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Briviact

Pronunciation: briv-ee-akt
Generic name: brivaracetam
Dosage form: oral tablet, oral solution, injection for intravenous use
Drug class: Pyrrolidine anticonvulsants

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 9, 2024.

What is Briviact?

Briviact (brivaracetam) is an anti-epileptic drug (also called an anticonvulsant) that may be used to treat partial onset seizures in adults and children 1 month and older with epilepsy.

Briviact works in the brain to help control seizures and is thought to target a specific protein called SV2A that helps nerve cells communicate with each other. By attaching to this protein, Briviact helps balance the brain's electrical activity and this mechanism can stop the sudden bursts of electricity that cause seizures.

Briviact gained FDA approval on February 18, 2016. There is currently no Briviact generic available.

Is Briviact a controlled substance?

Briviact is a federally controlled substance (Schedule V) because it can be abused or lead to dependence.

Keep Briviact in a safe place to prevent misuse and abuse. Selling or giving away Briviact may harm others and is against the law. 

Briviact side effects

The most common side effects of Briviact are:

Side effects of Briviact in children 1 month to less than 16 years of age are similar to those seen in adults.

Serious side effects and warnings

Briviact may cause the following serious side effects.

Suicidal thoughts and behaviors. Like other antiepileptic drugs, Briviact may cause suicidal thoughts or actions in a very small number of people; about 1 in 500 people taking it. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:

Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes. Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.

Do not stop Briviact without first talking to a healthcare provider. Stopping Briviact suddenly can cause seizures that will not stop (status epilepticus). 

Nervous system problems. Drowsiness, tiredness, and dizziness are common with Briviact but can be severe. Do not drive or operate machinery until you know how Briviact affects you. Briviact can also cause problems with balance and coordination.

Mental (psychiatric) symptoms. Briviact can cause mood and behavior changes such as aggression, agitation, anger, anxiety, apathy, mood swings, depression, hostility, and irritability. Irritability and anxiety are common with Briviact and can be severe. People who take Briviact can also get psychotic symptoms such as hallucinations (seeing or hearing things that are not there), delusions (false or strange thoughts or beliefs), and unusual behavior.

Get emergency medical help if you have signs of an allergic reaction to Briviact: hives; difficulty breathing; or swelling of your face, lips, tongue, or throat.

These are not all the possible side effects of Briviact. For more information, ask your healthcare provider or
pharmacist. Tell your healthcare provider about any side effect that bothers you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. 

Before taking this medicine

You should not use Briviact if you are allergic to brivaracetam, Briviact, or any of the inactive ingredients in the formulation you are taking/receiving.

Before taking Briviact, tell your healthcare provider about all of your medical conditions, including if you:

Briviact is not approved for use by anyone younger than 1 month of age.

Pregnancy

It is not known if Briviact will harm your unborn baby. Tell your healthcare provider right away if you become pregnant while taking Briviact. You and your healthcare provider will have to decide if you should take Briviact while you are pregnant. Follow your doctor's instructions about taking seizure medication if you are pregnant. Seizure control is very important during pregnancy, and having a seizure could harm both mother and baby. Do not start or stop taking this medicine without your doctor's advice, and tell your doctor right away if you become pregnant.

If you do become pregnant while taking Briviact, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of Briviact and other antiepileptic medicines during pregnancy.

Breastfeeding

Briviact passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take Briviact.

How should I take Briviact?

Take Briviact exactly as prescribed by your doctor. Your healthcare provider will tell you how much Briviact to take and when to take it. Your healthcare provider may change your dose if needed. Do not change your dose without talking to your healthcare provider.

Take Briviact oral tablets or oral solution with or without food.

Briviact injection is given as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth.

Briviact may be habit-forming and is a federally controlled substance (Schedule V). Misuse can cause addiction, overdose, or death. Selling or giving away this medicine is against the law.

Do not stop using Briviact suddenly, even if you feel fine. Stopping suddenly may cause serious medical problems or increased seizures. Follow your doctor's instructions about tapering your dose.

Briviact dosing information

Usual Briviact Adult Dose for Epilepsy

Initial oral dose: Briviact 50 mg orally 2 times a day

Maintenance dose: 25 mg to 100 mg orally twice a day based on clinical response and tolerability

Maximum dose: 200 mg/day

IV Administration: Briviact 50 mg by IV injection over 2 to 15 minutes

Usual Briviact Child Dose for Epilepsy

Briviact doses are based on weight in children. Your child's dose needs may change if the child gains or loses weight.

Briviact ablets, oral solution, and injection can be used interchangeably.

