Brivaracetam

Pronunciation: briv-are-a-see-tam
Generic name: brivaracetam
Brand name: Briviact
Dosage form: oral tablet, oral solution, injection for intravenous use
Drug class: Pyrrolidine anticonvulsants

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 9, 2024.

What is brivaracetam?

Brivaracetam (brand name Briviact) is an anti-epileptic drug (also called an anticonvulsant) that may be used to treat partial onset seizures in adults and children 1 month and older with epilepsy.

• Brivaracetam is often used along with other seizure medicines to give better control over seizures.

Brivaracetam works in the brain to help control seizures and is thought to target a specific protein called SV2A that helps nerve cells communicate with each other. By attaching to this protein, brivaracetam helps balance the brain's electrical activity and this mechanism can stop the sudden bursts of electrical activity that cause seizures.

Brivaracetam gained FDA approval on February 18, 2016, under the brand name Briviact. There is currently no brivaracetam generic available; brivaracetam is only available as Briviact.

Is brivaracetam a controlled substance?

Brivaracetam (brand name Briviact) is a federally controlled substance (Schedule V) because it can be abused or lead to dependence.

Keep brivaracetam in a safe place to prevent misuse and abuse. Selling or giving away brivaracetam may harm others and is against the law.

Brivaracetam side effects

The most common side effects of brivaracetam are:

• sleepiness
• dizziness
• feeling tired
• nausea and vomiting.

Side effects of brivaracetam in children 1 month to less than 16 years of age are similar to those seen in adults.

Serious side effects and warnings

Brivaracetam may cause the following serious side effects.

Suicidal thoughts and behaviors. Like other antiepileptic drugs, brivaracetam may cause suicidal thoughts or actions in a very small number of people; about 1 in 500 people taking it. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

• thoughts about suicide or dying
• new or worse depression
• feeling agitated or restless
• trouble sleeping (insomnia)
• acting aggressive, feeling angry, or being violent
• an extreme increase in activity and talking (mania)
• attempts to commit suicide
• new or worse anxiety
• panic attacks
• new or worse irritability
• acting on dangerous impulses
• other unusual changes in behavior or mood.

Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes. Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop brivaracetam without first talking to a healthcare provider. Stopping brivaracetam suddenly can cause seizures that will not stop (status epilepticus).

Nervous system problems. Drowsiness, tiredness, and dizziness are common with brivaracetam but can be severe. Do not drive or operate machinery until you know how brivaracetam affects you. brivaracetam can also cause problems with balance and coordination.

Mental (psychiatric) symptoms. 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. People who take brivaracetam can 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.

Get emergency medical help if you have signs of an allergic reaction to brivaracetam: hives; difficulty breathing; or swelling of your face, lips, tongue, or throat.

These are not all the possible side effects of brivaracetam. For more information, ask your healthcare provider or pharmacist. Tell your healthcare provider about any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. 

Before taking this medicine

You should not use brivaracetam if you are allergic to brivaracetam, brivaracetam, or any of the inactive ingredients in the formulation you are taking/receiving.

Before taking brivaracetam, tell your healthcare provider about all of your medical conditions, including if you:

• have or 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.

Brivaracetam is not approved for use by anyone younger than 1 month of age.

Pregnancy

It is not known if brivaracetam will harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking brivaracetam. You and your healthcare provider will have to decide if you should take brivaracetam while you are pregnant. Follow your doctor's instructions about taking seizure medication if you are pregnant. Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking this medicine without your doctor's advice, and tell your doctor right away if you become pregnant.

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

Breastfeeding

Brivaracetam passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take brivaracetam.

How should I take brivaracetam?

Take brivaracetam exactly as prescribed by your doctor. Your healthcare provider will tell you how much brivaracetam to take and when to take it. Your healthcare provider may change your dose if needed. Do not change your dose without talking to your healthcare provider.

• Brivaracetam is usually taken/given 2 times a day.

Take brivaracetam oral tablets or oral solution with or without food.

• Swallow brivaracetam tablets whole with a liquid and do not chew or crush the tablets before swallowing.
• Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Brivaracetam injection is given as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth.

Brivaracetam may be habit-forming and is a federally controlled substance (Schedule V). Misuse can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Do not stop using brivaracetam suddenly, even if you feel fine. Stopping suddenly may cause serious medical problems or increased seizures. Follow your doctor's instructions about tapering your dose.

Brivaracetam dosing information

Brivaracetam tablets, oral solutions, and injections can be used interchangeably.

