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Brivaracetam (briv a RA se tam) has been approved by the FDA to treat focal (partial) onset seizures in patients 1 month of age and older.

Your epilepsy treatment should always be discussed with your healthcare provider before use. Based on their judgment and knowledge, a drug may be prescribed for other epilepsy types not included in the indications. For more information, please see the prescribing information.

How can you take brivaracetam? (Available formulations)

You can take brivaracetam by mouth with or without food as a tablet or an oral solution. Brivaracetam is also available through intravenous injection.

Who should not take brivaracetam?

If you are allergic to brivaracetam or any of the inactive ingredients, then you should not take it.

Other considerations may influence whether you should take brivaracetam. Tell your healthcare provider if you:

  • have or have had depression, mood problems, or suicidal thoughts or behavior.
  • have liver problems.
  • have abused or been dependent on prescription medicines, street drugs, or alcohol.
  • are pregnant or plan to become pregnant.
  • are breastfeeding or plan to breastfeed.

What is important to know about taking brivaracetam?

Do not stop taking brivaracetam suddenly unless directed to do so by your healthcare provider.

As with all antiseizure medications, brivaracetam should be withdrawn gradually to minimize the risk of causing or worsening seizures or status epilepticus. You should not stop using brivaracetam suddenly unless your healthcare provider tells you to stop the medicine because of a serious side effect.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Taking brivaracetam with certain other medicines may cause side effects or affect how well they work. Do not start or stop other medicines without talking to your healthcare provider.

Women or those who are/plan to become pregnant
Use in pregnancy

At this time, there is not enough evidence regarding developmental risks associated with the use of brivaracetam in pregnant people. In animal studies, there were instances of developmental issues at greater than clinical doses, and evidence that brivaracetam could cross the placenta. However, having a seizure during pregnancy could harm both the pregnant individual and the baby. Tell your healthcare provider right away if you become pregnant. Do not start or stop taking seizure medication during pregnancy without your healthcare provider’s advice.

If you become pregnant while taking brivaracetam, talk to your healthcare provider about registering with the North American Antiepileptic Drug (NAAED) Pregnancy Registry. The purpose of this registry is to collect information about the safety of antiseizure medicine during pregnancy. You can enroll in this registry by calling 1-888-233-2334.

Use during breastfeeding

It may not be safe to breastfeed while taking brivaracetam. It is not known in humans if brivaracetam is present in breast milk, if there are effects on the breastfed infant, or if brivaracetam impacts milk production. Studies in animals have shown they excrete brivaracetam in their milk.

Talk to your healthcare provider about the risks. Your healthcare provider will consider the developmental and health benefits of breastfeeding along with your need for brivaracetam and the potential effect on the infant from brivaracetam or from your epilepsy.

What are the side effects of brivaracetam?

Brivaracetam is approved by the FDA because it is safe and effective for the majority of people who take it. However, there are risks associated with all medicines. Some side effects caused by brivaracetam can be very serious, and even life-threatening. It is important to be informed about these serious reactions and to be aware of their symptoms.

Common side effects

The most common reported side effects are drowsiness (somnolence)/sedation, dizziness, fatigue, and nausea/vomiting.

Rare, but serious side effects
Suicidal thoughts or behaviors

Studies have found that people who take antiseizure medications including brivaracetam may have suicidal thoughts or behaviors, which occur in approximately 1 in 500 patients. If you experience any thoughts or impulses to hurt yourself, you should contact your healthcare provider immediately.

Neurological reactions

Drowsiness, tiredness, and dizziness are common with brivaracetam, but can be severe. Brivaracetam can also cause problems with balance and coordination. Do not drive or operate machinery until you have gained sufficient experience on brivaracetam to gauge whether it adversely affects your ability to drive or operate machinery. The amount of sleepiness and fatigue you may experience is related to the dose you take. The chance of experiencing these adverse effects is greatest early in treatment but can occur at any time.

Do not drive or operate machinery until you have gained sufficient experience on brivaracetam to gauge whether it adversely affects your abilities.

Psychiatric reactions

Brivaracetam can cause mood and behavior changes such as aggression, agitation, anger, anxiety, apathy, mood swings, depression, hostility, and irritability. Irritability and anxiety are common with brivaracetam and can be severe. You may also get psychotic symptoms such as hallucinations (seeing or hearing things that are not there), delusions (false or strange thoughts or beliefs), and unusual behavior. Psychiatric adverse reactions were also observed in clinical trials with children and were generally similar to those observed in adults.

Hypersensitivity: bronchospasm and angioedema

Brivaracetam can cause hypersensitivity reactions. Difficulty breathing and wheezing due to bronchospasm (constriction of air tubes in lungs) as well as swelling around the face, lips, tongue, or throat (angioedema) have been reported in patients taking brivaracetam. If you develop a hypersensitivity reaction after treatment with brivaracetam, get emergency medical help and tell your healthcare provider as you will most likely need to discontinue its use.