6 Briviact Side Effects and How to Manage Them
Key takeaways:
Briviact (brivaracetam) treats partial-onset seizures in adults and children who are at least 1 month old. It comes as tablets, an oral solution, and an intravenous (IV) injection.
Drowsiness and dizziness are common Briviact side effects. Coordination issues, nausea, and vomiting are also possible. Serious allergic reactions and mental health-related side effects are rare.
Talk with your healthcare provider or pharmacist if you experience any long-lasting or problematic Briviact side effects. As a team, you can decide on strategies to manage them.
Table of contents
If you or a loved one experience partial-onset seizures, or seizures that start in one part of the brain, your healthcare provider may prescribe Briviact (brivaracetam) to manage them.
There are many ways Briviact may fit into your medication routine, too. You can take this twice-daily medication on its own or in combination with other seizure medications. It also comes as tablets, an oral solution (liquid), and an intravenous (IV) injection. It’s even FDA approved for people as young as 1 month old.
If you’re new to Briviact, it's normal to have questions about how to get the most out of your prescription. This includes preventing side effects. Your healthcare provider and pharmacist are good resources to help you understand Briviact’s side effects and how to manage them — but we’ll get you started with a primer on what you need to know.
Briviact side effects at a glance
Like all seizure medications, Briviact can cause side effects. Many are relatively mild, but some are more substantial.
Common Briviact side effects include:
Drowsiness
Tiredness
Dizziness
Nausea and vomiting
Briviact can also cause rare but serious side effects, such as:
Seizure risks from stopping Briviact too quickly
Anxiety
Aggression
Depression
Serious allergic reactions
Below, we’ll detail what to know about six notable Briviact side effects.
Keep in mind: Briviact is a Schedule V controlled substance. It has a potential for dependence and misuse, but this risk is much lower compared to other controlled substances — such as opioids and benzodiazepines.
1. Drowsiness or fatigue
Drowsiness is one of the most common Briviact side effects. It’s reported to happen in about one-fourth of people taking at least 50 mg of Briviact per day.
While you’re more likely to experience drowsiness and fatigue when you first start Briviact, it can happen at any time while you’re taking it. It’s generally short lived, but feeling sleepy can still put a damper on your daily life and productivity.
If you’re feeling drowsy after your first few Briviact doses, a few lifestyle changes may help. Getting a good night's sleep, eating a nutritious breakfast, and exercising are all good starting points. Taking your second daily dose of Briviact at bedtime may also help you feel less drowsy during the afternoon and evening.
Good to know: Certain interactions could also amplify how tired you feel. For instance, Briviact raises alcohol levels in the body if you take them together. Since alcohol can also cause drowsiness, taking them together can make this side effect even worse. It’s best to avoid alcohol while taking Briviact for this reason.
2. Dizziness and coordination issues
Dizziness and coordination problems affect several people taking Briviact. But they’re not typically long-term problems. They appear to happen more often when you’re first starting Briviact.
In the meantime, it’s best to avoid driving or performing other high-alert tasks while your body adjusts. Participating in activities like these while you’re dizzy could lead to accidents.
These symptoms can also raise the risk of falls. Older adults taking Briviact have an even higher risk of accidental falls. Here are some tips to prevent them:
Stand up slowly
Avoid walking on slippery surfaces
Hold handrails on stairs or take an elevator if available
Use grab bars in the shower
If you’re experiencing dizziness or balance issues that are becoming a problem, reach out to your healthcare provider. They may recommend adjusting your Briviact dose or switching medications altogether.
Also keep a current medication list handy. Your pharmacist can check to see if any of your prescription or over-the-counter (OTC) medications could be worsening any Briviact side effects.
3. Nausea and vomiting
Briviact may cause unpleasant stomach-related side effects, such as nausea and vomiting. Thankfully, these symptoms only affected a small percentage of people in clinical studies.
While you can take Briviact with or without food, taking it with a snack can help lessen nausea. Staying hydrated and avoiding spicy foods may also help. With your healthcare provider’s OK, you can also consider trying an OTC nausea medication — such as Pepto-Bismol (bismuth subsalicylate) — when needed.
