Formulary
Brivaracetam: Indications, Dosing, Side Effects and Interactions
Brivaracetam clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Brivaracetam: Indications, Dosing, Side Effects and Interactions
Brivaracetam clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Adjunctive therapy of focal seizures with or without secondary generalisation**
- **Adult** (By Mouth, Or By Intravenous Injection, Or By Intravenous Infusion): Initially 25-50 mg twice daily, adjusted according to response; usual maintenance 25-100 mg twice daily (max. per dose 100 mg twice daily).
**Adjunctive therapy of focal seizures with or without secondary generalisation for brivaracetam**
- **Child 2-17 years (body-weight 10-19 kg)** (By mouth, or by intravenous injection, or by intravenous infusion): Initially 0.5-1.25 mg/kg twice daily, adjusted according to response; usual maintenance 1.25 mg/kg twice daily (max. per dose 2.5 mg/kg twice daily).
- **Child 2-17 years (body-weight 20-49 kg)** (By mouth, or by intravenous injection, or by intravenous infusion): Initially 0.5-1 mg/kg twice daily, adjusted according to response; usual maintenance 1 mg/kg twice daily (max. per dose 2 mg/kg twice daily).
- **Child 2-17 years (body-weight 50 kg and above)** (By mouth, or by intravenous injection, or by intravenous infusion): Initially 25-50 mg twice daily, adjusted according to response; usual maintenance 50 mg twice daily (max. per dose 100 mg twice daily).
Side effects
Common or very common Anxiety; appetite decreased; constipation; cough; depression; dizziness; drowsiness; fatigue; increased risk of infection; insomnia; irritability; nausea; vertigo; vomiting Uncommon Behaviour abnormal; neutropenia; psychotic disorder Frequency not known Severe cutaneous adverse reactions (SCARs); suicidal behaviours
Interactions
**Other interactions (29):**
- Pharmacodynamic interactions Concomitant treatment with levetiracetam In the clinical studies, although the numbers were limited, there was no observed benefit of brivaracetam versus placebo in...
- Interaction with alcohol In a pharmacokinetic and pharmacodynamic interaction study between brivaracetam 200 mg single dose and ethanol 0.6 g/L continuous infusion in healthy subjects, there was no...
- Intake of brivaracetam with alcohol is not recommended.
- Pharmacokinetic interactions Effects of other medicinal products on the pharmacokinetics of brivaracetam In vitro data suggest that brivaracetam has a low interaction potential.
- The main disposition pathway of brivaracetam is by CYP-independent hydrolysis.
- Brivaracetam plasma concentrations may increase when coadministered with CYP2C19 strong inhibitors (e.g.
Pregnancy
Important safety information For brivaracetam MHRA/CHM advice: Antiepileptics: risk of suicidal thoughts and behaviour (August 2008) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs: updated advice on switching between different manufacturers' products (November 2017) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review (January 2021) See Epilepsy .
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Caution (risk of increased exposure). M Dose adjustments Initial dose of 25 mg twice daily; max. maintenance dose of 75 mg twice daily (limited information available). M
Medicinal forms
Tablet,Solution,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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