Dosing & Uses
Dosage Forms & Strengths
tablet: Schedule V
- 10mg
- 25mg
- 50mg
- 75mg
- 100mg
oral solution: Schedule V
- 10mg/mL
injection, solution: Schedule V
- 50mg/5mL single-dose vial
Partial-Onset Seizures
Indicated for partial-onset seizures
50 mg PO/IV q12hr initially; based on individual patient tolerability and therapeutic response, adjust dose between to 25-100 mg PO/IV BID (50-200 mg/day)
Injection may be used for patients when oral administration is temporarily not feasible; clinical study experience with injection is limited to 4 consecutive days of treatment
Dosage Modifications
Hepatic impairment
- All stages: Decrease starting dose to 25 mg BID and do not exceed 75 mg BID (150 mg/day)
Renal impairment
- Mild-to-moderate: No dose adjustment required
- ESRD undergoing dialysis: Not studied
Coadministration with rifampin
- Increase dose by 100% (ie, double dose)
Dosing Considerations
IV injection may be used when PO administration is temporarily not feasible; injection should be administered at the same dosage and same frequency as tablets or oral solution; clinical trials limited IV administration to 4 consecutive days
Dosage Forms & Strengths
tablet: Schedule V
- 10mg
- 25mg
- 50mg
- 75mg
- 100mg
oral solution: Schedule V
- 10mg/mL
injection, solution: Schedule V
- 50mg/5mL
Partial Onset Seizures
Tablets or oral solution
- Indicated for partial-onset seizures in children and adolescents ≥4 years
- <1 month : Safety and efficacy not established
-
≥1 month to <16 years
- <11 kg: 0.75-1.5 mg/kg PO/IV BID (1.5-3 mg/kg/day) initially; based on individual patient tolerability and therapeutic response, adjust dose between 0.75-3 mg/kg PO/IV BID (1.5-6 mg/kg/day)
- 11 to <20 kg: 0.5-1.25 mg/kg PO/IV BID (1-2.5 mg/kg/day) initially; based on individual patient tolerability and therapeutic response, adjust dose between 0.5-2.5 mg/kg PO/IV BID (1-5 mg/kg/day)
- 20 to <50 kg: 0.5-1 mg/kg PO/IV BID (1-2 mg/kg/day) initially; based on individual patient tolerability and therapeutic response, adjust dose between 0.5-2 mg/kg PO/IV BID (1-4 mg/kg/day)
- ≥50 kg: 25-50 mg PO/IV BID (50-100 mg/day) initially; based on individual patient tolerability and therapeutic response, adjust dose between 25-100 mg PO/IV BID (50-200 mg/day)
-
≥16 years
- 50 mg PO/IV BID (100 mg/day) initially; based on individual patient tolerability and therapeutic response, adjust dose between to 25-100 mg PO/IV BID (50-200 mg/day)
Dosage Modifications
Hepatic impairment
-
Starting dose adjustments
- <11 kg: Start at 0.75 mg/kg PO/IV BID (1.5 mg/kg/day)
- 11 to <50 kg: Start at 0.5 mg/kg PO/IV BID (1 mg/kg/day)
- ≥50 kg: Start at 25 mg PO/IV BID (50 mg/day)
-
Maximum dose with hepatic impairment
- <11 kg: Not to exceed 2.25 mg/kg PO/IV BID (4.5 mg/kg/day)
- 11 to <20 kg: Not to exceed 2 mg/kg PO/IV BID (4 mg/kg/day)
- 20 to <50 kg: Not to exceed 1.5 mg/kg PO/IV BID (3 mg/kg/day)
- ≥50 kg: Not to exceed 75 mg PO/IV BID (150 mg/day)
Renal impairment
- Mild-to-moderate: No dose adjustment required
- ESRD undergoing dialysis: Not studied
Coadministration with rifampin
- Increase dose by 100% (ie, double dose)
Dosing Considerations
IV injection may be used when PO administration is temporarily not feasible; injection should be administered at the same dosage and same frequency as tablets or oral solution; clinical trials limited IV administration to 4 consecutive days
Avoid abrupt withdrawal in order to minimize the risk of increased seizure frequency and status epilepticus
Absence Epilepsy (Orphan)
Orphan designation for treatment of juvenile or childhood absence epilepsy
Sponsor
- UCB, Inc; 1950 Lake Park Drive, Building 2100; Smyrna, Georgia
In general, dose selection for an elderly patient should be judicious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy
Refer to Adult Dosing
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (1)
- thalidomide
brivaracetam and thalidomide both increase sedation. Contraindicated.