1 month to 16 years

Weight: Less than 11 kg: Initial dose: Briviact 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: Briviact 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: Briviact 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: Briviact 25 to 50 mg orally twice a day; Maintenance dose: 25 to 100 mg orally twice a day

16 years of age and older

Initial dose: Briviact 50 mg orally 2 times a day.
Maintenance dose: 25 mg to 100 mg orally twice a day.

IV Administration may be used in patients 16 years or older when oral administration is temporarily not feasible.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I take too much Briviact?

If you take too much Briviact call your Poison Control Center or go to the nearest emergency room right away. 

What to avoid

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

What other drugs will affect Briviact?

Other drugs may interact with brivaracetam, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your other medicines. Especially tell your healthcare provider if you take:

Levetiracetam -- Briviact had no added therapeutic benefit when coadministered with levetiracetam.

When you start or stop taking Briviact, your doctor may need to adjust the doses of any other medicines you take regularly.

Not all possible drug interactions are listed here. See the Briviact Prescribing Information for a full list of interactions. 

Storage

Store at room temperature away from moisture and heat. Do not allow the liquid medicine to freeze. Throw away unused liquid after 5 months.

Briviact ingredients

Active ingredient: brivaracetam

Tablet inactive ingredients: croscarmellose sodium, lactose monohydrate, betadex (β-cyclodextrin), anhydrous lactose, and magnesium stearate.

Tablet film coating contains the inactive ingredients listed below:

Oral solution inactive ingredients: sodium citrate, anhydrous citric acid, methylparaben, sodium
carboxymethylcellulose, sucralose, sorbitol solution, glycerin, raspberry flavor, and purified water.

Injection inactive ingredients: sodium acetate, trihydrate (1.64 mg/mL), glacial acetic acid (for pH adjustment to 5.5), sodium chloride (9.00 mg/mL), and water for injection.

Who makes Briviact?

UCB makes Briviact.

Popular FAQ

Is Briviact a controlled substance?

Yes, Briviact contains brivaracetam and is listed by the DEA as a Schedule V controlled substance, which means it has a low potential for abuse compared to other controlled substances. According to the manufacturer, there is no evidence of any physical dependence or withdrawal syndrome with Briviact based on clinical studies. You should avoid driving or operating machinery until you know how this medicine will affect you as it can cause drowsiness or dizziness.

Can I drink alcohol while taking Briviact?

It is not recommended to drink alcohol while you are taking Briviact because Briviact can increase the negative effects of alcohol such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people may also find it difficult to make good decisions or find their physical coordination is impaired. Avoid or limit the use of alcohol to one small drink while you are taking Briviact.

Will Briviact cause memory loss?

There is no evidence that Briviact will cause memory loss and in fact, research to date has shown very favorable effects of Briviact on cognition and behavior. One study showed a significant improvement in attention and executive functioning (this is a set of mental skills that include working memory, flexible thinking, and self-control) and self-reported improvements in concentration and comprehension in 43 patients with epilepsy that were followed for 25 weeks. There were no changes in reaction times, verbal memory, mood, and aggression scores.

Is Briviact a seizure medication?

Yes. Briviact (brivaracetam) is an oral or injected prescription medicine used alone or with other seizure medicines to treat partial onset (focal) seizures in patients one month of age and older. Briviact seizure medicine is thought to work by reducing the frequency of partial-onset seizures by binding to synaptic vesicle protein 2A (SV2A) in the brain.

Can Briviact cause depression?

Briviact can cause depression and other mood and behavior changes such as aggression, agitation or irritability, anger, anxiety, mood swings or a lack in interest in life. Like other antiepileptic medications Briviact can increase the risk of suicidal thoughts or behaviors. If you are taking Briviact and you or others notice you seem depressed, anxious, or more irritable than usual, talk to your doctor.

Does Briviact cause weight loss?

Briviact has not been reported to cause weight loss in clinical studies. Other seizures medicines, such as felbamate, topiramate, and zonisamide can lead to weight loss. Briviact may cause nausea or vomiting which may reduce your appetite. Briviact is approved to be used alone or with other seizure medicines by FDA for the treatment of partial-onset (focal) seizures in patients 1 month of age and older. Contact your doctor if you have concerns about weight loss with Briviact.

What is the difference between Briviact and Keppra?

Briviact (brivaracetam) and Keppra (levetiracetam) are anticonvulsant medicines that target the synaptic vesicle protein 2A (SV2A) in the brain. The newer agent Briviact is noted to be more selective and has a higher affinity for this receptor than Keppra. Continue reading

Can Briviact be cut in half or crushed?

No, don’t cut or crush Briviact tablets. According to the manufacturer, Briviact tablets should only be swallowed whole with liquid. If you are having trouble swallowing the tablets, Briviact also comes in an oral solution. Continue reading

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.