Perampanel Brand Name– FYCOMPA
What is Perampanel
Perampanel (Fycompa) is a selective, non-competitive ionotropic alpha-amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptor antagonist approved for the treatment of partial-onset and primary generalized tonic-clonic seizures.
The AMPA receptor is present in nearly all excitatory neurons. Because of perampanel’s novel mechanism of action, it may be an effective adjunct medication in patients with refractory partial-onset seizures.
In addition, though further research is needed, animal models have suggested AMPA receptor antagonist efficacy for status epilepticus resistant to benzodiazepines.
Perampanel carries a black box warning for neuropsychiatric adverse events, which can be life-threatening; the drug is also associated with a high incidence of adverse effects that may affect balance and coordination.
Perampanel has been evaluated in phase 3, randomized, placebo-controlled trials for the treatment of motor fluctuations in patients with Parkinson’s disease on levodopa therapy; results demonstrated no improvements in motor function (“off” time)
Indications
- partial seizures
- tonic-clonic seizures
For monotherapy or adjunctive treatment of partial seizures with or without secondary generalization
Side Effects
- abdominal pain
- agitation
- anxiety
- arthralgia
- asthenia
- ataxia
- back pain
- blurred vision
- confusion
- constipation
- cough
- delirium
- depression
- diplopia
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysarthria
- emotional lability
- euphoria
- fatigue
- hallucinations
- headache
- hostility
- hypertriglyceridemia
- hypoesthesia
- hyponatremia
- infection
- irritability
- lethargy
- memory impairment
- musculoskeletal pain
- myalgia
- nausea
- paranoia
- paresthesias
- peripheral edema
- psychosis
- rash
- suicidal ideation
- throat irritation
- vertigo
- vomiting
- weight gain
Monitoring Parameters
- LFTs
- serum creatinine/BUN
Contraindications
- abrupt discontinuation
- behavioral changes
- bipolar disorder
- breast-feeding
- contraception requirements
- depression
- driving or operating machinery
- geriatric
- hepatic disease
- pregnancy
- psychiatric event
- psychosis
- renal failure
- renal impairment
- reproductive risk
- schizophrenia
- substance abuse
- suicidal ideation
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Acrivastine; Pseudoephedrine
- Alfentanil
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alprazolam
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamines
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
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- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
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- Bexarotene
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- Brompheniramine; Carbetapentane; Phenylephrine
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- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Buspirone
- Butabarbital
- Cannabidiol
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pyrilamine
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carisoprodol
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chloral Hydrate
- Chlorcyclizine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Clarithromycin
- Clemastine
- Clomipramine
- Clonazepam
- Clorazepate
- Clozapine
- Cobicistat
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
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- Codeine; Promethazine
- Conivaptan
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- Deutetrabenazine
- Dexamethasone
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Diazepam
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
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- Doxepin
- Doxorubicin
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Droperidol
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
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- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
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- Entacapone
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- Esketamine
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- Estazolam
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- Ethinyl Estradiol; Levonorgestrel
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- Etravirine
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- Flurazepam
- Fosamprenavir
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- Griseofulvin
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- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen; Oxycodone
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- Imipramine
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- Nafcillin
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- Nevirapine
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- Nortriptyline
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oxazepam
- Oxcarbazepine
- Oxycodone
- Oxymorphone
- Pentobarbital
- Perindopril; Amlodipine
- Perphenazine
- Perphenazine; Amitriptyline
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