Serious - Use Alternative (21)
- alfentanil
brivaracetam and alfentanil both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine
brivaracetam and buprenorphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine buccal
brivaracetam and buprenorphine buccal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine subdermal implant
brivaracetam and buprenorphine subdermal implant both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine transdermal
brivaracetam and buprenorphine transdermal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- buprenorphine, long-acting injection
brivaracetam and buprenorphine, long-acting injection both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl
brivaracetam and fentanyl both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl intranasal
brivaracetam and fentanyl intranasal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl iontophoretic transdermal system
brivaracetam and fentanyl iontophoretic transdermal system both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transdermal
brivaracetam and fentanyl transdermal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- fentanyl transmucosal
brivaracetam and fentanyl transmucosal both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- hydrocodone
brivaracetam and hydrocodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- hydromorphone
brivaracetam and hydromorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- lonafarnib
lonafarnib will increase the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.
- methadone
brivaracetam and methadone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- metoclopramide intranasal
brivaracetam, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- morphine
brivaracetam and morphine both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- oxycodone
brivaracetam and oxycodone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- oxymorphone
brivaracetam and oxymorphone both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- remifentanil
brivaracetam and remifentanil both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequate
- selinexor
selinexor, brivaracetam. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
Monitor Closely (170)
- acetaminophen/phenyltoloxamine
brivaracetam and acetaminophen/phenyltoloxamine both increase sedation. Use Caution/Monitor.
- acrivastine
acrivastine and brivaracetam both increase sedation. Use Caution/Monitor.
- alprazolam
brivaracetam and alprazolam both increase sedation. Use Caution/Monitor.
- amisulpride
amisulpride and brivaracetam both increase sedation. Use Caution/Monitor.
- amitriptyline
brivaracetam and amitriptyline both increase sedation. Use Caution/Monitor.
- amobarbital
brivaracetam and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
brivaracetam and amoxapine both increase sedation. Use Caution/Monitor.
- aripiprazole
brivaracetam and aripiprazole both increase sedation. Use Caution/Monitor.
- asenapine
asenapine and brivaracetam both increase sedation. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and brivaracetam both increase sedation. Use Caution/Monitor.
- avapritinib
avapritinib and brivaracetam both increase sedation. Use Caution/Monitor.
- baclofen
brivaracetam and baclofen both increase sedation. Use Caution/Monitor.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen and brivaracetam both increase sedation. Use Caution/Monitor.
- brexanolone
brexanolone, brivaracetam. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brexpiprazole
brexpiprazole and brivaracetam both increase sedation. Use Caution/Monitor.
- brimonidine
brimonidine and brivaracetam both increase sedation. Use Caution/Monitor.
brivaracetam and brimonidine both increase sedation. Use Caution/Monitor. - brompheniramine
brivaracetam and brompheniramine both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
buprenorphine subdermal implant and brivaracetam both increase sedation. Use Caution/Monitor.
- butabarbital
brivaracetam and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
brivaracetam and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
brivaracetam and butorphanol both increase sedation. Use Caution/Monitor.
