Briviact (brivaracetam) is a prescription drug that’s used to treat focal-onset seizures in adults and certain children. This drug can interact with alcohol, other medications, and some supplements. For example, Briviact can interact with St. John’s wort and certain other seizure medications.
Note: Briviact comes in three forms: oral tablet, oral liquid solution, and a liquid solution that’s given as an intravenous (IV) infusion. All forms of Briviact are expected to have the same interactions.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Before you start taking Briviact, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Briviact interacts with herbs or vitamins and supplements, see the “Are there other interactions with Briviact?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Briviact. Keep in mind that this table doesn’t include all drugs that may interact with Briviact. For more information about some of these interactions, see the “Drug interactions explained” section.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| certain other seizure medications | • carbamazepine (Tegretol, others) • fosphenytoin (Cerebyx) • phenytoin (Dilantin) | can increase the risk of side effects from certain other seizure drug |
| tricyclic antidepressants (TCAs) | • amitriptyline • imipramine (Tofranil) • nortriptyline (Pamelor) | can increase the risk of side effects from Briviact and the TCA, and can also make Briviact less effective |
| apalutamide (Erleada) | — | can make Briviact less effective |
| hydroxychloroquine (Plaquenil, Sovuna) | — | can make Briviact less effective |
| rifampin (Rifadin, Rimactane) | — | can make Briviact less effective |
| trazodone | — | can increase the risk of side effects from Briviact and trazodone, and can also make Briviact less effective |
Certain health conditions or other factors could raise your risk of harm if you take Briviact. In such cases, your doctor may not prescribe Briviact for you. These are known as contraindications. Briviact has one contraindication, which is described below.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Briviact or any of its ingredients, your doctor likely won’t prescribe Briviact for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Your doctor will likely recommend avoiding alcohol during your Briviact treatment. This is because Briviact and alcohol can cause some similar side effects, such as:
- sleepiness
- dizziness
- coordination problems
- reduced alertness
- slowed reaction times
If you drink alcohol during your Briviact treatment, you may be more likely to experience these side effects, or the side effects may be worsened.
If you have concerns about avoiding alcohol during your Briviact treatment, talk with your doctor or pharmacist.
Learn more about certain drug interactions that can occur with Briviact.
Interaction with certain other seizure medications
Briviact is used to treat seizures, and it can interact with certain other seizure medications.
Examples of seizure medications that can interact with Briviact include:
- carbamazepine (Tegretol, others)
- fosphenytoin (Cerebyx)
- phenytoin (Dilantin)
What could happen
Combining Briviact with a seizure medication it interacts with can increase the level of the other seizure medication in your body. This can raise your risk of side effects from the other seizure drug.
What you can do
If you use Briviact with a seizure medication it interacts with, your doctor may prescribe a dosage of the other seizure medication that’s lower than usual. You should not take a higher dose of either medication than your doctor prescribes.
If you take Briviact and other seizure medications together, tell your doctor right away if you have bothersome side effects.
If you have questions about taking Briviact with other seizure medications, talk with your doctor or pharmacist.
Interaction with TCAs
Briviact can interact with TCAs, which are used to treat depression. Some may also be prescribed for certain other conditions, including migraine and nerve pain.
Examples of TCAs include:
- amitriptyline
- imipramine (Tofranil)
- nortriptyline (Pamelor)
What could happen
Briviact and tricyclic antidepressants can cause some similar side effects, such as sleepiness and dizziness. So combining these drugs can raise your risk of these side effects.
TCAs can also lower the seizure threshold. This means you may be more likely to have seizures while taking a TCA. Briviact is used to help prevent seizures. So taking it with a TCA can make Briviact less effective at preventing seizures.
What you can do
If your doctor prescribes Briviact with a TCA, they may prescribe a higher dosage of Briviact for you.
If you take these drugs together, tell your doctor if you have bothersome side effects, such as sleepiness or dizziness.
If you have questions about taking Briviact with a TCA, talk with your doctor or pharmacist.
Interaction with rifampin
Briviact can interact with rifampin (Rifadin, Rimactane), which is used to treat tuberculosis (TB) and certain other infections.
What could happen
Taking rifampin with Briviact can make your body break down Briviact faster than usual. This can make Briviact less effective.
What you can do
If your doctor prescribes Briviact with rifampin, they’ll likely prescribe a dosage of Briviact that’s higher than usual.
If you have questions about taking Briviact with rifampin, talk with your doctor or pharmacist.
Briviact may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Briviact.
Does Briviact interact with supplements?
Before you start taking Briviact, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Briviact interactions with herbs
Briviact can interact with St. John’s wort, which is used to treat depression and some other conditions.
Taking St. John’s wort with Briviact can cause your body to break down Briviact faster than usual. This can make Briviact less effective at treating your seizures.
Your doctor will likely recommend that you don’t take St. John’s wort with Briviact. You can talk with them about possible alternatives.
Briviact interactions with vitamins
There are currently no reports of Briviact interacting with vitamins. But this doesn’t mean that vitamin interactions will not be recognized in the future.
For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Briviact.
Does Briviact interact with food?
There are currently no reports of Briviact interacting with food. If you have questions about eating certain foods during your treatment with Briviact, talk with your doctor.
Does Briviact interact with vaccines or lab tests?
There are currently no reports of Briviact interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Briviact treatment, talk with your doctor.
Does Briviact interact with cannabis or CBD?There are currently no reports of Briviact interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Briviact.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Briviact. Before taking Briviact, talk with your doctor about your health history. They’ll determine whether Briviact is right for you.
Health conditions or other factors that might interact with Briviact include:
Liver problems: Your liver helps clear Briviact from your system. If you have a liver problem, such as liver failure, Briviact levels can build up in your body. This can raise your risk of side effects from the drug.
Because of this, your doctor will likely prescribe a lower dosage of Briviact if you have liver problems.
Pregnancy: It’s not known whether Briviact is safe to use during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Briviact treatment.
If you do use Briviact while pregnant, consider enrolling in the North American Antiepileptic Drug Pregnancy Registry. This registry collects details about pregnancy issues reported with seizure medications such as Briviact. To learn more or sign up, visit the registry website or call 888-233-2334. You can also talk with your doctor for more details.
Breastfeeding: It’s not known whether it’s safe to use Briviact while breastfeeding. The drug passes into breast milk, but it isn’t known whether this may cause side effects in a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Briviact or any of its ingredients, your doctor will likely not prescribe Briviact. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Mental health conditions: Briviact may cause changes in your mental health or behavior. For example, it can cause or worsen problems such as anxiety, restlessness, hallucinations, rapid changes in mood, and depression. It can also raise your risk of suicidal thoughts and actions.
If you have a mental health condition, talk with your doctor about whether Briviact is right for you.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Taking certain steps can help you avoid interactions with Briviact. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- whether you drink alcohol or use cannabis
- other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a
medication list ) - what to do if you start taking a new drug during your Briviact treatment
It’s also important to understand Briviact’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Briviact exactly as prescribed can also help prevent interactions.
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 another 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.