Briviact (Brivaracetam) - Oral

What Is Briviact?

Briviact (brivaracetam) is an antiepilepsy medication used to prevent seizures classified as partial-onset. Partial-onset seizures affect the nerve cells in one part of the brain. 

Brivaracetam is a derivative of a class of drugs called racetams. It has a strong tendency to bind to the synaptic vesicle protein 2A (SV2A) in the brain’s nerve cells, which may help it prevent seizures by modifying nerve signals. SV2A is a membrane protein that regulates nerve and neurotransmitter activity to prevent the excess electrical activity of seizures. 

This medication is available in oral form as a solution or tablet and in an intravenous (IV, in a vein) injection formulation. This article will focus on the oral form of Briviact.

Drug Facts

Generic Name: Brivaracetam

Brand Name: Briviact

Drug Availability: Prescription

Administration Route(s): Oral

Therapeutic Classification: Anticonvulsant

Available Generically: No

Controlled Substance: Schedule V

Active Ingredient: Brivaracetam

Dosage Form(s): Tablet, solution

What Is Briviact Used For?

The Food and Drug Administration approved (Briviact) as both monotherapy and adjunctive (add-on) therapy for preventing partial-onset seizures, with or without secondary generalization. It is approved for adults and children aged 1 month and older.

Adjunctive seizure therapy is an add-on antiseizure medication used along with another antiseizure medication. 

Partial onset seizures are seizures that begin in one area of the brain. They can cause various symptoms, depending on which areas of the brain are affected. They can sometimes secondary generalize, affecting both sides of the brain and causing impaired consciousness, often with involuntary movements of both sides of the body. These seizures rarely last more than a few minutes. 

Briviact is considered a Schedule V controlled substance. Drugs and other substances that are considered controlled substances are split into five categories called schedules. Schedule V controlled substances have a lower risk of abuse than substances listed in the other schedules.

Briviact (Briavaracetam) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Briviact

This medication is prescribed to be taken every day, usually on a twice-a-day schedule. You can take the tablet or liquid forms of Briviact with or without food or drink. 

If you use the tablet form, try to swallow it whole without cutting or crushing it. For optimal epilepsy control, it’s important to time your dose regularly to maintain a consistent drug level in your body. 

You might be given Briviact in IV form under certain circumstances, such as during hospitalization for an illness or if you can’t take the medication by mouth.

Storage

Store Briviact in its original container at 77 degrees Fahrenheit. You can take it out for brief trips at temperatures between 59 degrees and 86 degrees. Do not freeze the Briviact oral solution.

Be sure to keep your medication out of the reach of children or pets. Discard any unused Briviact oral solution five months after the bottle is opened.

Off-Label Uses

Healthcare providers sometimes prescribe Briviact off-label, meaning for uses not approved by the FDA. 

Off-label uses for Briviact include:

  • Treatment of refractory epilepsy (epilepsy that does not improve with standard epilepsy medication)
  • Lennox-Gastaut syndrome (a developmental disorder that causes cognitive problems and epilepsy)
  • Status epilepticus (a prolonged seizure that does not stop on its own)

Your healthcare provider will educate you on the off-label use of Briviact. You might have a prescribed dose different from the standard amount for off-label use. 

However, you can expect to have the same side effect risks when taking Briviact off-label as when taking it for the approved indications. Let your healthcare provider know if you have any questions or concerns.

What Are the Side Effects of Briviact?

Briviact can cause mild or tolerable side effects and potentially severe adverse effects. It’s important to familiarize yourself with the potential side effects.

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at .fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects of Briviact are:

  • Sleepiness 
  • Dizziness 
  • Fatigue 
  • Nausea 
  • Vomiting 

Let your healthcare provider know if you experience any of these side effects. Getting treatment for the side effects can make them more manageable. Your provider might recommend you time your medication doses to minimize the side effects (e.g., taking your dose with a meal to prevent nausea).

Severe Side Effects

Briviact can cause harmful side effects. It isn’t possible to predict whether you will have serious side effects. Sometimes, the severe effects will begin soon after you start taking this medication, or they can begin after taking it for months or longer.  


Severe side effects of Briviact are:

  • Suicidal thoughts or behavior 
  • Psychotic symptoms
  • Bronchospasm (sudden narrowing of your airway)
  • Angioedema (swelling of the face, mouth, or body)

These effects can be dangerous and life-threatening. Get medical attention right away if you or someone else develops these symptoms.

Long-Term Side Effects

The effects of Briviact should wear off within several days after you stop taking it. However, severe side effects can have lasting consequences and potentially cause serious harm to your health.

Report Side Effects

Briviact may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Briviact Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (solution or tablets):
    • For partial onset seizures:
      • Adults and children 16 years of age and older—At first, 50 milligrams (mg) 2 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 100 mg 2 times a day.
      • Children 1 month to less than 16 years of age—Dose is based on body weight and must be determined by your doctor:
        • Weighing 50 kilograms (kg) or more—At first, 25 to 50 mg 2 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 100 mg 2 times a day.
        • Weighing 20 kg to less than 50 kg—At first, 0.5 to 1 milligram per kilogram (mg/kg) of body weight 2 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 2 mg/kg 2 times a day.
        • Weighing 11 kg to less than 20 kg—At first, 0.5 to 1.25 mg/kg of body weight 2 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 2.5 mg/kg 2 times a day.
        • Weighing less than 11 kg—At first, 0.75 to 1.5 mg/kg of body weight 2 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 3 mg/kg 2 times a day.
      • Children younger than 1 month of age—Use and dose must be determined by your doctor.

