Issues for Surgery
Precipitation of rebound seizures or status epilepticus if omitted.
Advice in the Perioperative period
Elective and Emergency Surgery
Patients should be advised to take their regular medications on the day of surgery1, 2, 3.
Abrupt withdrawal of any anticonvulsant drug should be avoided1.
Confirm with the patient if they need to be maintained on a specific manufacturer’s product (see Further Information).
Regular dosing of the patient’s usual oral medication should be re-established as early as possible post-operatively2, 3.
Tiagabine is only available as an oral preparation. If patients cannot resume their usual oral medication post-operatively, the advice of a Neurologist should be sought to determine the most appropriate antiepileptic preparation, dose, route and frequency to be used.
Interaction(s) with Common Anaesthetic Agents
None1, 4, 5, 6.
For general information regarding the use of anaesthetic agents in patients with epilepsy – see ‘Antiepileptics – A General Overview’.
Interaction(s) with other Common Medicines used in the Perioperative Period
None1, 4, 5, 6.
For general information regarding the use of antiemetics in patients with epilepsy – see ‘Antiepileptics – A General Overview’.
MHRA/CHM Advice: Antiepileptic Drugs: updated advice on switching between different manufacturer’s products (November 2017)1
Tiagabine is a category 3 antiepileptic, hence it is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific concerns such as patient anxiety, and risk of confusion or dosing errors. (For more information see ‘Antiepileptics – A General Overview’).