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Generic Name:

perampanel, Oral tablet

All Brands

  • FYCOMPA
SECTION 1 of 5

Highlights for perampanel

Oral tablet
1

Perampanel is an oral drug that’s used to treat partial-onset seizures in people with epilepsy. It’s used in combination with other drugs that treat seizures.

2

Common side effects include dizziness, sleepiness, irritability, nausea, weight gain, problems with muscle coordination and walking, feeling like you’re spinning (vertigo), and falling.

3

This drug may cause serious or life-threatening mental health and behavior problems. These include aggression, hostility, irritability, anger, and thoughts of hurting other people. Contact your doctor right away if you have any unusual changes in your mood, behavior, or personality. Your doctor may lower your dose or tell you to stop taking perampanel if these symptoms occur.

4

Perampanel may cause you to have thoughts of hurting yourself. Call your doctor if this happens, or if you have any unusual changes in your mood or behavior.

5

Never stop taking this drug without talking with your doctor first. If you stop taking this medication suddenly, it can cause you to have more seizures or a seizure that won’t stop.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Mental health and behavior problems warning. This drug may cause serious or life-threatening mental health and behavior problems. These include aggression, hostility, irritability, anger, and thoughts of hurting other people. Contact your doctor right away if you have any unusual changes in your mood, behavior, or personality while taking this drug or after stopping this medication. Your doctor may lower your dose or have you stop taking this drug if these symptoms occur or become worse.

Suicidal thoughts

This drug may cause you to have thoughts of hurting yourself. Call your doctor if this happens, or if you have any unusual changes in your mood or behavior.

Falling

This drug can make you feel dizzy and unsteady while walking. It may also increase your risk of falling, which could lead to serious injuries such as head injuries or broken bones (fractures). If you’re 65 years and older, your risk may be higher.

Pregnancy guidance

Tell your doctor if you’re pregnant or plan to become pregnant. It isn’t known if this drug will harm your unborn baby. If you become pregnant while taking this drug, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry. The purpose of this registry is to collect information about the safety of seizure medications taken during pregnancy.

What is perampanel?

This drug is a prescription drug that’s a controlled substance. It’s available as an oral tablet and oral suspension.

This drug is a brand-name drug. It isn’t available as a generic drug.

This drug should be taken as part of a combination therapy with other seizure medications.

Why it's used

This drug is used to treat partial-onset seizures with or without secondarily generalized seizures in people with epilepsy. It’s used as part of a combination therapy with other seizure medications.

How it works

This drug belongs to a class of drugs called anticonvulsants or antiepileptic drugs (AEDs). A class of drugs refers to medications that work similarly.

More Details

How it works

This drug belongs to a class of drugs called anticonvulsants or antiepileptic drugs (AEDs). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

It isn’t fully understood how this drug works. It may block a receptor in your brain known as the glutamate receptor. When it’s blocked, it stops the neurons in your brain from becoming too active. This reduces how often you have seizures.

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SECTION 2 of 5

perampanel Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with perampanel include:

  • dizziness

  • tiredness

  • irritability

  • nausea

  • weight gain

  • problems with muscle coordination and walking

  • feeling like you or the room is spinning (vertigo)

  • falling

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • serious mental health and behavior problems. Symptoms include:

    • new or worse aggressive behavior, hostility, anger, anxiety, or irritability
    • feeling suspicious or not trusting people
    • believing things that aren’t true
    • other unusual or extreme changes in your behavior or mood
  • suicidal thoughts or behaviors. Symptoms include:

    • thoughts about suicide and dying
    • attempts to commit suicide
    • new or worsening depression
  • falls or serious injuries. These include head injuries or broken bones (fractures).

  • multi-organ allergy (hypersensitivity) or drug reaction with eosinophilia and systemic symptoms (DRESS). Symptoms include:

    • swollen lymph nodes
    • fever
    • rash
    • yellowing of your skin or the whites of your eyes (jaundice)
    • decrease in urine output
    • severe muscle pain
    • chest pain
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness. It may make you dizzy and tired. Don’t drive, use machinery, or do similar tasks that require alertness until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

perampanel May Interact with Other Medications

Oral tablet

Perampanel can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

You shouldn’t drink alcohol while taking perampanel. It can make the side effects of sleepiness or dizziness worse.

Medications that might interact with this drug

Allergy medicines

These drugs slow down your central nervous system. This may cause drowsiness, dizziness, and slowed breathing. Since perampanel may also cause these effects, taking them together can increase your risk for these side effects.

