What is Perampanel: Uses, Dosage, Side Effects and More

Perampanel is a prescription medication that helps control seizures in people with epilepsy. It's an anticonvulsant drug that works by blocking certain brain signals that can trigger seizures, giving your brain a better chance to maintain its normal electrical activity.

This medication has been helping people manage their epilepsy since 2012, and it's particularly effective for certain types of seizures. If your doctor has prescribed perampanel or you're curious about this treatment option, understanding how it works and what to expect can help you feel more confident about your care.

What is Perampanel?

Perampanel belongs to a class of medications called AMPA receptor antagonists. It's a newer type of seizure medication that works differently from older epilepsy drugs by targeting specific receptors in your brain that are involved in seizure activity.

The medication comes as oral tablets that you take by mouth, usually once daily. It's designed to be used as part of your overall epilepsy treatment plan, often alongside other seizure medications to give you the best possible seizure control.

What is Perampanel Used For?

Perampanel is primarily used to treat two main types of seizures in people with epilepsy. Your doctor prescribes it when you need additional seizure control beyond what your current medications provide.

The medication is approved for treating partial-onset seizures, which start in one area of the brain and may or may not spread to other areas. These seizures can cause symptoms like strange sensations, involuntary movements, or changes in consciousness.

Perampanel also helps control primary generalized tonic-clonic seizures, previously known as grand mal seizures. These seizures affect the entire brain from the start and typically involve loss of consciousness and full-body convulsions.

Your doctor might recommend perampanel if your current seizure medications aren't providing adequate control, or if you're experiencing troublesome side effects from other drugs. It's typically used as an add-on treatment rather than as the sole medication for epilepsy.

How Does Perampanel Work?

Perampanel works by blocking AMPA receptors in your brain, which are like switches that can trigger seizure activity. When these receptors are overactive, they can cause the abnormal electrical storms we know as seizures.

Think of it this way: your brain has millions of electrical circuits, and seizures happen when too many circuits fire at once. Perampanel helps calm this overactivity by blocking one of the main pathways that can trigger these electrical storms.

This medication is considered moderately strong among seizure medications. It's not the mildest option available, but it's also not the most potent. This balance often makes it a good choice for people who need more seizure control but want to minimize side effects.

The drug takes time to build up in your system, which is why your doctor will start you on a low dose and gradually increase it. This approach helps your body adjust to the medication while reducing the risk of side effects.

How Should I Take Perampanel?

Take perampanel exactly as your doctor prescribes, usually once daily at bedtime. Taking it at night can help minimize daytime drowsiness, which is one of the most common side effects.

You can take perampanel with or without food, but try to be consistent with your choice. If you take it with food one day, continue taking it with food to maintain steady levels in your bloodstream.

Swallow the tablet whole with a glass of water. Don't crush, chew, or break the tablet, as this can affect how the medication is absorbed and released in your body.

If you're taking other seizure medications, continue taking them as prescribed unless your doctor tells you otherwise. Perampanel is typically used alongside other epilepsy drugs, not as a replacement.

Try to take your dose at the same time each evening to help maintain consistent levels of the medication in your system. Setting a phone reminder can help you remember, especially when you're first starting the medication.

How Long Should I Take Perampanel For?

Most people with epilepsy need to take perampanel long-term to maintain seizure control. Epilepsy is typically a chronic condition that requires ongoing treatment, and stopping seizure medications suddenly can trigger breakthrough seizures.

Your doctor will monitor your response to the medication over several months to determine if it's working well for you. Some people notice improvement within a few weeks, while others may need several months to see the full benefits.

If you and your doctor decide to stop perampanel, you'll need to reduce the dose gradually over several weeks or months. This tapering process helps prevent withdrawal seizures and allows your brain to adjust to the change.

Regular follow-up appointments are important to assess how well the medication is controlling your seizures and to monitor for any side effects. Your doctor may adjust your dose or treatment plan based on your response.

What Are the Side Effects of Perampanel?

Like all medications, perampanel can cause side effects, though not everyone experiences them. Understanding what to expect can help you manage any symptoms and know when to contact your doctor.