- carbamazepine
carbamazepine will decrease the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Brivaracetam plasma concentration decreased by 26%.
brivaracetam, carbamazepine. decreasing metabolism. Use Caution/Monitor. Brivaracetam reversibly inhibits epoxide hydrolase resulting in an increased concentration of carbamazepine epoxide, an active metabolite of carbamazepine. The carbamazepine epoxide plasma concentration increased up to 198%. May require carbamazepine dose reduction. . - carbinoxamine
brivaracetam and carbinoxamine both increase sedation. Use Caution/Monitor.
- cariprazine
brivaracetam and cariprazine both increase sedation. Use Caution/Monitor.
- carisoprodol
brivaracetam and carisoprodol both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate, brivaracetam. Either increases effects of the other by sedation. Use Caution/Monitor.
- cetirizine
brivaracetam and cetirizine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
brivaracetam and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
brivaracetam and chlorpheniramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
brivaracetam and chlorpromazine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
brivaracetam and chlorzoxazone both increase sedation. Use Caution/Monitor.
- clemastine
brivaracetam and clemastine both increase sedation. Use Caution/Monitor.
- clobazam
brivaracetam and clobazam both increase sedation. Use Caution/Monitor.
- clomipramine
brivaracetam and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
brivaracetam and clonazepam both increase sedation. Use Caution/Monitor.
- clonidine
brivaracetam and clonidine both increase sedation. Use Caution/Monitor.
- clorazepate
brivaracetam and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
brivaracetam and clozapine both increase sedation. Use Caution/Monitor.
- codeine
brivaracetam and codeine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
brivaracetam and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
brivaracetam and cyproheptadine both increase sedation. Use Caution/Monitor.
- dantrolene
brivaracetam and dantrolene both increase sedation. Use Caution/Monitor.
- daridorexant
brivaracetam and daridorexant both increase sedation. Use Caution/Monitor.
- desflurane
brivaracetam and desflurane both increase sedation. Use Caution/Monitor.
- desipramine
brivaracetam and desipramine both increase sedation. Use Caution/Monitor.
- deutetrabenazine
brivaracetam and deutetrabenazine both increase sedation. Use Caution/Monitor.
- dexbrompheniramine
brivaracetam and dexbrompheniramine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
brivaracetam and dexchlorpheniramine both increase sedation. Use Caution/Monitor.
- diazepam
brivaracetam and diazepam both increase sedation. Use Caution/Monitor.
- difenoxin hcl
brivaracetam and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
brivaracetam and dimenhydrinate both increase sedation. Use Caution/Monitor.
- diphenhydramine
brivaracetam and diphenhydramine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
brivaracetam and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- doxepin
brivaracetam and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
brivaracetam and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
brivaracetam and droperidol both increase sedation. Use Caution/Monitor.
- efavirenz
brivaracetam and efavirenz both increase sedation. Use Caution/Monitor.
- entacapone
brivaracetam and entacapone both increase sedation. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, brivaracetam. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
brivaracetam and estazolam both increase sedation. Use Caution/Monitor.
- eszopiclone
brivaracetam and eszopiclone both increase sedation. Use Caution/Monitor.
- ethanol
ethanol, brivaracetam. Other (see comment). Use Caution/Monitor. Comment: Coadministration with ethanol may enhance CNS depressant effects (eg, decreases in saccadic peak velocity, smooth pursuit, adaptive tracking performance, and Visual Analog Scale (VAS) alertness).
brivaracetam and ethanol both increase sedation. Use Caution/Monitor. - ethosuximide
brivaracetam and ethosuximide both increase sedation. Use Caution/Monitor.
- ethotoin
brivaracetam and ethotoin both increase sedation. Use Caution/Monitor.
- felbamate
brivaracetam and felbamate both increase sedation. Use Caution/Monitor.
- fenfluramine
brivaracetam and fenfluramine both increase sedation. Use Caution/Monitor.
- fexinidazole
fexinidazole will increase the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- fexofenadine
brivaracetam and fexofenadine both increase sedation. Use Caution/Monitor.
- flibanserin
brivaracetam and flibanserin both increase sedation. Use Caution/Monitor.