These drugs include:

  • clorpheniramine
  • diphenhydramine
  • doxylamine
  • hydroxyzine

Anxiety medications

These drugs slow down your central nervous system. This may cause drowsiness, dizziness, and slowed breathing. Since perampanel may also cause these effects, taking them together can increase your risk for these side effects.

These drugs include:

  • alprazolam
  • clonazepam
  • lorazepam

Birth control pills (contraceptives)

Perampanel may reduce the levels of a specific progesterone, levonorgestrel, in the body.  Lower levels would make it less effective at preventing pregnancy.

Herbal supplements

This supplement can increase the rate that your body processes perampanel. This can lead to lower blood levels. Lower levels will cause the drug to not work as well and will put you at risk for seizures.

  • St. John’s wort

Motion sickness drugs

These drugs slow down your central nervous system. This may cause drowsiness, dizziness, and slowed breathing. Since perampanel may also cause these effects, taking them together can increase your risk for these side effects.

These drugs include:

  • meclizine 
  • dimenhydrinate
  • promethazine

Pain medicines

These drugs slow down your central nervous system. This may cause drowsiness, dizziness, and slowed breathing. Since perampanel may also cause these effects, taking them together can increase your risk for these side effects.

These drugs include:

  • hydrocodone
  • oxycodone
  • morphine
  • hydromorphone

Seizure drugs

These drugs can increase the rate that your body processes perampanel. This can lead to lower blood levels. Lower levels will cause the drug to not work as well, which puts you at risk for seizures. These drugs also slow down your central nervous system, which may cause drowsiness and dizziness.  Since perampanel may also cause these effects, taking these drugs together can increase your risk for these side effects.

These drugs include:

  • carbamazepine
  • oxcarbazepine
  • phenytoin
  • phenobarbital

Tuberculosis drugs

This drug can increase the rate that your body processes perampanel. This can lead to lower blood levels. Lower levels will cause the drug to not work as well and will put you at risk for seizures.

  • rifampin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problems
People with liver problems

This drug is processed by your liver. If your liver isn’t working well, more of the drug may stay in your body longer. This puts you at risk for side effects. If you have mild or moderate liver problems, your doctor may lower your dose. If you have severe liver problems, you shouldn’t take this drug.

kidney problems
People with kidney problems

This drug is partly removed from your body by your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body longer. This puts you at risk for side effects. If you have moderate kidney problems, use this drug with caution. Your doctor may increase your dose more slowly and monitor you more closely. If you have severe kidney problems or are on dialysis, you shouldn’t use this drug.

mental health
People with mental health or behavior problems

Let your doctor know if you have a history of depression, mood problems, aggressive or hostile behavior, suicidal thoughts, or other mental health issues. Taking this drug may make these problems worse.

alcohol abuse
People with a history of drug or alcohol abuse

Tell your doctor if you’ve ever abused prescription medicines, street drugs, or alcohol. This drug is a controlled substance because it can be abused and lead to dependence. Your doctor may give you a different drug to treat your seizures.

Pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

If you become pregnant while taking this drug, talk to your doctor about registering with the North American Antiepileptic Drug Pregnancy Registry. The purpose of this registry is to collect information about the safety of drugs that treat seizures taken during pregnancy.

breast-feeding
Women who are breast-feeding

It isn’t known if this drug passes into breast milk. If it does, it may cause serious effects in a breast-feeding child.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

seniors
For seniors

Seniors may have a higher risk of side effects from this drug. You may be more likely to have dizziness, drowsiness, tiredness, and problems walking, losing balance, and falling compared to younger people.

As you age, your body may process this drug more slowly. Your doctor may start you on a lowered dose or monitor you more closely so that too much of this drug doesn’t build up in your body.

children
For children

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 12 years.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives
  • rash
  • blistering or peeling skin

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 5

How to Take perampanel (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Seizures (epilepsy)

Brand: Fycompa

Form: Oral tablet
Strengths: 2 mg, 4 mg, 6 mg, 8 mg, 10 mg, and 12 mg
Form: Oral suspension
Strengths: 0.5 mg/mL
Adult dosage (ages 18–64 years)

For treatment of partial-onset seizures:

  • If you’re not also taking enzyme-inducing antiepileptic drugs (AEDs):
    • The standard starting dose is 2 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose on a weekly basis by 2 mg per day.
    • The recommended dose range is 8–12 mg taken once per day at bedtime.
    • The maximum dose is 12 mg per day.
  • If you are taking enzyme-inducing antiepileptic drugs (AEDs), such as phenytoin, carbamazepine, and oxcarbazepine:
    • The standard starting dose is 4 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose depending on how you respond to and tolerate this medication.
    • The maximum dose is 12 mg per day.

