Usage of Briokem 50
Briokem 50 is indicated for:
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Focal onset seizures (partial seizures) with or without secondary generalization
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Adjunct therapy in patients with epilepsy not fully controlled on current regimen
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Can also be used in generalized epilepsy (off-label in some settings)
Mechanism of Action
Brivaracetam selectively binds to SV2A, a synaptic vesicle protein involved in neurotransmitter release modulation, resulting in:
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Suppression of neuronal hyperexcitability
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Inhibition of epileptic activity spread
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Improved seizure control with minimal sedation
Compared to levetiracetam, Brivaracetam has 20x higher affinity for SV2A and lower risk of irritability, agitation, or mood changes.
Key Benefits
✅ Rapid onset of antiepileptic action
✅ Improved behavioral and psychiatric tolerability
✅ Lower incidence of drowsiness, dizziness, and fatigue
✅ Safe as add-on therapy with most AEDs
✅ No need for titration in most patients — easy to initiate
Common Side Effects
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Somnolence or dizziness (dose-dependent)
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Fatigue
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Nausea or irritability (mild and self-limiting)
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Rare: Mood swings, aggression, suicidal thoughts (monitor closely)
Precautions
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Use cautiously in patients with depression or psychiatric history
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May cause drowsiness or impaired driving ability
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Monitor behavior, especially during initial weeks of therapy
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Avoid abrupt discontinuation to prevent withdrawal seizures
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Dose adjustment may be required in severe hepatic impairment
Drug Interactions
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Minimal drug interactions due to limited CYP metabolism
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Can be safely co-administered with most AEDs (lamotrigine, valproate, carbamazepine, etc.)
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Avoid use with alcohol or CNS depressants
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May slightly interact with rifampicin, carbamazepine epoxide (reduce efficacy)
Dosage and Administration
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Usual dose: 50 mg twice daily (can be increased to 100 mg BID if needed)
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Can be taken with or without food
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No need for slow titration in most cases
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Do not crush or split the tablet
Storage
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Store at room temperature below 25°C
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Protect from moisture and direct sunlight
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Keep out of reach of children
Patient Counseling Points
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Take the medication at the same time each day
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Do not stop abruptly — consult physician if side effects occur
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Inform your doctor about any mood changes, irritability, or suicidal thoughts
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Avoid driving or operating machinery until the effect is known
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Regular follow-ups for seizure control and side effect monitoring are important
