Brivaracetam Brand Name– BRIVIACT
What is Brivaracetam
Brivaracetam is a 2-pyrrolidine derivative and levetiracetam analog approved for partial onset seizures in patients aged 4 years and older when administered orally and in patients aged 16 years and older when administered intravenously.
The efficacy of brivaracetam as adjunctive therapy for partial seizures was evaluated in 3 randomized, double-blind, placebo-controlled, fixed-dose trials including adult patients who were not adequately controlled with 1 or 2 other antiepileptic drugs (n = 1,550).
Reductions in 7-day partial onset seizure frequency over placebo were 9.5% to 16.9% for a 50 mg/day regimen and 17% for a 100 mg/day regimen, and 28-day partial onset seizure frequency reductions were 25.2% and 25.7% for 100 mg/day and 200 mg/day regimens, respectively, over placebo.
Brivaracetam provided no additional clinical benefit to patients who were receiving concomitant levetiracetam.
Similar drug exposure occurs when brivaracetam is used as monotherapy in partial onset seizures.
Antiepileptic drugs (AEDs) such as brivaracetam increase the risk of suicidal ideation and behavior; closely monitor all patients receiving brivaracetam for emerging or worsening suicidal thoughts/behavior or depression.
Indications
- partial seizures
Side Effects
- agitation
- angioedema
- anxiety
- asthenia
- ataxia
- bronchospasm
- constipation
- depression
- dizziness
- drowsiness
- dysgeusia
- emotional lability
- euphoria
- fatigue
- hallucinations
- hyperactivity
- injection site reaction
- irritability
- lethargy
- leukopenia
- malaise
- nausea
- neutropenia
- nystagmus
- paranoia
- psychosis
- restlessness
- suicidal ideation
- vertigo
- vomiting
Monitoring Parameters
- LFTs
Contraindications
- abrupt discontinuation
- breast-feeding
- depression
- driving or operating machinery
- geriatric
- hepatic disease
- pregnancy
- renal failure
- suicidal ideation
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Amobarbital
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Butabarbital
- Carbamazepine
- Enzalutamide
- Ethanol
- Fosphenytoin
- Hydroxychloroquine
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Mephobarbital
- Methohexital
- Pentobarbital
- Phenobarbital
- Phenytoin
- Primidone
- Rifampin
- Secobarbital
- St. John’s Wort, Hypericum perforatum
- Thiopental
- Tipranavir
- Trazodone
- Tricyclic antidepressants