For treatment of primary generalized tonic-clonic seizures:

  • If you’re not also taking enzyme-inducing antiepileptic drugs (AEDs):
    • The standard starting dose is 2 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose on a weekly basis by 2 mg per day.
    • The recommended maintenance dose is 8 mg taken once per day at bedtime.
    • The maximum dose is 12 mg per day.
  • If you’re taking enzyme-inducing antiepileptic drugs (AEDs), such as phenytoin, carbamazepine, and oxcarbazepine:
    • The standard starting dose is 4 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose on a weekly basis by 2 mg per day.
    • The maximum dose is 12 mg per day.
Child dosage (ages 12–17 years)

For treatment of partial-onset seizures:

  • If you’re not also taking enzyme-inducing antiepileptic drugs (AEDs):
    • The standard starting dose is 2 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose on a weekly basis by 2 mg per day.
    • The recommended dose range is 8–12 mg taken once per day at bedtime.
    • The maximum dose is 12 mg per day.
  • If you are taking enzyme-inducing antiepileptic drugs (AEDs), such as phenytoin, carbamazepine, and oxcarbazepine:
    • The standard starting dose is 4 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose depending on how you respond to and tolerate this medication. Your daily dose shouldn’t be increased by more than 2 mg per week.  
    • The maximum dose is 12 mg per day.

For treatment of primary generalized tonic-clonic seizures:

  • If you’re not also taking enzyme-inducing antiepileptic drugs (AEDs):
    • The standard starting dose is 2 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose on a weekly basis by 2 mg per day.
    • The recommended dose range is 8–12 mg taken once per day at bedtime.
    • The maximum dose is 12 mg per day.
  • If you are taking enzyme-inducing antiepileptic drugs (AEDs), such as phenytoin, carbamazepine, and oxcarbazepine:
    • The standard starting dose is 4 mg taken by mouth once per day at bedtime.
    • Your doctor will increase your dose depending on how you respond to and tolerate this medication.
    • The maximum dose is 12 mg per day.
Child dosage (ages 0–11 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 12 years.

Senior dosage (ages 65 years and older)

Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or you may need a different schedule. Your doctor will wait at least 2 weeks between dose increases.

Special considerations

Liver problems: If you have mild or moderate liver problems, your doctor may lower your dose. If you have severe liver problems, you shouldn’t use perampanel.

  • Mild liver problems: The maximum dose is 6 mg per day.
  • Moderate liver problems: The maximum dose is 4 mg per day.

Kidney problems: If you have moderate kidney problems, use perampanel with caution. Your doctor will increase your dose more slowly and monitor you more closely. If you have severe kidney problems or are on dialysis, you shouldn’t use this drug.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don’t take it as prescribed.

If you don't take it at all or stop taking it

If you don’t take this drug at all or stop taking it, you may have seizures more often.

If you skip or miss doses

If you miss a dose, you may have seizures more often.

If you take too much

Taking too much may cause you to have more dizziness. This drug can stay in your body for a long time. If you take too much, your doctor will treat whatever symptoms you have.

If you think that you’ve taken too much of this drug, call your local poison control center or go to the emergency room right away.

What to do if you miss a dose

If you miss a dose, take the next dose the following day as prescribed by your doctor. Call your doctor if you miss more than one dose.

How to tell if the drug is working

If this drug is working, you should have fewer seizures.

This drug is used for long-term treatment.

Important considerations for taking this drug
timing
Take this drug at bedtime to reduce the chance of dizziness and drowsiness
crush or cut the tablet
You can crush or cut the tablet
storage
Store this drug at room temperature
See Details
refillable
This medication is refillable
See Details
travel
Travel
See Details
Clinical monitoring
Clinical monitoring
See Details
not usually stocked
Not every pharmacy stocks this drug, so call ahead
prior authorization required
Insurance
See Details

Store this drug at room temperature

  • Keep it from 59°F (15°C) to 86°F (30°C).
  • Keep this drug away from high temperature.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

This medication is refillable

A schedule III drug, such as perampanel, may be refilled if your doctor authorizes it on the prescription. It may only be refilled up to five times within six months after the prescription was given. After five refills, or after 6 months, whichever occurs first, you’ll need a new prescription from your doctor.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Before starting and during treatment with this drug, your doctor may check your:

  • liver function
  • kidney function
  • weight

Your doctor may also monitor you for the following:

  • seizures. You and your doctor should monitor how often you have seizures.
  • mental health and behavioral problems. This drug can cause new or worsen existing mental health and behavioral problems. You and your doctor should watch for any unusual changes in your behavior and mood.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

SECTION 5 of 5

How Much Does perampanel Cost?

Oral tablet

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 10, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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