Brivaracetam

Anti-epileptic · Anticonvulsant

Indications

As adjunctive treatment in the management of partial onset seizures with or without secondary generalization in adults, adolescents and children from age 4 yrs with epilepsy.

Dosage

Adults: Initial: 50 mg daily or 100 mg daily based on physician’s assessment of need for seizure control in 2 equally divided doses, once in the morning and once in the evening. Maint dose: 100 mg daily. May be adjusted in the range of 50 mg to 200 mg daily on the basis of patient’s response. Children: =4 yrs: Weight =50 kg: 50 mg daily. May be given 100 mg daily based on physician’s assessment of need for seizure control in 2 equally divided doses, once in the morning and once in the evening. Maint dose: 100 mg daily. May be adjusted in the range of 50 mg to 200 mg daily on the basis of patient’s response. Weight <50 kg: 1 mg/kg daily. May be given 2 mg/kg daily based on physician’s assessment of need for seizure control in 2 equally divided doses, once in the morning and once in the evening. Maint dose: 2 mg/kg daily. May be adjusted in the range of 1 mg/kg to 4 mg/kg daily on the…

Adverse Effects

Nausea, vomiting, constipation, fatigue, upper RT infections, cough, influenza, decreased appetite, depression, anxiety, insomnia, irritability, dizziness, somnolence, convulsion, vertigo.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: End-stage renal disease patients undergoing dialysis. Precautions: Hepatic impairment.

Interactions

CYP2C19 strong inhibitors (e.g. fluconazole, fluvoxamine). Rifampicin. Carbamazepine, phenobarbital, phenytoin, oral contraceptives. Lonafarnib, intranasal metoclopramide, selinexor.

Advice to Patient

Take with or without meals. Swallow whole tab with liquid. Do not chew or crush. If a dose is missed, take it as soon as you remember and then take the following dose at the usual morning or evening time. To discontinue taking this medication, do not stop abruptly. Instead, withdraw it gradually by 50 mg daily on a weekly basis. After 1 week of treatment at 50 mg daily, a final week of treatment at the dose of 20 mg daily is recommended. Avoid driving, operating machine and doing tasks that require alertness until you are aware of the effects of this medication.

Pharmacokinetics

Absorption: Rapidly and completely absorbed after oral administration. Coadministration with a high fat meal reduces the absorption rate while the extent of absorption remains same. Bioavailability: Absolute: 100%. Metabolism: Hepatic. Half-life elimination: Terminal: Approx. 9 hrs. Time to peak, plasma: 0.25-3 hrs. Excretion: Urine (>95%). Faeces (<1%).

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.