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  CAUTIONS, FURTHER INFORMATION The effectiveness of clobazam may decrease significantly after weeks or months of continuous therapy. l INTERACTIONS → Appendix 1: clobazam l SIDE-EFFECTS Appetite decreased . consciousness impaired . constipation . drug abuse . dry mouth .fall . gait unsteady . libido loss . movement disorders . muscle spasms . nystagmus .respiratory disorder. severe cutaneous adverse reactions (SCARs). skin reactions . speech impairment. weight increased l BREAST FEEDING Benzodiazepines are present in milk, and should be avoided if possible during breast-feeding. Monitoring All infants should be monitored for sedation, feeding difficulties, adequate weight gain, and developmental milestones. l RENAL IMPAIRMENT Dose adjustments Start with small doses in severe impairment. l MONITORING REQUIREMENTS ▶ In children Routine measurement of plasma concentrations of antiepileptic drugs is not usually justified, because the target concentration ranges are arbitrary and often var

  ▶ With rectal use Dissolve contents of sachet in small amount of water and administer rectally [unlicensed use]. l PATIENT AND CARER ADVICE Patients and their carers should be warned to report any new visual symptoms that develop. Medicines for Children leaflet: Vigabatrin for preventing seizures www.medicinesforchildren.org.uk/vigabatrin-preventingseizures l MEDICINAL FORMS There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral solution Powder CAUTIONARY AND ADVISORY LABELS 3, 8, 13 ▶ Sabril (Sanofi) Vigabatrin 500 mg Sabril 500mg oral powder sachets sugar-free | 50 sachet P £24.60 DT = £24.60 Tablet CAUTIONARY AND ADVISORY LABELS 3, 8 ▶ Sabril (Sanofi) Vigabatrin 500 mg Sabril 500mg tablets | 100 tablet P £44.41 DT = £44.41 BNF 78 Epilepsy and other seizure disorders 333 Nervous system 4 Zonisamide 20-Feb-2019 l INDICATIONS AND DOSE Monotherapy for treatment of focal seizures with or wi