Indications of Briva 25 mg
Briva 25 mg is indicated for the treatment of partial-onset seizures in patients 4 years of age and older. As the safety of Briva 25 mg injection in pediatric patients has not been established, Briva 25 mg injection is indicated for the treatment of partial-onset seizures only in adult patients (16 years of age and older).
Theropeutic Class
Adjunct anti-epileptic drugs
Pharmacology
The precise mechanism by which Briva 25 mg exerts its anticonvulsant activity is not known. Briva 25 mg displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the anticonvulsant effect.Briva 25 mg binds SV2A with high affinity. SV2A is known to play a role in epileptogenesis through modulation of synaptic GABA release. It is thought that Briva 25 mg exerts its anti-epileptogenic effects through its binding to SV2A. Briva 25 mg is also known to inhibit Na+ channels which may also contribute to its anti-epileptogenic action
Dosage of Briva 25 mg
Adults (16 Years and older): The recommended starting dosage for monotherapy or adjunctive therapy is 50 mg twice daily (100 mg per day).Based on individual patient tolerability and therapeutic response, the dosage may be adjusted down to 25 mg twice daily (50 mg per day) or up to 100 mg twice daily (200 mg per day).Pediatric Patients (4 Years to less than 16 Years): The recommended dosage is based on body weight and is administered orally twice dailyInjection: for intravenous and adult use only when oral administration is temporarily not feasible; dosing is the same as oral regimen.
Administration of Briva 25 mg
Briva 25 mg injection should be administered intravenously over 2 to 15 minutes. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Product with particulate matter or discoloration should not be used. Briva 25 mg injection is for single dose only.
Interaction of Briva 25 mg
Rifampin: Because of decreased concentrations, increasing Briva 25 mg dosage in patients on concomitant rifampin is recommended.Carbamazepine: Because of increased exposure to carbamazepine metabolite, if tolerability issues arise, consider reducing carbamazepine dosage in patients on concomitant Briva 25 mg.Phenytoin: Because phenytoin concentrations can increase, phenytoin levels should be monitored in patients on concomitant Briva 25 mg.Levetiracetam: Briva 25 mg had no added therapeutic benefit when co-administered with levetiracetam.
Contraindications
Hypersensitivity to Briva 25 mg or any of the inactive ingredients in Briva 25 mg
Side Effects of Briva 25 mg
Most common adverse reactions (at least 5% for Briva 25 mg and at least 2% more frequently than placebo) are somnolence/sedation, dizziness, fatigue, and nausea or vomiting.
Pregnancy & Lactation
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs), such as Briva 25 mg, during pregnancy. No data are available regarding the presence of Briva 25 mg in human milk, the effects on the breastfed infant, or the effects of the drug on milk production. Studies in lactating rats have shown excretion of Briva 25 mg or metabolites in milk
Precautions & Warnings
Suicidal Behavior and Ideation: Monitor patients for suicidal behavior and ideation.Neurological Adverse Reactions: Monitor for somnolence and fatigue, and advise patients not to drive or operate machinery until they have gained sufficient experience on Briva 25 mg.Psychiatric Adverse Reactions: Behavioral reactions including psychotic symptoms, irritability, depression, aggressive behavior, and anxiety; monitor patients for symptoms.Hypersensitivity: Bronchospasm and Angioedema: Advise patients to seek immediate medical care. Discontinue and do not restart Briva 25 mg if hypersensitivity occurs. Withdrawal of Antiepileptic Drugs: Briva 25 mg should be gradually withdrawn.
Storage Conditions
Store at 25°C; excursions permitted between 15°C to 30°C
Use In Special Populations
Hepatic Impairment: Dose adjustment is recommended for all stages of hepatic impairment.Renal Impairment: Dose adjustments are not required for patients with impaired renal function.
Drug Classes
Adjunct anti-epileptic drugs
Mode Of Action
The precise mechanism by which Briva 25 mg exerts its anticonvulsant activity is not known. Briva 25 mg displays a high and selective affinity for synaptic vesicle protein 2A (SV2A) in the brain, which may contribute to the anticonvulsant effect.Briva 25 mg binds SV2A with high affinity. SV2A is known to play a role in epileptogenesis through modulation of synaptic GABA release. It is thought that Briva 25 mg exerts its anti-epileptogenic effects through its binding to SV2A. Briva 25 mg is also known to inhibit Na+ channels which may also contribute to its anti-epileptogenic action
Pregnancy
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antiepileptic drugs (AEDs), such as Briva 25 mg, during pregnancy. No data are available regarding the presence of Briva 25 mg in human milk, the effects on the breastfed infant, or the effects of the drug on milk production. Studies in lactating rats have shown excretion of Briva 25 mg or metabolites in milk
Pediatric Uses
Hepatic Impairment: Dose adjustment is recommended for all stages of hepatic impairment.Renal Impairment: Dose adjustments are not required for patients with impaired renal function.