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BRIVARACETAM is a brand name for Brivaracetam. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: Brivaracetam is indicated as adjunctive therapy in the treatment of partial onset seizures with or without secondary generalisation in adults, adolescents and children from 2 years of age with epilepsy.
Verbatim from this product's MHRA label. Tap a section to expand.
Posology Brivaracetam solution for injection/infusion is an alternative route of administration for patients when oral administration is temporarily not feasible. There is no experience with twice daily intravenous administration of brivaracetam for a period longer than 4 days.
The recommended posology for adults, adolescents and children from 2 years of age is summarised in the following table. The dose should be administered in two equally divided doses, approximately 12 hours apart. 5 mg/kg/day 1 – 5 mg/kg/day * Based on individual patient response, the dose may be adjusted between this effective dose range.
** Based on physician’s assessment of need for seizure control Adults Brivaracetam may be initiated with either intravenous or oral administration. When converting from oral to intravenous administration or vice versa, the total daily dose and frequency of administration should be maintained.
The recommended starting dose is either 50 mg/day or 100 mg/day based on physician’s assessment of required seizure reduction versus potential side effects. Based on individual patient response and tolerability, the dose may be adjusted in the effective dose range of 50 mg/day to 200 mg/day.
Adolescents and children weighing 50 kg or more The recommended starting dose is 50 mg/day. Brivaracetam may also be initiated at 100 mg/day based on physician’s assessment of need for seizure control. The recommended maintenance dose is 100 mg/day.
Based on individual patient response, the dose may be adjusted in the effective dose range of 50 mg/day to 200 mg/day. Adolescents and children weighing from 20 kg to less than 50 kg The recommended starting dose is 1 mg/kg/day. Brivaracetam may also be initiated at doses up to 2 mg/kg/day based on physician’s assessment of need for seizure control.
The recommended maintenance dose is 2 mg/kg/day. Based on individual patient response, the dose may be adjusted in the effective dose range of 1 mg/kg/day to 4 mg/kg/day. Children weighing from 10 kg to less than 20 kg The recommended starting dose is 1 mg/kg/day.
5 mg/kg/day based on physician’s assessment of need for seizure control. 5 mg/kg/day. Based on individual patient response, the dose may be adjusted in the effective dose range of 1 mg/kg/day to 5 mg/kg/day. Missed doses If patients missed one dose or more, it is recommended that they take a single dose as soon as they remember and take the following dose at the usual morning or evening time.
0 %). They were usually mild to moderate in intensity. Somnolence and fatigue were reported at a higher incidence with increasing dose. 7 % for patients randomized to placebo. 8 %). Tabulated list of adverse reactions In the table below, adverse reactions, which were identified based on review of the three placebo-controlled, fixed-dose studies safety database in subjects ≥ 16 years of age and from post-marketing experience, are listed by System Organ Class and frequency.
The frequencies are defined as follows: very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1,000 to < 1/100) and not known (frequency cannot be estimated from available data). Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
System organ class Frequency Adverse reactions Infections and infestations Common Influenza Blood and lymphatic system disorders Uncommon Neutropenia Immune system disorders Uncommon Type I hypersensitivity Metabolism and nutrition disorders Common Decreased appetite Common Depression, anxiety, insomnia, irritability Psychiatric disorders Uncommon Suicidal ideation, psychotic disorder, aggression, agitation Very common Dizziness, somnolenceNervous system disorders Common Convulsion, vertigo Respiratory, thoracic and mediastinal disorders Common Upper respiratory tract infections, cough Gastrointestinal disorders Common Nausea, vomiting, constipation Skin and subcutaneous tissue disorders Not known Stevens-Johnson syndrome(1) General disorders and administration site conditions Common Fatigue (1) Adverse reactions reported in post marketing experience.
5 % (6/1,099) brivaracetam patients and 0 % (0/459) placebo patients. Four of these subjects had decreased neutrophil counts at baseline, and experienced additional decrease in neutrophil counts after initiation of brivaracetam treatment.
None of the 6 cases of neutropenia were severe, required any specific treatment or led to discontinuation of brivaracetam and none had associated infections. 7 % (3/459) placebo patients. 4). Reactions suggestive of immediate (Type I) hypersensitivity have been reported in a small number of brivaracetam patients (9/3022) during clinical development.