Usual Brivaracetam Adult Dose for Epilepsy

Initial oral dose: brivaracetam 50 mg orally 2 times a day

• Adjust the dose up or down based on individual patient tolerability and response.
• Maintenance dose: 25 mg to 100 mg orally twice a day based on clinical response and tolerability
• Maximum dose: 200 mg/day

IV Administration: brivaracetam 50 mg by IV injection over 2 to 15 minutes twice a day.

• May be used when oral administration is temporarily not feasible.
• Administer at the same dose and frequency as oral formulations.
• Experience with IV injection is limited to 4 consecutive days of treatment.

Usual Brivaracetam Child Dose for Epilepsy

Brivaracetam doses are based on weight in children. Your child's dose needs may change if the child gains or loses weight.

1 month to 16 years

Weight: Less than 11 kg: Initial dose: brivaracetam 0.75 to 1.5 mg/kg orally twice a day; Maintenance dose: 0.75 to 3 mg/kg orally twice a day
Weight: 11 kg to less than 20 kg: Initial dose: brivaracetam 0.5 to 1.25 mg/kg orally twice a day; Maintenance dose: 0.5 to 2.5 mg/kg orally twice a day
Weight: 20 kg to less than 50 kg: Initial dose: brivaracetam 0.5 to 1 mg/kg orally twice a day; Maintenance dose: 0.5 to 2 mg/kg orally twice a day
Weight: 50 kg or greater: Initial dose: brivaracetam 25 to 50 mg orally twice a day; Maintenance dose: 25 to 100 mg orally twice a day

16 years of age and older

Initial dose: brivaracetam 50 mg orally 2 times a day.
Maintenance dose: 25 mg to 100 mg orally twice a day.

IV Administration may be used in patients 16 years or older when oral administration is temporarily not feasible.

• Administer at the same dose and frequency as oral formulations.
• Experience with the IV injection is limited to 4 consecutive days of treatment.

Related/similar drugs

gabapentin, clonazepam, lamotrigine, pregabalin, lorazepam, diazepam, topiramate

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I take too much brivaracetam?

If you take too much brivaracetam call your Poison Control Center or go to the nearest emergency room right away.

What to avoid

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

What other drugs will affect brivaracetam?

Other drugs may interact with brivaracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your other medicines. Especially tell your healthcare provider if you take:

• Rifampin -- the dosage of brivaracetam may need to be increased
• Carbamazepine -- the dosage of carbamazepine may need to be reduced
• Phenytoin -- the dosage of phenytoin may need to be reduced.

Levetiracetam -- brivaracetam had no added therapeutic benefit when coadministered with levetiracetam.

When you start or stop taking brivaracetam, your doctor may need to adjust the doses of any other medicines you take regularly.

Not all possible drug interactions are listed here. See the brivaracetam Prescribing Information for a full list of interactions. 

Storage

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. Throw away unused liquid after 5 months.

Brivaracetam ingredients

The following information applies to the Briviact branded formulations of brivaracetam.

Active ingredient: brivaracetam

Brivaracetam tablet inactive ingredients: croscarmellose sodium, lactose monohydrate, betadex (β-cyclodextrin), anhydrous lactose, and magnesium stearate.

The tablet film coating contains the inactive ingredients listed below:

• 10 mg tablets: polyvinyl alcohol, talc, polyethylene glycol 3350, titanium dioxide
• 25 mg and 100 mg tablets: polyvinyl alcohol, talc, polyethylene glycol 3350, titanium dioxide, yellow iron oxide, black iron oxide
• 50 mg tablets: polyvinyl alcohol, talc, polyethylene glycol 3350, titanium dioxide, yellow iron oxide, red iron oxide
• 75 mg tablets: polyvinyl alcohol, talc, polyethylene glycol 3350, titanium dioxide, yellow iron oxide, red iron oxide, black iron oxide. 

Brivaracetam oral solution inactive ingredients: sodium citrate, anhydrous citric acid, methylparaben, sodium
carboxymethylcellulose, sucralose, sorbitol solution, glycerin, raspberry flavor, and purified water.

Brivaracetam injection inactive ingredients: sodium acetate, trihydrate (1.64 mg/mL), glacial acetic acid (for pH adjustment to 5.5), sodium chloride (9.00 mg/mL), and water for injection.

Who makes brivaracetam?

UCB makes brivaracetam under the brand name Briviact

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer