Clinical Information

Brivaracetam is a newer antiepileptic drug, an analogue of levetiracetam, that is used as therapy for partial onset seizures in patients one month or older. It is available in both an oral and intravenous solution and oral tablet. When taken orally, it is rapidly and completely absorbed. It is primarily excreted through the renal system and has an elimination half-life of approximately nine hours. While the exact mechanism for brivaracetam's anticonvulsive effects is unknown, it has a high and selective binding affinity for synaptic vesicle protein 2A in the brain. The drug has a narrow therapeutic range and a wide interindividual variability in rate of elimination.

Adults and children 16 years and older typically take 25 mg twice daily up to 100 mg twice daily. Trough therapeutic reference ranges in plasma have been reported between 0.5 to 0.9 mcg/mL (mg/L) with toxicity more common above 1.8 mcg/mL. The most common adverse effects include somnolence/sedation, dizziness, fatigue, and nausea/vomiting. Vertigo, balance disorder, fatigue, nausea, diplopia, anxiety, and bradycardia have also been reported following brivaracetam overdose.