Suicidal ideation and behaviour Suicidal ideation and behaviour have been reported in patients treated with antiepileptic drugs (AEDs), including brivaracetam, in several indications. A metaanalysis of randomized placebo-controlled clinical studies of AEDs has also shown a small increased risk of suicidal ideation and behaviour.
The mechanism of this risk is not known and the available data do not exclude the possibility of an increased risk for brivaracetam. Patients should be monitored for signs of suicidal ideation and behaviours and appropriate treatment should be considered.
Patients (and caregivers of patients) should be advised to seek medical advice should any signs of suicidal ideation or behaviour emerge. 8, paediatric data. Hepatic impairment There are limited clinical data on the use of brivaracetam in patients with pre-existing hepatic impairment.
2). Severe cutaneous adverse reactions (SCARs) Severe cutaneous adverse reactions (SCARs) including Stevens-Johnson syndrome (SJS), which can be life-threatening or fatal, have been reported in association with brivaracetam treatment.
At the time of the prescription patients should be advised of the signs and symptoms and monitored closely for skin reactions. If signs and symptoms suggestive of these reactions appear, brivaracetam should be withdrawn immediately and an alternative treatment should be considered.
1 mg sodium per vial, equivalent to 1 % of the WHO recommended maximum daily intake of 2 g sodium for an adult.
1.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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This may avoid the brivaracetam plasma concentration falling below the efficacy level and prevent breakthrough seizures from occurring. Discontinuation For patients from 16 years of age, if brivaracetam has to be discontinued, it is recommended that the dose is reduced gradually by 50 mg/day on a weekly basis.
For patients below the age of 16 years, if brivaracetam has to be discontinued, it is recommended that the dose is reduced by a maximum of half the dose every week until a dose of 1 mg/kg/day (for patients with a body weight less than 50 kg) or 50 mg/day (for patients with body weight of 50 kg or more) is reached.
After 1 week of treatment at 50 mg/day, a final week of treatment at the dose of 20 mg/day is recommended. 2). The clinical experience in patients ≥ 65 years is limited. 2). Brivaracetam is not recommended in end-stage renal disease patients undergoing dialysis due to lack of data.
Based on data in adults, no dose adjustment is necessary in paediatric patients with impaired renal function. No clinical data are available in paediatric patients with renal impairment. Hepatic impairment Exposure to brivaracetam was increased in adult patients with chronic liver disease.
2). No clinical data are available in paediatric patients with hepatic impairment. Age and body weight Recommended starting dose Recommended maximum daily dose Adolescents and children weighing 50 kg or more, and adults 50 mg/day 150 mg/day Adolescents and children weighing from 20 kg to less than 50 kg 1 mg/kg/day 3 mg/kg/day Children weighing from 10 kg to less than 20 kg 1 mg/kg/day 4 mg/kg/day Paediatric patients less than 2 years of age The efficacy of brivaracetam in paediatric patients aged less than 2 years has not yet been established.
2 but no recommendation on a posology can be made. Method of administration - Intravenous bolus: brivaracetam may be administered as an intravenous bolus without dilution. 6). This medicinal product must not be mixed with other medicinal products.
g. status epilepticus and is therefore not recommended for such conditions.
Adverse reactions with intravenous administration generally appeared to be similar to those observed with oral administration. 8 % of the patients. Paediatric population The safety profile of brivaracetam observed in children from 1 month of age was consistent with the safety profile observed in adults.
1 % of adults. The majority of events were mild or moderate in intensity, were non-serious, and did not lead to discontinuation of study drug. 7 %). No specific pattern of adverse event (AE) was identified in children from 1◦month to < 4◦years of age when compared to older paediatric age groups.
No significant safety information was identified indicating the increasing incidence of a particular AE in this age group. As data available in children younger than 2 years of age is limited, brivaracetam is not indicated in this age range.
Limited clinical data are available in neonates. Elderly Of the 130 elderly subjects enrolled in the brivaracetam phase 2/3 development program (44 with epilepsy), 100 were 65-74 years of age and 30 were 75-84 years of age. The safety profile in elderly patients appears to be similar to that observed in younger adult patients.
Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store