Perampanel(per am’ pah nel)
Fycompa
PREGNANCY CATEGORY C
Drug Classes
Antiepileptic
Glutamate receptor antagonist
Therapeutic Actions
Noncompetitive glutamate receptor antagonist; glutamate is a primary excitatory neurotransmitter; precise mechanism of antiepileptic effect is not understood.
Indications
Adjunct treatment of partial-onset seizures with or without secondary generalized seizures in patients 12 yr and older with epilepsy
Contraindications and Cautions
Contraindicated with known allergy to components of drug, severe hepatic or renal impairment, concurrent use of strong CYP3A inducers.
Use cautiously with mild to moderate hepatic impairment, concurrent use of other antiepileptics, pregnancy, lactation.
Available Forms
Tablets—2, 4, 6, 8, 10, 12 mg
Dosages
Adults and children 12 yr and older
Starting dose, 2 mg/day PO at bedtime, 4 mg/day PO at bedtime if also taking other enzyme-inducing antiepileptics. May increase by maximum 2 mg/day at weekly intervals (every 2 wk in elderly patients) to maximum dose of 12 mg/day PO at bedtime.
Patients with mild to moderate hepatic impairment
Maximum daily dose is 6 mg/day PO at bedtime for mild impairment, 4 mg/day PO at bedtime for moderate impairment.
Patients with severe hepatic or renal impairment, patients on dialysis
Not recommended.
Pharmacokinetics
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