- fluphenazine
brivaracetam and fluphenazine both increase sedation. Use Caution/Monitor.
- flurazepam
brivaracetam and flurazepam both increase sedation. Use Caution/Monitor.
- gabapentin
brivaracetam and gabapentin both increase sedation. Use Caution/Monitor.
- ganaxolone
brivaracetam and ganaxolone both increase sedation. Use Caution/Monitor.
- guanfacine
brivaracetam and guanfacine both increase sedation. Use Caution/Monitor.
- haloperidol
brivaracetam and haloperidol both increase sedation. Use Caution/Monitor.
- hydroxyzine
brivaracetam and hydroxyzine both increase sedation. Use Caution/Monitor.
- iloperidone
brivaracetam and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
brivaracetam and imipramine both increase sedation. Use Caution/Monitor.
- isoflurane
brivaracetam and isoflurane both increase sedation. Use Caution/Monitor.
- ketamine
brivaracetam and ketamine both increase sedation. Use Caution/Monitor.
- ketotifen, drug-eluting contact lens
brivaracetam and ketotifen, drug-eluting contact lens both increase sedation. Use Caution/Monitor.
- lamotrigine
brivaracetam and lamotrigine both increase sedation. Use Caution/Monitor.
- lasmiditan
lasmiditan, brivaracetam. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, brivaracetam. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levetiracetam
brivaracetam, levetiracetam. Other (see comment). Use Caution/Monitor. Comment: Coadministration provided no added therapeutic benefit and may cause additive/synergistic adverse effects.
brivaracetam and levetiracetam both increase sedation. Use Caution/Monitor. - levocetirizine
brivaracetam and levocetirizine both increase sedation. Use Caution/Monitor.
- levorphanol
brivaracetam and levorphanol both increase sedation. Use Caution/Monitor.
- loratadine
brivaracetam and loratadine both increase sedation. Use Caution/Monitor.
- lorazepam
brivaracetam and lorazepam both increase sedation. Use Caution/Monitor.
- loxapine
brivaracetam and loxapine both increase sedation. Use Caution/Monitor.
- lumateperone
brivaracetam and lumateperone both increase sedation. Use Caution/Monitor.
- lurasidone
brivaracetam and lurasidone both increase sedation. Use Caution/Monitor.
- maprotiline
brivaracetam and maprotiline both increase sedation. Use Caution/Monitor.
- mavacamten
brivaracetam will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.
- meclizine
brivaracetam and meclizine both increase sedation. Use Caution/Monitor.
- meperidine
brivaracetam and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
brivaracetam and meprobamate both increase sedation. Use Caution/Monitor.
- metaxalone
brivaracetam and metaxalone both increase sedation. Use Caution/Monitor.
- methocarbamol
brivaracetam and methocarbamol both increase sedation. Use Caution/Monitor.
- methohexital
brivaracetam and methohexital both increase sedation. Use Caution/Monitor.
- methsuximide
brivaracetam and methsuximide both increase sedation. Use Caution/Monitor.
- midazolam
brivaracetam and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, brivaracetam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- mirtazapine
brivaracetam and mirtazapine both increase sedation. Use Caution/Monitor.
- molindone
brivaracetam and molindone both increase sedation. Use Caution/Monitor.
- nalbuphine
brivaracetam and nalbuphine both increase sedation. Use Caution/Monitor.
- nitrous oxide
brivaracetam and nitrous oxide both increase sedation. Use Caution/Monitor.
- nortriptyline
brivaracetam and nortriptyline both increase sedation. Use Caution/Monitor.
- olanzapine
brivaracetam and olanzapine both increase sedation. Use Caution/Monitor.
- oliceridine
brivaracetam and oliceridine both increase sedation. Use Caution/Monitor.
- olopatadine intranasal
brivaracetam and olopatadine intranasal both increase sedation. Use Caution/Monitor.
- opicapone
brivaracetam and opicapone both increase sedation. Use Caution/Monitor.
