| Management |
Vigabatrin should generally not be used with other drugs associated with serious adverse ophthalmic effects such as retinopathy or glaucoma unless the benefits clearly outweigh the risks. These drugs may include amiodarone, deferoxamine, ethambutol, quinine derivatives, tamoxifen, and long-term corticosteroids. Vision testing at baseline (no later than 4 weeks after starting vigabatrin) and at least every 3 months during therapy is required for adults. Vision testing is also required about 3 to 6 months after the discontinuation of vigabatrin therapy. Due to the risk of irreversible vision loss, vigabatrin should be withdrawn from patients who fail to show substantial clinical benefit within 3 months of initiation, or sooner if treatment failure becomes obvious. The patient's response and continued need for vigabatrin should be periodically reassessed. The lowest dosage and shortest duration of treatment consistent with clinical objectives should be employed. |
