brivaracetam

medtigo

brivaracetam

Brand Name :

Briviact

Synonyms :

brivaracetam

Class :

SV2A Ligands

Action and Spectrum

Actions and Spectrum:

The action of brivaracetam is not fully understood, but it is believed to work by binding to a specific type of receptor in the brain called the synaptic vesicle protein 2A (SV2A) receptor. This binding is thought to enhance the release of neurotransmitters, such as GABA, which can help to reduce seizures.

The spectrum of activity of brivaracetam includes the treatment of seizures and other neurological conditions, such as anxiety and depression. It may also have potential for use in cognitive enhancement and memory improvement. However, further research is needed to fully understand the potential benefits and risks of brivaracetam in these areas.

Dosing & Uses

Drug Interaction

Adverse Reaction

Frequency Defined

>10%

Dizziness (12%)

Somnolence and sedation (16%)

1-10%

Nausea and vomiting (5%)

Constipation (2%)

Fatigue (9%)

Irritability (3%)

Black Box Warning

Black Box Warning

The FDA has issued a black box warning for brivaracetam due to the risk of suicidal thoughts and behaviors. This warning states that patients taking brivaracetam should be monitored closely for signs of suicidal thoughts or behavior, and that healthcare providers should inform patients and caregivers about the risk of suicide.

Contraindication / Caution

Contraindication/Caution:

Contraindication:

brivaracetam should not be used in patients with known hypersensitivity to the drug.

Caution:

brivaracetam should be used with caution in patients with moderate to severe renal impairment as it is eliminated primarily through the kidneys. Dose adjustments may be necessary in these patients.
It should also be used with caution in patients with a history of depression or suicidal thoughts as it may increase the risk of suicidal ideation and behavior.
brivaracetam may interact with other medications and should be used with caution in patients taking other medications, particularly those that affect the central nervous system or are metabolized by the liver.
Pregnant or breastfeeding women should also use caution when taking brivaracetam as there is limited data on its safety in these populations.
Patients should be advised to avoid drinking alcohol or taking other CNS depressants while taking brivaracetam as it may increase the risk of sedation and drowsiness.

Pregnancy / Lactation

Pregnancy warnings:   

AU TGA pregnancy category: B3
US FDA pregnancy category: Not assigned

Lactation:

Excreted into human milk is known

Pregnancy Categories:     

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.  

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.  

Category N: There is no data available for the drug under this category.

Pharmacology

Pharmacology:

brivaracetam (brand name: Briviact) is a medication used to treat seizures in people with epilepsy. It is classified as a selective, high-affinity, and positive allosteric modulator of the synaptic vesicle protein 2A (SV2A) receptor.

Pharmacodynamics:

Mechanism of Action: The exact mechanism of action of brivaracetam is not fully understood, but it is believed to work by binding to the SV2A receptor in the brain. This binding increases the release of the neurotransmitter GABA, which helps to inhibit the abnormal electrical activity in the brain that causes seizures.

Pharmacokinetics:

Absorption

brivaracetam has a high oral bioavailability and is rapidly and almost completely absorbed after oral administration. It has a peak plasma time of 1 hour, but this can be delayed with a high-fat meal.

Distribution

The protein binding of brivaracetam is low, at ≤20%, and it has a relatively low volume of distribution (Vd) of 0.5 L/kg.

Metabolism

The metabolism of brivaracetam is primarily mediated by hepatic and extra-hepatic amidase, which converts the drug into its carboxylic acid metabolite. This metabolite is not pharmacologically active and is excreted through the urine.

brivaracetam is also metabolized by CYP2C19, which leads to the formation of the hydroxy metabolite.

Elimination and excretion

The half-life of brivaracetam is around 9 hours, which means that half of the drug is eliminated from the body within 9 hours after a single dose.

brivaracetam is primarily excreted through the urine, with more than 95% of the dose being eliminated in this way. Less than 1% of the dose is excreted through the feces.

In terms of excretion of the drug and its metabolites, less than 10% of the dose is excreted unchanged in the urine, while 34% of the dose is excreted as the carboxylic acid metabolite in urine. The remaining fraction of the dose is eliminated as other inactive metabolites.

Adminstartion

Administration:

Oral administration

brivaracetam is administered orally, typically as a tablet or oral solution. The recommended dosage and frequency of administration will vary depending on the individual’s condition and response to treatment. It is important to follow the dosing instructions provided by a healthcare provider and not to alter or stop taking the medication without consulting a healthcare provider.

brivaracetam should be taken with or without food. If a dose is missed, it should be taken as soon as possible. However, if it is almost time for the next dose, the missed dose should be skipped, and the regular dosing schedule should be resumed.

It is important to note that brivaracetam may cause drowsiness or dizziness and should be used with caution when operating heavy machinery or driving. It may also interact with other medications, and it is important to inform a healthcare provider of all medications being taken.

Patient Information Leaflet

Patient information leaflet

Generic Name: brivaracetam

Why do we use brivaracetam?

brivaracetam is used to treat seizures, particularly in adults with epilepsy who have not adequately responded to other treatments. It is a type of antiepileptic drug that works by binding to a specific type of protein in the brain called the SV2A protein. This binding helps to reduce the activity of nerve cells in the brain that are involved in seizures.

brivaracetam is typically used as an adjunctive therapy, meaning it is used in combination with other antiepileptic drugs. It is used to control seizures that are not well-controlled with other treatments, and it may be used in people who have had seizures that are difficult to control or have a high risk of seizures.

brivaracetam

No data available for drug.

DRUG INTERACTION

brivaracetam

&

brivaracetam +

Contraindicated

Serious Use Alternative

Monitor Closely

Minor

brivaracetam

No data available for drug.

DRUG INTERACTION

brivaracetam

&

brivaracetam +

Contraindicated

Serious Use Alternative

Monitor Closely

Minor

medtigo

brivaracetam

Brand Name :

Synonyms :

Class :

Action and Spectrum

Dosing & Uses

Drug Interaction

Adverse Reaction

Black Box Warning

Contraindication / Caution

Pregnancy / Lactation

Pharmacology

Adminstartion

Patient Information Leaflet

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