- opium tincture
brivaracetam and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
brivaracetam and orphenadrine both increase sedation. Use Caution/Monitor.
- oxazepam
brivaracetam and oxazepam both increase sedation. Use Caution/Monitor.
- paliperidone
brivaracetam and paliperidone both increase sedation. Use Caution/Monitor.
- pentazocine
brivaracetam and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
brivaracetam and pentobarbital both increase sedation. Use Caution/Monitor.
- perampanel
brivaracetam and perampanel both increase sedation. Use Caution/Monitor.
- perphenazine
brivaracetam and perphenazine both increase sedation. Use Caution/Monitor.
- pheniramine
brivaracetam and pheniramine both increase sedation. Use Caution/Monitor.
- phenobarbital
phenobarbital will decrease the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Brivaracetam plasma concentration decreased by 19%.
brivaracetam and phenobarbital both increase sedation. Use Caution/Monitor. - phenytoin
phenytoin will decrease the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Brivaracetam plasma concentration decreased by 21%.
brivaracetam increases levels of phenytoin by decreasing metabolism. Use Caution/Monitor. Up to 20% increase in phenytoin plasma concentrations observed. Monitor phenytoin levels when brivaracetam is coadministered or discontinued from ongoing phenytoin therapy. . - pimozide
brivaracetam and pimozide both increase sedation. Use Caution/Monitor.
- pomalidomide
brivaracetam and pomalidomide both increase sedation. Use Caution/Monitor.
- pregabalin
brivaracetam and pregabalin both increase sedation. Use Caution/Monitor.
- primidone
brivaracetam and primidone both increase sedation. Use Caution/Monitor.
- prochlorperazine
brivaracetam and prochlorperazine both increase sedation. Use Caution/Monitor.
- promethazine
brivaracetam and promethazine both increase sedation. Use Caution/Monitor.
- propofol
brivaracetam and propofol both increase sedation. Use Caution/Monitor.
- protriptyline
brivaracetam and protriptyline both increase sedation. Use Caution/Monitor.
- pyrilamine
brivaracetam and pyrilamine both increase sedation. Use Caution/Monitor.
- quazepam
brivaracetam and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
brivaracetam and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
brivaracetam and ramelteon both increase sedation. Use Caution/Monitor.
- remimazolam
brivaracetam and remimazolam both increase sedation. Use Caution/Monitor.
- reserpine
brivaracetam and reserpine both increase sedation. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. The dose of brivaracetam should be increased up to 100% (ie, double the dosage) in patients while receiving concomitant treatment with rifampin.
- risperidone
brivaracetam and risperidone both increase sedation. Use Caution/Monitor.
- rucaparib
rucaparib will increase the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.
- scopolamine
brivaracetam and scopolamine both increase sedation. Use Caution/Monitor.
- sevoflurane
brivaracetam and sevoflurane both increase sedation. Use Caution/Monitor.
- sodium oxybate
brivaracetam and sodium oxybate both increase sedation. Use Caution/Monitor.
- sparsentan
sparsentan will decrease the level or effect of brivaracetam by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates.
- stiripentol
stiripentol, brivaracetam. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- sufentanil
brivaracetam and sufentanil both increase sedation. Use Caution/Monitor.
- sufentanil SL
brivaracetam and sufentanil SL both increase sedation. Use Caution/Monitor.
- suvorexant
brivaracetam and suvorexant both increase sedation. Use Caution/Monitor.
- tapentadol
brivaracetam and tapentadol both increase sedation. Use Caution/Monitor.
- tasimelteon
brivaracetam and tasimelteon both increase sedation. Use Caution/Monitor.
- temazepam
brivaracetam and temazepam both increase sedation. Use Caution/Monitor.
- tetrabenazine
brivaracetam and tetrabenazine both increase sedation. Use Caution/Monitor.
- thioridazine
brivaracetam and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
brivaracetam and thiothixene both increase sedation. Use Caution/Monitor.
