A review of the drug−drug interactions of the antiepileptic drug brivaracetam
Autor: | Cédric Laloyaux, Brian D. Moseley, Jean-Marie Nicolas, Hugues Chanteux, Barry E. Gidal, Armel Stockis |
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Rok vydání: | 2020 |
Předmět: |
0301 basic medicine
Drug Phenytoin media_common.quotation_subject Brivaracetam Pharmacology 03 medical and health sciences 0302 clinical medicine Pharmacokinetics Seizures medicine Humans Drug Interactions SV2A media_common business.industry Brain Carbamazepine Pyrrolidinones 030104 developmental biology Neurology Tolerability Anticonvulsants Neurology (clinical) business 030217 neurology & neurosurgery Primidone medicine.drug |
Zdroj: | Epilepsy Research. 163:106327 |
ISSN: | 0920-1211 |
DOI: | 10.1016/j.eplepsyres.2020.106327 |
Popis: | Brivaracetam is an antiepileptic drug (AED) indicated for the treatment of focal seizures, with improved safety and tolerability vs first-generation AEDs. Brivaracetam binds with high affinity to synaptic vesicle protein 2A in the brain, which confers its antiseizure activity. Brivaracetam is rapidly absorbed and extensively biotransformed, and exhibits linear and dose-proportional pharmacokinetics at therapeutic doses. Brivaracetam does not interact with most metabolizing enzymes and drug transporters, and therefore does not interfere with drugs that use these metabolic routes. The favorable pharmacokinetic profile of brivaracetam and lack of clinically relevant drug-drug interactions with commonly prescribed AEDs or oral contraceptives allows administration without dose adjustment, and avoids potential untoward events from decreased efficacy of an AED or oral contraceptive due to a drug-drug interaction. Few agents have been reported to affect the pharmacokinetics of brivaracetam. The strong enzyme-inducing AEDs carbamazepine, phenytoin and phenobarbital/primidone have been shown to moderately lower brivaracetam plasma concentrations, with no adjustment of brivaracetam dose needed. Dose adjustment should be considered when brivaracetam is coadministered with the more potent CYP inducer, rifampin. Additionally, caution should be used when adding or ending treatment with the strong enzyme inducer, St. John's wort. In summary, brivaracetam (50-200 mg/day) has a favorable pharmacokinetic profile and is associated with few clinically relevant drug-drug interactions. |
Databáze: | OpenAIRE |
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