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This medication comes with several important safety warnings and considerations, which are essential for anyone prescribed tiagabine (Gabitril) to review. It is crucial to discuss any concerns with your healthcare provider.

• Intended Use: Tiagabine is specifically for individuals diagnosed with partial (focal) seizures and should not be used by those without a seizure condition, as it may induce seizures in such individuals.

• Risk of Suicidal Thoughts: There is an increased risk of suicidal thoughts or behavior with the use of antiepileptic drugs like tiagabine. Be vigilant for any signs of new or worsening depression or mood changes, particularly during the initial months of treatment or following a dose adjustment. Immediate medical attention is necessary if you experience thoughts of self-harm.

• Withdrawal Seizures: It is important not to discontinue tiagabine abruptly without medical guidance, as this may trigger withdrawal seizures. If discontinuation is needed, your healthcare provider will provide a tapering schedule to minimize risks.

• Uncontrolled Seizures: On rare occasions, individuals taking tiagabine have experienced uncontrolled seizures (status epilepticus), a condition requiring hospitalization and posing a risk of long-term brain damage. If you have a history of status epilepticus, consult your healthcare provider before starting tiagabine.

• Cognitive and Energy Impairments: Tiagabine can impact cognitive functions, making concentration and communication challenging, and may cause drowsiness and fatigue. Usually mild, these effects should be reported to your provider if persistent or bothersome, as dose adjustments may be beneficial.

• Serious Rash: Although rare, serious rashes have been reported in individuals taking tiagabine. These can be life-threatening, especially if they cover large areas, form blisters, or affect sensitive areas such as the eyes, mouth, or genitals. Seek immediate medical advice if a rash develops.

Keep in mind that there are no specific contraindications noted for tiagabine. Always follow your healthcare provider's instructions and report any adverse effects or concerns promptly.

Gabitril (tiagabine) is an antiepileptic medication used to manage partial seizures. When taking Gabitril, it's important to be aware of potential interactions with other substances, as these can affect its effectiveness or increase the risk of side effects.

Interactions with Other Medications:

• Enzyme-Inducing Antiepileptic Drugs (AEDs): Medications such as Phenytoin, Carbamazepine, Phenobarbital, and Primidone can increase the metabolism of Gabitril, leading to lower levels of the drug in the bloodstream. This may reduce its effectiveness in controlling seizures.

• Valproate: Gabitril may cause a slight decrease (about 10%) in the levels of valproate, another antiepileptic drug. However, this change is generally not considered clinically significant and usually does not require a dose adjustment.

• Cimetidine: This medication, often used to treat heartburn and ulcers, can increase the bioavailability of Gabitril by approximately 5%. This effect is typically not significant enough to necessitate a change in Gabitril dosage.

• St. John's Wort: This herbal supplement can enhance the metabolism of Gabitril, potentially reducing its effectiveness. Therefore, combining Gabitril with St. John's Wort is contraindicated.

Interactions with Central Nervous System (CNS) Depressants:

Combining Gabitril with other CNS depressants, such as alcohol, sleeping pills, muscle relaxants, or medications for anxiety and depression, can amplify side effects like drowsiness, dizziness, and impaired coordination. It's advisable to avoid or limit the use of these substances while taking Gabitril.

General Recommendations:

Always inform your healthcare provider about all medications, supplements, and herbal products you are currently using. This will help them assess potential interactions and adjust your treatment plan accordingly. Do not start or stop any medication without consulting your healthcare provider, as this could affect the effectiveness of your seizure management or lead to unwanted side effects.