- tiagabine
brivaracetam and tiagabine both increase sedation. Use Caution/Monitor.
- tizanidine
brivaracetam and tizanidine both increase sedation. Use Caution/Monitor.
- tolcapone
brivaracetam and tolcapone both increase sedation. Use Caution/Monitor.
- topiramate
brivaracetam and topiramate both increase sedation. Use Caution/Monitor.
- tramadol
brivaracetam and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
brivaracetam and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
brivaracetam and triazolam both increase sedation. Use Caution/Monitor.
- trifluoperazine
brivaracetam and trifluoperazine both increase sedation. Use Caution/Monitor.
- triprolidine
brivaracetam and triprolidine both increase sedation. Use Caution/Monitor.
- valproic acid
brivaracetam and valproic acid both increase sedation. Use Caution/Monitor.
- vigabatrin
brivaracetam and vigabatrin both increase sedation. Use Caution/Monitor.
- zaleplon
brivaracetam and zaleplon both increase sedation. Use Caution/Monitor.
- ziconotide
brivaracetam and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
brivaracetam and ziprasidone both increase sedation. Use Caution/Monitor.
- zolpidem
brivaracetam and zolpidem both increase sedation. Use Caution/Monitor.
- zonisamide
brivaracetam and zonisamide both increase sedation. Use Caution/Monitor.
Minor (0)
Adverse Effects
>10%
Somnolence and sedation (16%)
Dizziness (12%)
1-10%
Fatigue (9%)
Nausea and vomiting (5%)
Cerebellar coordination and balance disturbances (3%)
Irritability (3%)
Constipation (2%)
Postmarketing Reports
Dysgeusia, euphoric mood, feeling drunk, infusion site pain, decreased appetite
Warnings
Contraindications
Hypersensitivity; bronchospasms and angioedema have occurred
Cautions
May cause psychiatric adverse reactions, including nonpsychotic and psychotic symptoms; advise patients and caregivers/families to be alert for these behavioral changes and report them to their physician immediately
Hypersensitivity reactions reported, including bronchospasm and angioedema; if a patient develops hypersensitivity reactions after treatment, the drug should be discontinued
If discontinued, withdraw drug gradually because of the risk of increased seizure frequency and status epilepticus; if withdrawal is needed because of a serious adverse event, consider rapid discontinuation
Suicidal Behavior
- Antiepileptic drugs increase the risk of suicidal behavior and ideation; monitor for the emergence or worsening of depression, unusual changes in mood or behavior, or suicidal thoughts, behavior, or self-harm; advise patients and caregivers/families to be alert for these behavioral changes and report them to their physician immediately
- Anyone considering prescribing an antiepileptic drug, such as this one, must balance risk of suicidal thoughts or behaviors with risk of untreated illness; epilepsy and many other illnesses for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior
- Should suicidal thoughts and behavior emerge during treatment, consider whether the emergence of these symptoms in any given patient may be related to the illness being treated
Drug interactions overview
- CYP2C19 poor metabolizers and patients using inhibitors of CYP2C19 may require dose reduction
- Strong CYP2C19 inducers (eg, rifampin) require dose increase (see Dosage Modifications)
- Coadministration with carbamazepine may increase exposure to carbamazepine-epoxide, the active metabolite of carbamazepine; though data did not reveal any safety concerns, if tolerability issues arise when coadministered, consider carbamazepine reducing the dose
- Because brivaracetam can increase plasma concentrations of phenytoin, monitor phenytoin levels in patients when concomitant brivaracetam is added to or discontinued from ongoing phenytoin therapy
- No added therapeutic benefit to levetiracetam when the two drugs were coadministered
Pregnancy & Lactation
Pregnancy
No adequate and well-controlled studies on pregnant women
Available data from North American Antiepileptic Drug (NAAED) pregnancy registry, a prospective cohort study, case reports, and a case series are insufficient to identify a risk of major birth defects, miscarriage, or other maternal or fetal outcomes associated with use during pregnancy
