Briviact® is the brand name of a medication used in the United States and other countries to treat seizures.  It has been approved by the FDA in the U.S. for use in people aged 16 years and older with focal seizures, when it is given in addition to another seizure medicine.

It is manufactured by UCB Pharma. Brivaracetam(Briv-ar-acetam)  is the generic name of this medication. The name or look of the medicine may be different in other countries. The dose (measured in milligrams, abbreviated "mg") will usually be the same. 

Briviact

Used to treat

  • Temporal Lobe Epilepsy
  • Complex Partial Seizures
  • Secondarily Generalized Seizures
  • Simple Partial Seizures

Forms

Forms

  • 50 mg tablets
  • 100 mg tablets
  • oral solution
  • injection for intravenous use

Dosing

Typical dosing instructions:

The usual dose of Briviact ranges between 100 and 200 mg each day. Your prescribing health care provider may start it at a low dose (for example 100 mg daily and increase the dose as needed.

Follow your doctor’s directions carefully about how much to take and when to make changes.  

What are the dose ranges for Brivaracetam?

Briviact will be available as tablets, an oral solution, and an injection which can be used temporarily when oral forms are not possible.

Dosage strengths: 

  • Tablets: 10 mg, 25 mg, 50 mg, 75 mg, 100  mg
  • Oral solution: 10 mg per ml
  • Injection: 50 mg per 5 ml, in single dose vials
How well does the Brivaracetam work?

How to Take

Briviact usually needs to be taken two times a day.

It can be taken with or without food, but it‘s best to take it the same way every day. Swallow the tablets whole. Don’t bite or chew it.

It is often started on a lower dose, using 50 mg tablets. If the amount of Briviact you take is increased or changed, a higher dose of 100 mg per tablet may be given.

  • Check all prescriptions and make sure you are taking the right number of tablets and the right amount (in mg) if the dose has been changed. Also check your prescriptions each time you get a new refill of medicine.

A liquid form can be used by people who can’t swallow pills.  Use an accurate measuring spoon or syringe (not a regular teaspoons) every time so the dose will be correct.  Again always read the bottle for the amount of milligrams per milliliter.This will help make sure you get the correct dose.

Take only the amount that your doctor tells you to take.  If you think you’ve taken an extra tablet (or liquid), call your doctor for advice.   If you take a larger number of tablets (or liquid), call the poison control center or your hospital’s ER unless your doctor gave you special instructions.

Don’t stop taking Briviact or change the amount without talking to your doctor first.  Stopping any seizure medication all at once can cause serious problems, including seizures.

Brivaracetam also comes in an IV form and can be used temporarily if it can’t be taken by mouth for some reason.The same dose and frequency should be used.      

How to store?

Store Briveteracetam at room temperature(25C-77F) in a dry place away from light.

Do not store in a bathroom or a moist place.

Keep out of the reach of children

What if I forget?

Taking the right amount of seizure medicine on time every day is the most important step in preventing seizures. Try these steps to help you remember when to take seizure medicine.

  • Take a missed dose as soon as you remember it,  unless it is close to the time for your next dose.
  • If it is already time for the next dose, skip the missed dose and go back to your normal dosing regimen.
  • Avoid taking 2 doses at the same time or taking extra doses.
  • If you are not sure about what to do, call the doctor's office for advice. Do your best to follow the doctor's directions.
  • To avoid missed doses, get a special pillbox or to set an alarm on your watch or on phone.
  • Write down any missed doses on your seizure calendar. Share this with the doctor or nurse at each visit.
  • Write down or record  any missed doses on your seizure calendar. Share this with the doctor or nurse at each visit.
How does Brivaracetam affect the brain?

Brivaracetam helps prevent brain cells from working as fast. In one study in animals, brivaracetam was seen to[1]  increase the threshold needed to reach another seizure, to decrease duration of a seizure, and to also increase the number of stimulations required to reach a seizure.

What are the most common side effects of Brivaracetam?
  • Feeling tired, sleepy, or sedated
  • Dizziness
  • Nausea and vomiting
What are the most serious side effects of Brivaracetam?

