Brivaracetam: Uses, Dosage, Side Effects, and Safety Information

Brivaracetam is an anti-epileptic medicine used to treat partial-onset (focal) seizures in people with epilepsy. It has a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, although its exact mechanism for controlling seizures is not fully understood.

Common Indications

Epilepsy. Used for partial-onset seizures. In India, brivaracetam is approved as adjunctive therapy for partial-onset seizures in patients 16 years of age and older. Approved age ranges can differ in other countries, so check the specific product labeling for your region.

Dosage and Administration

• Adults 16 years and older. Starting dose is typically 50 mg twice daily as the usual starting dose. Maximum is 100 mg twice daily. Dosing can be adjusted according to response and tolerability. Route is oral tablets, oral solution, or intravenous injection.
• Children and younger adolescents. Dosing is age- and weight-based and should follow the specific product labeling and the prescribing doctor’s instructions. Adult doses should not be applied to children or younger adolescents.

Stopping the Medicine

Brivaracetam should generally be withdrawn gradually under medical supervision, because abrupt withdrawal may increase the risk of increased seizures and status epilepticus. The specific tapering schedule can vary between patients and should be decided by the prescribing doctor.

Adverse Reactions

Common side effects include sleepiness (somnolence), dizziness, fatigue, nausea, and irritability. Avoid driving or operating machinery until you know how the medicine affects you.

Serious reactions include new or worsening depression, unusual behavior or mood changes, aggression, or suicidal thoughts or behavior, which should be reported promptly to a doctor. Serious hypersensitivity reactions, including angioedema and bronchospasm, can occur. Seek urgent medical attention for severe allergic symptoms such as swelling of the face or throat, or difficulty breathing.

Contraindications

Brivaracetam is contraindicated in patients with known hypersensitivity to brivaracetam or any of the inactive ingredients in the specific product.

Drug Interactions

• Carbamazepine. Brivaracetam can increase exposure to carbamazepine’s active epoxide metabolite; tolerability should be monitored if the two are taken together.
• Phenytoin. Brivaracetam can increase phenytoin concentrations; monitoring may be required.
• Rifampin. Rifampin can reduce brivaracetam exposure; the doctor may need to adjust treatment.
• Levetiracetam. Combining the two does not appear to provide additional seizure-control benefit based on available evidence.
• Alcohol. Brivaracetam can increase the effects of alcohol on attention, memory, coordination, and alertness. Avoid or limit alcohol and discuss alcohol use with your doctor.
• Always share your complete medicine list with your doctor or pharmacist.

Effects on Pregnancy and Organ Function

• Pregnancy. Available human pregnancy data are insufficient to determine the risk of major birth defects, miscarriage, or other pregnancy outcomes. Animal studies suggest potential fetal harm. If you are pregnant or planning pregnancy, discuss the benefits and risks of brivaracetam with your doctor before changing treatment.
• Kidney. No dose adjustment is generally required for renal impairment. However, brivaracetam is not recommended for patients with end-stage renal disease undergoing dialysis, because it has not been adequately studied in this population.
• Liver. Dose adjustment is generally recommended in hepatic impairment, since liver impairment can affect how much brivaracetam the body is exposed to. The specific dose should be determined by the treating doctor.

Brand Names (India and US)

India: Brevipil

US: Briviact (Brivaracetam)

How HealthPil Can Help

HealthPil’s neurologists can help patients discuss epilepsy treatment, seizure control, and medication-related questions. Book a consultation to discuss your treatment with a qualified doctor.