Rectal administration of vigabatrin achieves higher plasma concentration than oral administration

Abstract

AbstractVigabatrin is a synthetic GABA derivative that is used to treat infantile spasms and as an adjunctive therapy in resistant cases of epilepsy. We present an 18‐month‐old white male with a history of infantile spasms, very well controlled on oral phenobarbital, and vigabatrin 55 mg/kg BID, who was admitted for urgent surgical management of esophageal obstruction. Vigabatrin is known to be administered orally only with a bioavailability of 80%. As oral administration was not possible, the medicine was crushed and dissolved in 15 cc of water to be administered rectally. The patient achieved serum level three times higher than the oral route. Our case suggests that rectal administration of vigabatrin might be an efficient route to achieve therapeutic drug‐plasma level.