Brivaracetam interactions

Full monograph for Brivaracetam Check it against another medicine

Medicines

195 documented

Severity

Mechanism

Medicines documented to interact with Brivaracetam, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Apalutamide	Major	Metabolism	Coadministration with potent inducers of CYP450 2C19 may decrease the plasma concentrations of brivaracetam. According to the prescribing information…	4 sources — open the full entry
Rifampicin	Major	Metabolism	Coadministration with rifampin may significantly decrease the plasma concentrations of brivaracetam. The proposed mechanism is rifampin induction of the CYP450…	2 sources — open the full entry
Rifampicin + Isoniazid	Major	Metabolism	Coadministration with rifampin may significantly decrease the plasma concentrations of brivaracetam. The proposed mechanism is rifampin induction of the CYP450…	2 sources — open the full entry
Rifampicin + Isoniazid + Pyrazinamide + Ethambutol	Major	Metabolism	Coadministration with rifampin may significantly decrease the plasma concentrations of brivaracetam. The proposed mechanism is rifampin induction of the CYP450…	2 sources — open the full entry
Alprazolam	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Amitriptyline Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Amitriptyline Hydrochloride + Chlordiazepoxide	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms	44 sources — open the full entry
Aripiprazole	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Asenapine Maleate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Baclofen	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Brexpiprazole	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Bromocriptine Mesylate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Carbamazepine	Moderate	Metabolism	Coadministration with potent inducers of CYP450 isoenzymes may decrease the plasma concentrations of brivaracetam, which is partially metabolized by CYP450…	4 sources — open the full entry
Carbidopa + LevodopaExtended release Prolonged release	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	36 sources — open the full entry
Cariprazine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Carisoprodol	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Cenobamate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Cetirizine Hydrochloridebase Ophthalmic	Moderate	Synergy	Concurrent use of cetirizine or levocetirizine with alcohol or other agents that exhibit central nervous system (CNS) depressant effects may result in additive…	10 sources — open the full entry
Chloral Hydrate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Chloroquine Phosphate	Moderate	Synergy	Chloroquine or hydroxychloroquine may lower the convulsive threshold, which may antagonize the action of antiepileptic medications. Seizures have been rarely…	10 sources — open the full entry
Chlorpheniramine Maleate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Chlorpromazine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Cinnarizine + Dimenhydrinate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Citalopram Hydrobromide	Moderate	Antagonism	The efficacy of anticonvulsants may be diminished during coadministration with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine…	28 sources — open the full entry
Clobazam	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Clomipramine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Clonazepam	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Clonidine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Clopidogrel + Aspirin	Moderate	Metabolism	Coadministration with inhibitors of CYP450 2C19 may reduce the efficacy of clopidogrel, whose antiplatelet effect is dependent in part on bioactivation by the…	21 sources — open the full entry
Clopidogrel Bisulphate	Moderate	Metabolism	Coadministration with inhibitors of CYP450 2C19 may reduce the efficacy of clopidogrel, whose antiplatelet effect is dependent in part on bioactivation by the…	21 sources — open the full entry
Clozapine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Cyclizine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Cyclobenzaprine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dantrolene Sodium	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Desvenlafaxine Succinate	Moderate	Antagonism	The efficacy of anticonvulsants may be diminished during coadministration with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine…	28 sources — open the full entry
Deutetrabenazine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dexmedetomidine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dextromethorphan + Bupropion	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dextromethorphan + Phenylephrine + Triprolidine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms	44 sources — open the full entry
Dextromethorphan + Pseudoephedrine + Triprolidine	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms	44 sources — open the full entry
Dextromethorphan Hydrobromide	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dextromethorphan Hydrobromide + Guaifenesin	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Dextromethorphan Polistirex	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Diazepam	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Difelikefalin Acetate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	36 sources — open the full entry
Diphenhydramine + Dextromethorphan + Levomenthol	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…2 documented mechanisms	44 sources — open the full entry
Diphenhydramine + Levomenthol	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Diphenhydramine Hydrochloride	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Diphenhydramine Hydrochloride + Zinc Acetate	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry
Doxepin (Oral)	Moderate	Synergy	Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these…	44 sources — open the full entry

Food & lifestyle

alcohol
Moderate
Synergy
Alcohol may potentiate some of the pharmacologic effects of central nervous system (CNS)-active agents. Use in combination may result in additive CNS depression and/or impairment of judgment, thinking, and psychomotor skills.
What to do: Patients receiving CNS-active agents should be advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled against driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
5 sources
1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
4. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
5. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Brivaracetam needs care, as documented in this source.

Bronchial Spasm
Moderate
Bronchospasm and angioedema have been reported in patients taking brivaracetam and a hypersensitivity reaction to this agent could predispose patients at risk. Caution is recommended when using brivaracetam in patients predisposed to bronchospasm and angioedema.
1 source
1. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
Depressive Disorder
Moderate
Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.
16 sources
1. "Product Information. Tegretol (carbamazepine)." Novartis Pharmaceuticals (2002):
2. "Product Information. Klonopin (clonazepam)." Roche Laboratories (2001):
3. "Product Information. Dilantin (phenytoin)." Parke-Davis (2001):
4. "Product Information. Cerebyx (fosphenytoin)." Parke-Davis (2001):
5. "Product Information. Mysoline (primidone)." Elan Pharmaceuticals (2001):
6. "Product Information. Lyrica (pregabalin)." Pfizer U.S. Pharmaceuticals Group (2005):
7. "Product Information. Sabril (vigabatrin)." Lundbeck Inc (2009):
8. "Product Information. Potiga (ezogabine)." GlaxoSmithKline (2011):
Show all 16 sourcesShow fewer sources
1. "Product Information. Qsymia (phentermine-topiramate)." Vivus Inc (2012):
2. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
3. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):
4. "Product Information. Diacomit (stiripentol)." Biocodex USA (2018):
5. "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC (2018):
6. "Product Information. Xcopri (cenobamate)." SK Life Science, Inc. (2020):
7. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):
8. "Product Information. Ztalmy (ganaxolone)." Marinus Pharmaceuticals, Inc (2022):
Kidney Diseases
Moderate
No dose adjustments are needed for patients with impaired renal function. The use of brivaracetam is not recommended in patients with end-stage renal disease undergoing dialysis as there are no data in this patient population.
No sources recorded
Liver Diseases
Moderate
Brivaracetam is primarily metabolized by hydrolysis in the liver. A pharmacokinetic study in adult subjects with hepatic cirrhosis, Child-Pugh grades A, B, and C, showed 50%, 57%, and 59% increases in brivaracetam exposure, respectively, compared to matched healthy controls. Because of increases in brivaracetam exposure, dosage adjustment is recommended for all stages of hepatic impairment as per manufacturer recommendation. Care and close monitoring is recommended when using this agent in patients with liver disease.
1 source
1. "Product Information. Briviact (brivaracetam)." UCB Pharma Inc (2016):

Medicines

Food & lifestyle

alcohol

Conditions

Bronchial Spasm

Depressive Disorder

Kidney Diseases

Liver Diseases