Patient leaflet - Sabril 500 mg film-coated tablets
1. WHAT SABRIL IS AND WHAT IT IS USED FOR
Sabril is used to help control various forms of epilepsy.
It is used together with your current medication to treat “difficult to control” epilepsy. It will initially be prescribed by a specialist. Your response to the treatment will be monitored.
It is also used to control infantile spasms (West’s syndrome).
2. BEFORE YOU TAKE SABRIL
Do not take Sabril:
- if you are allergic to vigabatrin or any of the other ingredients of this medicine (listed in Section 6).
Warnings and precautions
Talk to your doctor before taking Sabril if:
- you are breast-feeding
- you are pregnant or plan to become pregnant
- you have or have had depression or any other psychiatric illness in the past
- you have had any kidney problems
- you have had any problems with your eyes
If you develop symptoms like sleepiness, reduced consciousness and movements (stupor) or confusion consult your doctor who will decide upon a dose reduction or withdrawal.
A small number of people being treated with antiepileptics such as vigabatrin have had thoughts of harming or killing themselves. If at any time you have had these thoughts, immediately contact your doctor.
Children
Movement disorders and abnormalities in magnetic resonance imaging (MRI) brain scans have been seen in young infants treated for infantile spasms (West’s syndrome). If you observe unusual movement disorders
in the child, consult your doctor who will decide if it is necessary to consider changing the treatment.
Other medicines and Sabril
Please tell your doctor if you are taking clonazepam as the concomitant use with Sabril can increase the risk of sedation.
Please tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
Sabril should not be used in combination with other medicines that may have side effects related to the eye.
Pregnancy, breast-feeding and fertility
If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor for advice before taking this medicine.
Do not take Sabril during pregnancy unless your doctor tells you to. Sabril may cause problems to unborn children. However, do not stop taking the medicine suddenly because this may risk the mother’s health as well as the baby’s health.
Sabril passes into breast milk. If you are breast-feeding, ask your doctor for advice before taking this medicine. Breast-feeding should not be done during treatment.
Driving and using machines
Do not drive or operate machinery if your epilepsy is uncontrolled.
Sabril sometimes causes symptoms like drowsiness or dizziness and your ability to concentrate and react may be reduced. If such symptoms occur whilst taking Sabril, you should not do any hazardous tasks such as driving or operating machinery.
Visual disorders, which can affect your ability to drive and use machines, have been found in some patients taking this medicine. If you wish to continue driving you must be tested regularly (every six months) for the presence of visual disorders even if you do not notice any changes to your vision.
Sabril contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially ‘sodium-free’.
3. HOW TO TAKE SABRIL
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
It is important to follow your doctor’s instructions exactly. Never change the dose yourself. The doctor prescribes the dose and adjusts it individually for the patients.
The usual starting dose for adults is 1 g (2 tablets) daily. However, your doctor may wish to increase or decrease the dose depending on your response; the usual adult daily dose is 2 to 3 g (4 to 6 tablets). The highest recommended dose is 3 g/day.
If you are older people and/or have kidney problems, your doctor may wish to give you a smaller dose.
Use in children
Resistant partial epilepsy
For children, the dose is based on age and weight. The usual starting dose for children is 40 milligrams per kilogram bodyweight daily. The following table gives the number of tablets to give to a child according to his/her bodyweight. Remember that this is just a guideline. The child’s doctor may wish to have slightly different doses.
Bodyweight 10 - 15 kg 0.5-1 g (1-2 tablets)/day
15 - 30 kg 1-1.5 g (2-3 tablets)/day
30 - 50 kg 1.5-3 g (3-6 tablets)/day
greater than 50 kg 2-3 g (4-6 tablets)/day
(adult dose).
Children with infantile spasms (West’s Syndrome)
The recommended starting dose for infants with West’s Syndrome (infantile spasms) is 50 milligrams per kilogram bodyweight per day although higher doses may be used sometimes.
Method of administration
The route of administration is oral use (by mouth). Always swallow the tablet with at least a half of a drinking glass of water.
You can take Sabril before or after meals.
The daily dose can be taken as a single dose or divided in two doses.
If you take more Sabril than you should
If you or your child accidentally take too many Sabril tablets, tell your doctor immediately or go to your nearest hospital or Poison Information Centre.
Possible signs of overdose include drowsiness or loss/depressed level of consciousness.
If you forget to take Sabril
If you forget to take a dose, take it as soon as you do remember. If it is almost time for your next dose, just take one dose. Do not take a double dose to make up for the missed dose.
If you stop taking Sabril
Do not stop taking this medicine without talking to your doctor. If your doctor decides to stop your treatment you will be advised to gradually reduce the dose. Do not stop suddenly as this may cause your seizures to occur again.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
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4. POSSIBLE SIDE EFFECTS
Like all medicines, this medicine can cause side effects, although not everybody gets them.
