Briviact: Uses, Dosage, How it works, Side Effects, Interactions

What is Briviact?

 Briviact is the brand name for the antiepileptic medication brivaracetam. It is used to treat partial-onset seizures in adults and children who are at least 4 years old. Partial-onset seizures are a type of epileptic seizure that begins in a specific area of the brain.

Brivaracetam works by decreasing abnormal electrical activity in the brain, which can help reduce the frequency and severity of seizures. It is believed to exert its antiepileptic effects through several mechanisms, although the exact way it works is not completely understood. Here are some key aspects of how Briviact is thought to work:

1.        Binding to synaptic vesicle protein 2A (SV2A): Brivaracetam has a high affinity for a protein called synaptic vesicle protein 2A (SV2A), which is found in the nerve cells (neurons) in the brain. SV2A is involved in regulating the release of neurotransmitters, which are the chemicals that allow neurons to communicate with each other. By binding to SV2A, Briviact may modulate neurotransmitter release, reducing excessive excitatory signals in the brain, and ultimately, preventing seizures.

2.        Modulating neuronal excitability: Briviact is thought to influence the excitability of neurons, making them less prone to abnormal, excessive electrical activity that can lead to seizures. This modulation of neuronal excitability can help in reducing the likelihood and severity of seizures.

The exact details of Briviact’s mechanism of action are still an area of ongoing research, and it may interact with various processes within the brain to provide its antiepileptic effects. It’s important to note that the specific way an antiepileptic drug works can vary between individuals, and healthcare professionals consider various factors when prescribing such medications.

Briviact is used to treat partial-onset seizures in people with epilepsy, and while it can be effective for many individuals, it may not be suitable for everyone. The decision to use Briviact or any antiepileptic medication should be made by a qualified healthcare provider who can assess the individual’s specific condition and medical history

Who Can Use Briviact?

Briviact is intended for individuals aged one month and older, but it is not recommended for children under one month. It is important to note that Briviact is a federally controlled substance (CV) due to the potential for misuse and dependence. Users are advised to store it in a secure location to prevent misuse, as selling or giving away Briviact is illegal.

Like some other antiepileptic drugs, Briviact may rarely lead to suicidal thoughts or actions in a small percentage of users (approximately 1 in 500 individuals). If you experience symptoms such as thoughts of suicide, attempts to commit suicide, worsening depression, anxiety, restlessness, panic attacks, insomnia, irritability, aggression, violent behavior, dangerous impulses, extreme hyperactivity, or unusual changes in behavior or mood, it is imperative to contact a healthcare provider immediately. It is essential to avoid discontinuing Briviact without consulting a healthcare provider, as abrupt cessation can lead to serious issues, including seizures that do not stop (status epilepticus).

Who Should Avoid Briviact?

If you are allergic to brivaracetam or any of the ingredients in Briviact, you should not take it. Before starting Briviact, it is crucial to inform your healthcare provider about your medical history, including any past experiences with depression, mood problems, suicidal thoughts or behavior, liver problems, or any history of substance abuse. Additionally, inform your healthcare provider if you are pregnant, planning to become pregnant, breastfeeding, or intending to breastfeed, as the effects of Briviact on unborn babies and breastfeeding infants are not fully understood.

What is the Recommended Dosage for Briviact?

 Your doctor will determine the appropriate dosage of Briviact for your specific needs. Below are commonly prescribed dosages, but it’s crucial to follow the dosage instructions provided by your healthcare professional.

Available Forms and Strengths: Briviact is accessible in tablet and liquid solution forms for oral administration. It is also available as a liquid solution for intravenous (IV) infusion, which is administered at a medical facility through a vein over a period.

•          Briviact oral tablets come in the following strengths:

•          10 milligrams (mg)

•          25 mg

•          50 mg

•          75 mg

•          100 mg

•          Briviact oral liquid solution contains 10 mg of the drug per milliliter (mL) of liquid.

•          Briviact injectable solution contains 50 mg of the drug per 5 mL of liquid.

Your doctor will prescribe the most suitable dosing regimen for you before starting Briviact treatment. Depending on the medication’s effectiveness, they may adjust the dosage up to the maximum if necessary.

The usual pediatric dosing for epilepsy with Briviact is as follows:

For children aged 1 month to 16 years:

•          Weight less than 11 kg:

•          Initial dose: 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: 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: 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: 25 to 50 mg orally twice a day

•          Maintenance dose: 25 to 100 mg orally twice a day

For individuals aged 16 years and older:

•          Initial dose: 50 mg orally twice a day

•          Maintenance dose: 25 mg to 100 mg orally twice a day

Typically, Briviact tablets or liquid solution are taken twice daily. Your doctor might initiate treatment with a specific dosage and then modify it based on your response to the medication.

Briviact injections are generally used on a short-term basis when tablets or liquid solutions cannot be taken. Injections are administered twice daily at the same dosage as the tablets or liquid solution.

Missed Dose: If you forget to take your Briviact dose, take it as soon as you remember. However, if your next dose is due soon, it’s best to skip the missed dose. Never take two doses at once to compensate for a missed one. If you have questions about the timing of your next dose after missing one, consult your doctor or pharmacist.

Long-Term Use: In most cases, Briviact is prescribed for long-term treatment to prevent partial-onset seizures.

Onset of Action: Briviact begins working in your body as soon as you take your first dose, although it may take some time before you notice a reduction in the frequency of your seizures.