Suicidal ideation and behavior

On July 10, 2008, an advisory panel was convened by the Food and Drug Administration (FDA) to review data that the FDA had previously collected from drug studies showing an association between many antiepileptic drugs (AEDs) and suicidal ideation and behavior, which together are called suicidality. According to the FDA’s Alert, among the patients with epilepsy in these drug studies, 1 out of 1000 people taking the placebo (inactive substance) showed suicidality compared to approximately 3.5 out of 1000 people who took an AED. The FDA advisory panel voted to accept the FDA's data at that meeting. The FDA has provided the following information for patients, family members, and caregivers

  • Taking antiepileptic medicines may increase the risk of having suicidal thoughts or actions.
  • Do not make any changes to the medication regimen without first talking with the responsible healthcare professional.
  • Pay close attention to any day-to-day changes in mood, behavior and actions. These changes can happen very quickly so it is important to be mindful of any sudden differences.
  • Be aware of common warning signs that might be a signal for risk of suicide. Some of these are:
    • Talking or thinking about wanting to hurt yourself or end your life
    • Withdrawing from friends and family
    • Becoming depressed or having your depression get worse
    • Becoming preoccupied with death and dying
    • Giving away prized possessions

People taking any seizure medicine should contact their doctor before stopping any seizure medicine because this may possibly lead to seizures and worsening of mood.

Impact of Brivaracetam on bone health

Patients with chronic treatment of epilepsy, typically adults, are at greater risk for fractures, and osteoporosis. The possible role of Brivaracetam in the development of osteoporosis and bone weakness is not known.

Vitamin D levels and possibly bone density should be monitored to determine proper ways to prevent bone loss in people taking seizure medicines.

Who should not take Brivaracetam?

Do not take brivaracetam  if  your are allergic to this medicine or to any of its inactive ingredients (see packet insert for listing).

How does the body digest Brivaracetam?

After medicine is swallowed, it must be absorbed into the blood so it can move throughout the body. The process of absorbing medicine or food, digesting it, and getting rid of from the body is called metabolism.

The way the body metabolizes a certain medicine affects how often it must be taken. It also determines whether the medication will interact with other medications or be affected by other medical conditions [1] such as liver or kidney.

Brivaracetam is primarily eliminated or broken down by the liver.

How well does the Brivaracetam work?

All seizure medications may not work for everyone, and the best drug for you will depend on many factors. Your doctor may try a series of seizure medications or combinations of medications to find the right therapy for you.

What else is Brivaracetam used for?

Currently there are no other known uses for briveracetam beyond seizure control.

Can Brivaracetam be taken with other medicines?

Brivaracetam does not seem to interact with other medications, but studies noted decreased effectiveness of brivaracetam when it was combined with levetiracetam.

What are the effects of Brivaracetam on Children?

It is not known if brivatracetam is safe and effective in children under 16 year’s old.

If a woman takes Brivaracetam during pregnancy will it hurt the baby?

This is not yet known. This drug is labeled by the FDA as a Category C drug. This means that brivatracetam should be used during pregnancy only if the potential benefit justifies the potential risk to the baby.

Pregnancy: Studies in animals show possible harmful effects to the developing fetus, but this needs to be studied more  in humans as more women use the drug. Tell your healthcare provider right away if you become pregnant while taking brivaracetam  You and your health care provider will have to decide if you should take brevitracetam while you are pregnant.  If you were taking brivaracetam while pregnant, consider enrolling in the North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling 1-888-233-2334 (www.aedpregnancyregistry.org).

Breastfeeding: Animal studies show that brivaracetam can be found in breastmilk. It is not known if brivaracetam is excreted in human milk, however. Because no information is available on use of brivaracetam during breastfeeding, a different  drug may be preferred. If the mother takes brivaracetam while breastfeeding,  the infant should be be monitored closely by a health care provider. 

What are the effects of Brivaracetam on Seniors

Brivaracetam has been studied in seniors and no concerns have been reported yet. 

What are the dose ranges for Brivaracetam?

The recommended starting dose is 50mg twice a day.  Depending on how well the medicine is tolerated the dose ican be lowered to 25mg twice a day or increased to 200mg twice a day as needed. 

Special Concerns for Brivaracetam

This is not yet known.