Brivaracetam

What is brivaracetam?

Brivaracetam is an anti-seizure medication, which means that it is used to treat and/or reduce seizures.

You may hear brivaracetam called by its brand name, Brivlera. Brivaracetam comes in a tablet or liquid form. In the hospital, it may also be given as an injection into a vein.

Before giving brivaracetam to your child

Tell your child’s health-care provider if your child has an allergy to brivaracetam or any of the ingredients in the formulation.

Tell your child’s health-care provider if your child is currently taking levetiracetam (brand name Keppra). Because they work in very similar ways, children do not benefit from being on both levetiracetam and brivaracetam. Sometimes, children may experience side effects on levetiracetam that get better when switched to brivaracetam. Your child should only be taking one of brivaracetam or levetiracetam.

Talk with your child’s health-care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• severe liver or kidney problems

How should you give brivaracetam to your child?

• Give brivaracetam exactly as your health-care provider tells you, even if your child seems better.
• Talk to your child's health-care provider before you stop giving brivaracetam for any reason. Do not suddenly stop giving this medicine to your child as this can cause seizures. Brivaracetam can be taken with or without food.
• The tablets should preferably be swallowed whole, with water.
• If your child cannot swallow the whole tablet, you may split and/or crush the tablet and mix the contents with a glass of water, as long as your child drinks all the liquid immediately after mixing. Crushed tablets may be mixed with a small amount of food.
• If your child is taking liquid brivaracetam, measure out each dose with the special spoon, dropper or syringe that the pharmacist gave you. Liquid brivaracetam may be administered through a feeding tube. Liquid brivaracetam may be mixed with a small amount of soft food or drink.
• Give this medicine at the same time each day. Pick times that are easy for you to remember so you do not miss doses. Brivaracetam is usually given twice a day.

What should you do if your child misses a dose?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does this medicine take to work?

• You should start to notice a reduction in the number of seizures your child has within a couple weeks of starting the medication.
• If there is no reduction in the number of seizures after several weeks after reaching the target dose, contact your child’s health-care provider.

What are the possible side effects of brivaracetam?

Your child may have some of these side effects while they take brivaracetam.

Check with your child's health-care provider if your child continues to have any of these side effects, if they do not go away or if they bother your child:

• headache
• nausea
• tiredness
• dizziness
• vomiting

Call your child’s health-care provider during office hours if your child has any of these side effects:

• changes in mood (more angry, sad or nervous)
• clumsiness or unsteadiness

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's health-care provider right away or take your child to the nearest Emergency Department if your child has any of these side effects:

• chest pain
• changes in mood or behaviour (thoughts of suicide or hurting themselves)
• swelling in the mouth, tongue, face and/or throat
• itching and/or rash
• wheezing or difficulty breathing

What safety measures should you take when your child is using this medicine?

Do not stop giving your child brivaracetam suddenly because this may cause your child’s seizures to increase. The health-care provider may want to slowly reduce the dose before stopping it completely.

There are some medicines that should not be taken together with brivaracetam, or, in some cases, the dose of brivaracetam or the other medicine may need to be adjusted. It is important that you tell your health-care provider if your child takes any other medications (prescription, over the counter or herbal), including:

• antibiotics, including rifampin
• some other seizure medications, including carbamazepine, phenobarbital and phenytoin
• certain medications for treating depression or anxiety, including fluoxetine and fluvoxamine

Brivaracetam may make your child dizzy or more tired than usual. Monitor your child carefully when they are doing something that may result in injury, such as climbing stairs, riding a bike or playing at a playground.

What other important information should you know?

• Keep a list of all medications your child is on and show the list to their health-care provider.
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
• Make sure you always have enough brivaracetam to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep all appointments so that the health-care provider can check your child's reaction to brivaracetam.
• Keep brivaracetam at room temperature (15°C to 30°C) in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Canadian Pharmacists Association (2024). Brivlera. Retrieved from https://www-e-therapeutics-ca.myaccess.library.utoronto.ca/search.

Lexicomp Online, The Hospital for Sick Children Electronic Formulary and Lexi-Drugs (2024). Brivaracetam.

Keep Brivaracetam out of your child’s sight and reach and locked up in a safe place. If your child takes too much Brivaracetam, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.