Home Drug Guide Brivaracetam

Drug Guide

Generic Name

Brivaracetam

Brand Names Briviact

Classification

Therapeutic: Anticonvulsant/Antiepileptic

Pharmacological: Selective SV2A protein ligand

FDA Approved Indications

  • Partial-onset seizures in patients 16 years of age and older

Mechanism of Action

Brivaracetam binds selectively to synaptic vesicle protein 2A (SV2A), modulating neurotransmitter release and reducing neuronal excitability, thus preventing seizures.

Dosage and Administration

Adult: Start with 50 mg twice daily; titrate gradually to a target dose of 100 mg twice daily based on response and tolerability.

Pediatric: Not approved for pediatric use; consult latest guidelines for off-label considerations.

Geriatric: Adjust dose based on renal function; start at lower end of dosing range.

Renal Impairment: Reduce dose or extend dosing interval in patients with moderate to severe impairment.

Hepatic Impairment: Use with caution; no specific adjustment recommended in mild hepatic impairment.

Pharmacokinetics

Absorption: Rapid, complete absorption after oral administration.

Distribution: Widely distributed; approximately 20% protein bound.

Metabolism: Primarily metabolized via hydrolysis and minor oxidative metabolism; extensive phase I and phase II metabolism.

Excretion: Excreted mainly in urine as metabolites; minimal unchanged drug.

Half Life: Approximately 9 hours.

Contraindications

  • Hypersensitivity to brivaracetam or any component of the formulation.

Precautions

  • Use cautiously in patients with psychiatric history; potential for mood changes and behavioral abnormalities.

Adverse Reactions - Common

  • Dizziness (>10%)
  • Somnolence (>10%)
  • Fatigue (>10%)

Adverse Reactions - Serious

  • Suicidal thoughts or behavior (Less common)
  • Allergic reactions including rash, angioedema (Rare)

Drug-Drug Interactions

  • Other CNS depressants (additive sedation)
  • Medicines that alter hepatic enzyme activity (may affect brivaracetam levels)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for seizure control, behavioral changes, and adverse reactions.

Diagnoses:

  • Risk for injury due to dizziness or somnolence
  • Risk for mood disturbance or behavioral changes

Implementation: Administer consistently, monitor renal function, and assess for side effects.

Evaluation: Evaluate seizure frequency and severity, behavioral status, and tolerability.

Patient/Family Teaching

  • Do not stop medication abruptly.
  • Report mood changes or suicidal thoughts.
  • Avoid alcohol and CNS depressants unless approved by healthcare provider.

Special Considerations

Black Box Warnings:

  • None specified for brivaracetam.

Genetic Factors: None specifically noted.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Dizziness, somnolence, sedation, agitation, ataxia, nystagmus.

Treatment: Supportive care, stabilization of airway, breathing, and circulation; activated charcoal if within appropriate time window; hemodialysis in severe cases.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable up to the expiration date when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.