Briviact is typically prescribed by a healthcare professional and comes in various forms, including tablets, oral solution, and injection. The specific dosage and administration instructions will vary depending on the individual’s age, weight, and the severity of their condition.

Activities to Avoid While Taking Briviact

Briviact may cause drowsiness, tiredness, dizziness, and affect your balance and coordination. Therefore, it is advisable not to drive or operate heavy machinery until you are aware of how Briviact affects you.

Potential Side Effects

Briviact can cause various side effects, and it’s important to be aware of them. Some of the potential side effects of Briviact include:

Serious Side Effects (Seek Immediate Medical Attention):

1.        Signs of an allergic reaction to Briviact, such as hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

2.        New or worsening symptoms like mood or behavior changes, anxiety, panic attacks, sleep disturbances, impulsivity, irritability, agitation, hostility, aggression, restlessness, hyperactivity (mentally or physically), depression, or thoughts of suicide or self-harm.

3.        Severe dizziness or drowsiness.

4.        Feeling light-headed to the point of almost passing out.

5.        Loss of balance or coordination.

6.        Unusual thoughts or behavior.

7.        Hallucinations (seeing or hearing things that are not real).

Common Side Effects:

1.        Dizziness.

2.        Drowsiness.

3.        Nausea.

4.        Vomiting.

5.        Feeling tired.

It’s essential to report any unusual or severe side effects to your healthcare provider promptly. Everyone’s response to medication can vary, and your doctor can help you manage any side effects or adjust your treatment as needed. This list does not cover all possible side effects, and other reactions may occur. If you experience any unexpected or concerning symptoms while taking Briviact, consult your doctor for medical advice. You can also report side effects to the FDA at 1-800-FDA-1088.

Briviact interactions

Briviact (brivaracetam) can interact with other medications, substances, or medical conditions. It’s important to inform your healthcare provider about all the medications, supplements, and medical conditions you have to avoid potentially harmful interactions. Here are some notable interactions and considerations related to Briviact:

1. Central Nervous System (CNS) Depressants: Briviact can enhance the sedative effects of other CNS depressants, such as alcohol, benzodiazepines, and certain opioids. Combining Briviact with these substances may lead to excessive drowsiness, dizziness, or impaired coordination.

2. Birth Control Pills: Briviact may reduce the effectiveness of hormonal contraceptives (birth control pills). It’s important to use alternative or additional contraceptive methods if you are taking Briviact and rely on hormonal birth control.

3. Antiepileptic Drugs (AEDs): There may be interactions with other antiepileptic drugs. Your doctor will consider these interactions when prescribing Briviact and may adjust the dosage of other AEDs if necessary.

4. CYP2C19 Enzyme Inhibitors and Inducers: Briviact is metabolized by the CYP2C19 enzyme system. Medications that inhibit or induce this enzyme may impact the levels of Briviact in your body, potentially requiring dosage adjustments.

5. Suicidal Thoughts and Antidepressants: Some individuals taking Briviact may experience changes in mood or suicidal thoughts. If you are prescribed antidepressant medications, these mood changes should be closely monitored.

6. Kidney Function: Briviact is primarily eliminated through the kidneys. If you have impaired kidney function, your doctor may need to adjust the dosage to avoid accumulation of the drug in your body.

7. Pregnancy and Breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, it’s essential to discuss the risks and benefits of taking Briviact with your healthcare provider. The medication may affect the developing fetus or be excreted in breast milk.

It is crucial to maintain open communication with your healthcare provider about your medication regimen and any potential interactions or side effects you experience. They can help you make informed decisions and ensure that your treatment is as safe and effective as possible. Never make changes to your medication regimen without consulting a healthcare professional.

Briviact Vs. Keppra

Briviact (brivaracetam) and Keppra (levetiracetam) are both antiepileptic medications used to treat various types of seizures, but they have some differences in terms of their properties, mechanisms of action, and potential side effects. Here’s a comparison of Briviact and Keppra:

Mechanism of ActionBinds to SV2A in neurons, thought to regulate neurotransmitter release and reduce abnormal electrical activitySimilar to Briviact, believed to interact with SV2A and modulate neurotransmitter release
IndicationsTreatment of partial-onset seizures in adults and children (age 4 and older) with epilepsyTreatment of a broader range of seizure types, including partial-onset, myoclonic, and generalized tonic-clonic seizures in adults and children
Dosing FrequencyTypically taken twice dailyCan be prescribed either twice daily or as an extended-release formulation for once-daily dosing
Common Side EffectsDizziness, drowsiness, changes in mood or behaviorDizziness, drowsiness, changes in mood or behavior, somnolence
InteractionsBoth medications can interact with other drugs and substances, potentially affecting their effectiveness or increasing the risk of side effectsBoth medications can interact with other drugs and substances, potentially affecting their effectiveness or increasing the risk of side effects
Safety ProfilesGenerally well-established, but individual responses may varyGenerally well-established, but individual responses may vary
CostCost may differ, and insurance coverage may varyCost may differ, and insurance coverage may vary

The choice between Briviact and Keppra often depends on individual factors such as the type of seizures, treatment response, side effects, dosing frequency, and other medical conditions. Your healthcare provider will consider these factors when recommending one of these medications. It’s important to work closely with your healthcare team to find the most effective and well-tolerated treatment for your specific situation.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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