Animal data
- In animal studies, brivaracetam produced evidence of developmental toxicity (increased embryofetal mortality and decreased fetal body weights in rabbits; decreased growth, delayed sexual maturation, and long-term neurobehavioral changes in rat offspring) at maternal plasma exposures greater than clinical exposures
Pregnancy Registry
- Recommend that pregnant patients enroll in the North American Antiepileptic Drug Pregnancy Registry; this can be done by calling the toll-free number 1-888-233-2334, and must be done by patients themselves
- Information on the registry can also be found at the Web site http://www.aedpregnancyregistry.org/
Lactation
Data from published literature indicate that the drug is present in human milk; there is insufficient information on effects on breastfed infant or on milk production
The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Exact mechanism unknown
Displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the anticonvulsant effect
Absorption
Highly permeable and is rapidly and almost completely absorbed after PO administration
Peak plasma time: 1 hr (without food); slower absorption with a high-fat meal
Distribution
Protein bound: ≤20%
Vd: 0.5 L/kg
Metabolism
Primarily metabolized by hydrolysis of the amide moiety to form the corresponding carboxylic acid metabolite and is mediated by hepatic and extra-hepatic amidase
Secondarily metabolized by hydroxylation on the propyl side chain to form the hydroxy metabolite that is mediated primarily by CYP2C19
An additional hydroxy acid metabolite is created by hydrolysis of the amide moiety on the hydroxy metabolite or hydroxylation of the propyl side chain on the carboxylic acid metabolite (mainly by CYP2C9)
The 3 metabolites are not pharmacologically active
Elimination
Half-life: 9 hr
Excretion
- Urine (>95%); feces (<1%)
- <10% of the dose is excreted unchanged in the urine
- 34% of the dose is excreted as the carboxylic acid metabolite in urine
Pharmacogenomics
In human subjects possessing genetic variations in CYP2C19, production of the hydroxy metabolite is decreased 2-fold or 10-fold, while the blood level of brivaracetam itself is increased by 22% or 42%, respectively, in individuals with one or both mutated alleles
CYP2C19 poor metabolizers and patients using inhibitors of CYP2C19 may require dose reduction
Administration
Oral Administration
May take with or without food
Tablet
- Swallow whole; do not chew or crush
Oral solution
- Use a calibrated measuring device to measure and deliver the prescribed dose accurately
- No dilution is necessary
- May also be administered using an NT-tube or G-tube
IV Compatibilities
0.9% NaCl
Dextrose 5%
Lactated Ringer injection
IV Preparation
Inspect visually for particulate matter and discoloration prior to administration; product with particulate matter or discoloration should not be used
Vial is for single dose only
IV Administration
Can be administered IV without further dilution or may be mixed with diluents (see IV Compatibilities)
Infuse IV over 2-15 minutes
Discontinuation
Avoid abrupt withdrawal in order to minimize the risk of increased seizure frequency and status epilepticus
Storage
Oral
- Store at 25°C (77°F); excursions permitted between 15-30°C (59-86°F)
- Oral solution: Do not freeze; discard any unused oral solution remaining after 5 months of first opening the bottle
IV
- Unopened vials: Store at 25°C (77°F); excursions permitted between 15-30°C (59-86°F); do not freeze
- Diluted solution: Store at room temperature in PVC bag for up to 4 hr
- Discard any unused portion
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
Briviact intravenous - | 50 mg/5 mL vial | ![]() | |
Briviact oral - | 100 mg tablet | ![]() | |
Briviact oral - | 75 mg tablet | ![]() | |
Briviact oral - | 50 mg tablet | ![]() | |
Briviact oral - | 25 mg tablet | ![]() | |
Briviact oral - | 10 mg tablet | ![]() | |
Briviact oral - | 10 mg/mL solution | ![]() |
Copyright © 2010 First DataBank, Inc.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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