIL, but they do allow SABRIL to be stopped if vision has gotten worse, which usually will lessen further damage. Even these regular vision tests may not show vision damage before it is serious and permanent. Parents, caregivers, and healthcare providers may not recognize the symptoms, or find vision loss in babies, until it is severe.
  • If vision tests are not done regularly, your healthcare provider may stop prescribing SABRIL for you (or your child). Some people are not able to complete vision testing. If vision testing cannot be done, your healthcare provider may continue prescribing SABRIL, but will not be able to watch for any vision loss.
  • Brain pictures taken by magnetic resonance imaging (MRI) show changes in some babies after they are given SABRIL. It is not known if these changes are harmful.
  • Like other antiepileptic drugs, SABRIL may cause suicidal thoughts and actions in some people. Call a healthcare provider right away if you (or your child) have any symptoms, especially sudden changes in mood, behaviors, thoughts or feelings, and especially if they are new, worse, or worry you.
  • Do not stop SABRIL without first talking to a healthcare provider. Stopping SABRIL suddenly can cause seizures that will not stop.
  • SABRIL can cause serious side effects such as low red blood cell counts (anemia), sleepiness and tiredness, nerve problems, weight gain, and swelling. Because SABRIL causes sleepiness and tiredness, do not drive, operate machinery, or perform any hazardous task, unless it is decided that these things can be done safely. SABRIL may make certain types of seizures worse. Tell your healthcare provider right away if seizures get worse.
  • Before starting SABRIL, tell your doctor about all of your (or your child’s) medical conditions including depression, mood problems, suicidal thoughts or behavior, any allergic reaction to SABRIL, vision problems, kidney problems, low red blood cell counts (anemia), and any nervous or mental illness. Tell your doctor about all the medicines you (or your child) take.
  • If you are breastfeeding or plan to breastfeed, SABRIL can pass into breast milk and may harm your baby. If you are pregnant or plan to become pregnant, it is not known if SABRIL will harm your unborn baby. You and your healthcare provider will have to decide if you should take SABRIL while you are pregnant.
  • The most common side effects of SABRIL in adults include: problems walking or feeling uncoordinated, feeling dizzy, shaking (tremor), joint pain, memory problems and not thinking clearly, and eye problems like blurry vision, double vision, and eye movements that cannot be controlled. The most common side effects of SABRIL in children 10 to 16 years of age include weight gain, upper respiratory tract infection, tiredeness, and aggression. Also expect side effects like those seen in adults.
  • The most common side effects of SABRIL in babies include: sleepiness—some babies may have a harder time suckling and feeding or may be irritable, swelling in the bronchial tubes (bronchitis), ear infection, and irritability.
  • Tell your healthcare provider if you or your child have any side effect that bothers you or that does not go away. These are not all of the possible side effects of SABRIL. For more information, ask your healthcare provider or pharmacist.

For more information, please see SABRIL Medication Guide, full Prescribing Information including Boxed Warning for risk of permanent vision loss, and Instructions for Use; or call toll-free 1-888-457-4273.

Consulte la Información de prescripción completa de SABRIL, incluido el recuadro de advertencia para conocer los riesgos de pérdida permanente de visión, la Guía del medicamento y las Instrucciones de uso; o llame al número gratuito 1-888-457-4273.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

REFERENCES:

  1. Sabril full Prescribing Information. Lundbeck.