The most common side effects tend to be mild to moderate and often improve as your body adjusts to the medication. Here are the side effects that people most frequently report:

• Dizziness and drowsiness, especially when starting the medication
• Fatigue and feeling tired during the day
• Headache and difficulty concentrating
• Nausea and stomach upset
• Balance problems or unsteadiness when walking
• Blurred vision or double vision
• Weight gain over time

These common side effects usually become less bothersome as your body adapts to the medication. Taking perampanel at bedtime can help reduce daytime drowsiness and dizziness.

Some people may experience mood changes while taking perampanel, and this is something to watch for carefully. The medication can sometimes affect your emotions or behavior in ways that concern you or your family.

Mood-related side effects that warrant attention include increased irritability, anxiety, or feelings of aggression. Some people also report feeling more depressed or having unusual thoughts. If you notice significant changes in your mood or behavior, contact your doctor promptly.

Serious side effects are less common but require immediate medical attention. These rare but important side effects include severe allergic reactions, thoughts of self-harm, or significant changes in mental state.

If you experience difficulty breathing, swelling of your face or throat, or severe skin reactions, seek emergency medical care immediately. These could be signs of a serious allergic reaction.

Who Should Not Take Perampanel?

Perampanel isn't suitable for everyone, and your doctor will consider several factors before prescribing it. People with certain medical conditions or those taking specific medications may need to avoid perampanel or use it with extra caution.

You shouldn't take perampanel if you're allergic to the medication or any of its ingredients. Tell your doctor about any previous allergic reactions to seizure medications or other drugs.

People with severe liver problems may not be able to take perampanel safely, as the liver processes this medication. Your doctor may need to adjust your dose or choose a different medication if you have liver disease.

Mental health conditions require special consideration when using perampanel. The medication can worsen depression, anxiety, or other psychiatric conditions in some people. If you have a history of mental health issues, discuss this thoroughly with your doctor.

Pregnancy and breastfeeding also require careful consideration. While perampanel may be necessary for seizure control during pregnancy, it's important to discuss the risks and benefits with your doctor before becoming pregnant or while breastfeeding.

Older adults may be more sensitive to perampanel's side effects, particularly dizziness and drowsiness. Your doctor might start with a lower dose and increase it more slowly if you're over 65.

Perampanel Brand Names

Perampanel is available under the brand name Fycompa in most countries, including the United States. This is the original brand name under which the medication was first approved and marketed.

Currently, Fycompa is the primary brand name you'll encounter when your doctor prescribes perampanel. Generic versions of perampanel may become available in the future, but Fycompa remains the most widely recognized name.

When picking up your prescription, make sure the pharmacy gives you the correct medication. The tablets should be clearly labeled with the brand name Fycompa and the appropriate dosage strength.

Perampanel Alternatives

Several other seizure medications can serve as alternatives to perampanel if it's not suitable for you or doesn't provide adequate seizure control. Your doctor will consider your specific type of epilepsy and other factors when choosing alternatives.

Newer seizure medications that work similarly to perampanel include lacosamide, eslicarbazepine, and brivaracetam. These drugs also target different aspects of brain electrical activity and may be good options if perampanel doesn't work well for you.

Older, well-established seizure medications like carbamazepine, phenytoin, and valproic acid remain effective alternatives. These medications have been used for decades and may be preferred in certain situations.

For people with specific types of epilepsy, medications like levetiracetam or lamotrigine might be better choices. Your doctor will consider your seizure type, other medical conditions, and potential drug interactions when selecting alternatives.

The choice of alternative medication depends on many individual factors, including your seizure pattern, side effect tolerance, and other medications you're taking. Never switch seizure medications without consulting your doctor first.

Is Perampanel Better Than Levetiracetam?

Both perampanel and levetiracetam are effective seizure medications, but they work differently and may be better suited for different people. There's no universal "better" medication – it depends on your individual needs and how you respond to each drug.

Perampanel is typically taken once daily at bedtime, which many people find more convenient than levetiracetam's twice-daily dosing. This simpler schedule can help with medication adherence and may fit better into your daily routine.

Levetiracetam tends to have fewer drug interactions and may be safer for people with liver problems. It's also available in more formulations, including liquid and injection forms, which can be helpful in certain situations.

Side effect profiles differ between the two medications. Perampanel more commonly causes drowsiness and dizziness, while levetiracetam may be more likely to cause mood changes or behavioral issues in some people.

Your doctor will consider factors like your seizure type, other medications you're taking, your lifestyle, and your previous responses to seizure medications when choosing between these options. What works best for one person may not be ideal for another.