Modifications

In some cases, your healthcare provider may choose to modify your treatment. You may require a dose adjustment if you have any level of liver impairment or if you are taking the medication rifampin.

There is not enough data on the risks of using Briviact during pregnancy or breastfeeding. Talk to your healthcare provider if you are pregnant or plan to become pregnant while taking this medication. 

If you are taking antiepileptic drugs during pregnancy, your healthcare provider may recommend that you enroll in pregnancy registries to monitor outcomes.

Missed Dose

 If you miss one of your doses, try to take it as soon as you can. However, skip the missed dose if it’s almost time for your next dose and continue with your regular dosing schedule. Do not double up on doses to make up for it.

Overdose: What Happens If I Take Too Much Briviact?

Taking too much Briviact can be dangerous to your health. The adverse effects of taking too much of this medication can develop within a few hours.

The effects of Briviact overdose can include:

  • Dizziness 
  • Balance problems 
  • Fatigue 
  • Nausea 
  • Double vision 
  • Anxiety 
  • Slow heart rate 

There is no treatment to reverse the effects of Briviact. If you take too much, contact your healthcare provider. You may need to be monitored for your heart rate, oxygen levels, and breathing. Treatment may be necessary for overdose symptoms.

What Happens If I Overdose on Briviact?

If you think you or someone else may have overdosed on Briviact, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Briviact, call 911 immediately.

Precautions

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It is very important that your doctor check your or your child's progress at regular visits, especially for the first few months you are taking this medicine to allow for a change in the dose and to check for any unwanted effects.

Brivaracetam may cause changes in mood or behavior, problems with coordination, or unusual tiredness or weakness. Tell your doctor right away if you start to feel depressed, anxious, angry, getting upset easily, restless, or have thoughts about hurting yourself. Report any unusual thoughts or behavior that trouble you, especially if they are new or getting worse quickly.

This medicine may make you dizzy, drowsy, tired, or less alert than you are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause serious allergic reactions, including bronchospasm and angioedema. Tell your doctor if you have difficulty in breathing or swallowing, a fever, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals, nausea, reddening of the skin, especially around the ears, swelling of the eyes, face, or inside of the nose, or unusual tiredness or weakness.

Do not stop using brivaracetam without first checking with your doctor. Stopping the medicine suddenly may cause your seizures to return or to occur more often. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Briviact?

Your healthcare provider may not prescribe you this medication if you have a hypersensitivity to Briviact or any of the inactive ingredients in Briviact.

What Other Medications Interact With Briviact?

Briviact may interact with the following, requiring careful monitoring and dose adjustments: 

Taking Briviact with Keppra (levetiracetam) can increase the risk of harmful side effects. It is not recommended to take these medications together.

What Medications Are Similar?

There are over 20 available antiseizure medications. 

Keppra is similar to Briviact. Like Briviact, it binds to the SV2A. However, Briviact has a 15- to 20-fold higher affinity for binding to this protein.

Briviact is an analogue of Keppra (levetiracetam). Like Briviact, levetiracetam binds to the SV2A protein. However, Briviact has a 15- to 30-fold higher affinity for this protein than levetiracetam.

Other antiepilepsy drugs that are approved as add-on therapies include: 

Frequently Asked Questions

  • What is Briviact used for?

    Briziact is an antiseizure medication used as an add-on treatment to prevent partial-onset seizures in epilepsy.

  • How does Briviact work?

    Briviact binds to a protein on the nerves in the brain to stabilize their activity. This action may play a role in its antiseizure effects.

  • What drugs should not be taken with Briviact?

    You should not take Briviact with Keppra (levetiracetam). You may need dosing adjustments if you take Briviact with phenytoin, carbamazepine, or rifampin.

  • How long does it take for Briviact to work?

    Oral forms of Briviact start to take effect within the first day of use.

  • What are the side effects of Briviact?

    Common side effects include sleepiness, fatigue, irritability, nausea, vomiting, and dizziness. Less commonly, Briviact can cause severe side effects of suicidal thoughts or actions, psychosis, severe breathing problems, and angioedema.

  • How do I stop taking Briviact?

    You should only stop taking this medication under the direction of your healthcare provider. They may give you a schedule to gradually taper it (reduce the dose), or you might need another antiseizure prescription to replace Briviact. Suddenly stopping Briviact can cause you to have a seizure.

How Can I Stay Healthy While Taking Briviact?

When taking Briviact, you must use it as directed and monitor yourself for early signs of side effects. Additionally, avoid any activities that could cause you to have seizures. 

Common seizure triggers include

  • Alcohol intake
  • Lack of sleep
  • Flashing lights
  • Stress
  • Skipping meals

Be aware of the potential side effects of Briviact and your other antiseizure medication, and talk to your healthcare provider about any mild or moderate side effects. You can also create an action plan with your healthcare provider in the event you develop severe side effects or have a seizure. Discuss the safety of driving or operating machinery with your healthcare provider. 

Tell your healthcare provider about any new medical conditions and all over-the-counter or prescription medications, supplements, or herbs that you take.

Medical Explainer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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