Brivaracetam
Mechanism :
Brivaracetam displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the antiepileptic effect.
Indication :
- Partial-onset seizures: Treatment of partial-onset seizures in patients with epilepsy as monotherapy or adjunctive therapy.
Contraindications :
Hypersensitivity to brivaracetam or any component of the formulation.
Dosing :
Children ≥4 years and Adolescents <16 years:
Oral:
11 to <20 kg:
Initial: 0.5 to 1.25 mg/kg twice daily; may increase up to a maximum of 2.5 mg/kg twice daily based on individual patient response and tolerability.
20 to <50 kg:
Initial: 0.5 to 1 mg/kg twice daily; may increase up to a maximum of 2 mg/kg twice daily based on individual patient response and tolerability.
≥50 kg:
Initial: 25 to 50 mg twice daily; may increase up to a maximum of 100 mg twice daily based on individual patient response and tolerability.
Adverse Effect :
Drowsiness, fatigue, hypersomnia, lethargy, abnormal gait, ataxia, dizziness, psychiatric disturbance, asthenia, nystagmus, decreased WBC, nausea, vomiting, infusion site pain.
Interaction :
CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants.
CYP2C19 Inducers: May increase the metabolism of CYP2C19 Substrates.
Levetiracetam: May diminish the therapeutic effect of Brivaracetam.
Orlistat: May decrease the serum concentration of Anticonvulsants.
Opioid Analgesics: CNS Depressants may enhance the CNS depressant effect of Opioid Analgesics.
Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the adverse/toxic effect of Selective Serotonin Reuptake Inhibitors.
Hepatic Dose :
Baseline hepatic impairment:
Children 4 years and above weighing > 50 kg: Start with 25 mg PO twice daily. Increase to maximum 75 mg PO twice daily (150 mg/day).
Children 4 to 15 years: Start with 0.5 mg/kg/dose PO twice daily. Increase to maximum 1.5 mg/kg/dose PO twice daily in children weighing 20 to 49 kg and upto 2 mg/kg/dose PO twice daily in children weighing 11 to 19 kg.