Brivaracetam

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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

  1. agitation
  2. angioedema
  3. anxiety
  4. asthenia
  5. ataxia
  6. bronchospasm
  7. constipation
  8. depression
  9. dizziness
  10. drowsiness
  11. dysgeusia
  12. emotional lability
  13. euphoria
  14. fatigue
  15. hallucinations
  16. hyperactivity
  17. injection site reaction
  18. irritability
  19. lethargy
  20. leukopenia
  21. malaise
  22. nausea
  23. neutropenia
  24. nystagmus
  25. paranoia
  26. psychosis
  27. restlessness
  28. suicidal ideation
  29. vertigo
  30. 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

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