As with other antiepileptic medicines, some patients may experience an increase in the number of seizures (fits) whilst taking this medicine. If this happens to you, or to your child, contact your doctor immediately.
Talk to your doctor immediately if you experience:
Very common side effects (may affect more than 1 in 10 people)
- Visual field changes – About ⅓ or 33 out of 100 patients treated with Sabril may have changes in the visual field (narrow visual field). This “visual field defect” can range from mild to severe. It is usually detected after months or years of treatment with Sabril. The changes in the visual field may be irreversible, so it must be found early. If you or your child experience(s) visual disturbances, contact your doctor or hospital immediately.
Other side effects include:
Very common side effects (may affect more than 1 in 10 people)
- Tiredness and pronounced sleepiness
- Joint pain
Common side effects (may affect up to 1 in 10 people)
- Headache
- Weight gain
- Shaking (tremor)
- Swelling (oedema)
- Dizziness
- Sensation of numbness or tingling (pins and needles)
- Disturbance of concentration and memory
Psychological disturbances including agitation, aggression, nervousness, irritability, depression, thought disturbance and feeling suspicious without
reason (paranoia), insomnia. These side effects are usually reversible when the dose is reduced or gradually discontinued. However, do not decrease your dose without first talking to your doctor. Contact your doctor if you experience these side effects.
- Nausea, vomiting and abdominal pain
- Blurred vision, double vision, and uncontrolled movement of the eye, which may cause dizziness
- Speech disorder
- Decrease in the number of red blood cell count (anaemia)
- Unusual hair loss or thinning (alopecia)
Uncommon side effects (may affect up to 1 in 100 people)
- Lack of coordination in movements or fumbling
- More severe psychological disturbances such as feeling elated or over-excited which causes unusual behaviour, and feeling detached from reality
- Skin rash
Rare side effects (may affect up to 1 in 1,000 people)
- Serious allergic reaction, which causes swelling of the face or throat: If you experience these symptoms, you should tell your doctor immediately.
- Hives or nettle rash
Marked sedation, stupor and confusion. These side effects are usually reversible when the dose is reduced or gradually discontinued. However, do not decrease your dose without first talking to your doctor. Contact
your doctor if you experience these side effects.
- Suicide attempt
- Other eye problems such as retinal disorder, for example poor vision at night and difficulty adjusting from bright to dim areas, sudden or unexplained loss of vision, loss of sight from the edges of your field of vision, sensitivity to light.
Very rare side effects (may affect up to 1 in 10,000 people)
- Other eye problems such as pain in your eyes (optic neuritis) and loss of vision, including colour vision (optic atrophy)
- Hallucinations (feeling, seeing or hearing things that are not there)
- Liver problems
Not known frequency (frequency cannot be estimated from the
available data)
- Decreased sharpness of vision
- Abnormal changes in brain pictures taken by MRI
- Swelling in the protective layer of nerve cells in part of the brain as observed in MRI pictures
Additional side effects in children
Very common side effects (may affect more than 1 in 10 people)
- Excitation or restless
Not known frequency (frequency cannot be estimated from the available data)
- Movement disorders in young infants treated for infantile spasm.
- Abnormal changes in brain pictures taken by MRI, particularly in infants
Swelling in the protective layer of nerve cells in part of the brain as observed in MRI pictures, particularly in infants
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
5. HOW TO STORE SABRIL
- Keep out of the sight and reach of children.
- Do not use this medicine after the expiry date which is stated on the carton and the blister after EXP. The expiry date refers to the last day of that month.
- If the tablets become discoloured or show signs of any deterioration, you should seek the advice of your pharmacist who will advise you what to do.
Do not throw away any medicine via wastewater or household waste.
Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
6. CONTENTS OF THE PACK AND FURTHER INFORMATION
What Sabril contains
The active substance is vigabatrin.
Each tablet contains 500 mg of vigabatrin.
The other ingredients are: microcrystalline cellulose (E460), povidone K30 (E1201), sodium starch glycollate (typeA), magnesium stearate, hypromellose 15 mPa.S (E464), titanium dioxide (E171) and macrogol 8000.
What Sabril looks like and contents of the pack
White to off-white, oval, biconvex film-coated tablets with a break-line on one side and “SABRIL” engraved on the other side.
Sabril is available in blister packs of 50 or 100 tablets.
Manufacturer and product licence holder
Sabril is manufactured by Patheon France S.A.S., 40 Boulevard de Champaret, 38317 Bourgoin-Jallieu, France.
Procured from within the EU by product licence holder Star Pharmaceuticals Ltd, 5 Sandridge Close, Harrow, Middlesex, HA1 1XD. Repackaged by Servipharm Ltd.
Leaflet revision and issue date (Ref) 23.07.21[8]
Sabril is a trademark of Aventisub LLC.
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