4. Seizure risks with rapid withdrawal
Like with other seizure medications, stopping Briviact suddenly could raise your risk of experiencing seizures. It could also lead to longer lasting ones. This is especially true if you’ve been taking Briviact for awhile and your body is used to it.
If you want or need to stop taking Briviact, it’s important to talk with your healthcare provider or pharmacist. They can help you gradually lower your dose in a safe way.
5. Mental health-related side effects, including thoughts of self harm
Some people taking Briviact in clinical studies experienced one or more mental health-related side effects. Irritability, anxiety, and depression are a few examples.
It’s important to keep these symptoms in check when possible. This often comes down to being honest about how you’re feeling. Let your healthcare provider know if you’re living with any mental health conditions before starting Briviact. If you’re experiencing depression, they may want to check that your symptoms are being managed with therapy, an antidepressant, or a combination of both.
There is some good news though. Briviact tends to cause fewer mental health-related side effects than other similar medications. For instance, Briviact works in a similar way as the seizure medication Keppra (levetiracetam). But research suggests Briviact may cause fewer mental health side effects than Keppra.
Good to know: All seizure medications — including Briviact — include a warning about the potential risk of suicide. This is a standard precaution that the FDA requires on their labeling. But one review found that newer seizure medications, including Briviact, don’t actually raise the risk of suicide.
For additional resources or to connect with mental health services in your area, call SAMHSA’s National Helpline at 1-800-662-4357. For immediate assistance, call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.
6. Severe allergic reactions
Allergic reactions aren’t a true medication side effect. But they’re still an important risk to be aware of.
While rare, there have been some reports of severe allergic reactions among some people taking Briviact. Seek emergency care right away if you experience any of these anaphylaxis symptoms:
Trouble breathing
Throat tightness
Swelling of face, lips, tongue
Hives
When to contact your healthcare provider about Briviact side effects
Reach out to your healthcare provider about any Briviact side effects that are bothersome, don’t go away, or get worse at any point. They can talk with you about the next steps to manage them. This may include lowering your dose or switching medications altogether.
That being said, you know your body best. If you’re experiencing something that feels severe or life threatening, it’s better to call 911 or go to the nearest ER.
The bottom line
Common Briviact (brivaracetam) side effects include drowsiness, dizziness, and nausea. These tend to get better as your body adjusts to the medication. While serious risks are rare, Briviact may cause mental health changes or allergic reactions. Contact your healthcare provider if you’re concerned about any Briviact side effects.
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References
Biton, V., et al. (2013). Brivaracetam as adjunctive treatment for uncontrolled partial epilepsy in adults: A phase III randomized, double-blind, placebo-controlled trial. Epilepsia.
Brandt, C., et al. (2020). Safety and tolerability of adjunctive brivaracetam in epilepsy: In-depth pooled analysis. Epilepsy and Behavior.
Hesdorffer, D. C., et al. (2009). The FDA alert on suicidality and antiepileptic drugs: Fire or false alarm? Epilepsia.
Hirsch, M., et al. (2018). Tolerability, efficacy and retention rate of brivaracetam in patients previously treated with levetiracetam: A monocenter retrospective outcome analysis. Seizure.
Khaleghi, F., et al. (2017). Brivaracetam (Briviact): A novel adjunctive therapy for partial-onset seizures. Pharmacy and Therapeutics.
Klein, P., et al. (2018). A review of the pharmacology and clinical efficacy of brivaracetam. Clinical Pharmacology: Advances and Applications.
Klein, P., et al. (2021). Suicidality risk of newer antiseizure medications. Journal of the American Medical Association Neurology.
Kruithof, A. C., et al. (2017). Pharmacological interactions between brivaracetam and ethanol in healthy males. Journal of Psychopharmacology.
Maximos, M., et al. (2017). Risk of falls associated with antiepileptic drug use in ambulatory elderly populations. Canadian Pharmacists Journal.
Sirven, J. I., et al. (2023). Stopping seizure medications. Epilepsy Foundation.
UCB, Inc. (2023). Briviact [package insert].
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