Briviact vs. Keppra for Epilepsy: 6 Differences to Consider
Key takeaways:
Briviact (brivaracetam) and Keppra (levetiracetam) are both considered safe and effective medications for certain types of epilepsy. They work by targeting the SV2A receptor in the brain to reduce seizure activity.
Keppra treats a wider range of seizure disorders than Briviact and has fewer drug interactions to consider. But it typically requires several weeks to reach the recommended dosage when you first start taking it.
Briviact doesn’t require a slow increase in dosage over time. So it may start working faster than Keppra. Briviact may also cause fewer mental health-related side effects than Keppra. But it’s a controlled substance, so Briviact may not be the best choice for those with a history of substance misuse.
Briviact and Keppra are both available as brand-name medications. But you can also find Keppra as a lower-cost generic. GoodRx can help make your prescription more affordable.
Access savings on related medications
Table of contents
When you or someone in your family is living with epilepsy, you know how crucial it is to find the right treatment to manage seizures. Briviact (brivaracetam) and Keppra (levetiracetam) are two common anti-seizure medications. They have a few things in common — but they have key differences between them that you’ll want to be aware of.
Understanding how Briviact and Keppra compare can be useful. It will help you have a more informed discussion about your treatment options with your healthcare team. Here, we’ll walk through six key differences between Briviact versus Keppra to consider.
1. Briviact and Keppra work slightly differently to help control seizures
Briviact and Keppra both target a receptor (binding site) in the brain called SV2A. We don’t exactly know how SV2A is involved in seizures. But medications that target this protein help reduce seizure activity in people living with epilepsy.
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Briviact targets the SV2A receptor specifically. But Keppra affects other types of receptors in the brain.
Both medications are considered safe and effective for treating certain types of epilepsy. But Keppra’s broader activity may raise the risk of certain side effects compared to Briviact — more on that later.
2. Keppra has more approved uses than Briviact
Keppra is currently approved for more types of epilepsy than Briviact. Your prescriber may choose one medication over another based on the type of seizures you’re experiencing.
The FDA first approved Keppra in 1999. It’s approved for several types of seizures, including:
Partial-onset seizures in adults and children ages 1 month and older
As an add-on treatment for myoclonic seizures in adults and children ages 12 and older living with juvenile myoclonic epilepsy
As an add-on treatment for tonic-clonic seizures in adults and children ages 6 and older
Briviact, on the other hand, is a newer anti-epileptic medication. The FDA approved it in 2016 to treat partial-onset seizures in adults and children ages 1 month and older.
3. Briviact is a controlled substance — Keppra isn’t
Both Briviact and Keppra require a prescription from a licensed healthcare professional. But only Briviact is a controlled substance.
Controlled substances are medications with a potential for dependence and misuse. They’re grouped in Schedules from 1 to 5, with 5 being the lowest-risk category.
The DEA considers Briviact a Schedule 5 controlled substance. This means it has a risk of dependence and misuse, but the risk is relatively low compared to some other controlled substances, such as opioids.
While Briviact is considered safe when taken as prescribed, your prescription might have stricter regulations around getting it filled. And it may not be the best choice for those with a history of substance misuse.
Keppra, on the other hand, is not a controlled substance. So you don’t typically have any extra restrictions on when and how you fill your prescription. Keppra may also be a better option for those with a history of substance misuse.
4. You may reach an effective dose faster with Briviact than with Keppra
You’ll typically take both Briviact and Keppra twice daily (although Keppra is also available in a once-daily extended-release formula known as Keppra XR). They both come in oral tablets as well as an oral suspension (liquid). But they have different approaches when it comes to starting treatment.
With Keppra, you’ll likely start at a low dosage and gradually increase it every 2 weeks until you reach the recommended dosage. This gradual increase helps your body adjust and can reduce side effects. But it also means that it may take a few weeks to reach an effective dosage.
With Briviact, on the other hand, you usually start with the recommended dosage. It doesn’t require a slow buildup the way that Keppra does. Your prescriber may still need to adjust your dosage based on how you respond. But in most cases, these changes can be made right away, without a 2-week waiting period. This may offer a more convenient option for some people.
Keep in mind: You shouldn’t make any changes to your Keppra or Briviact dosage, or stop taking them altogether, without talking to your healthcare team. These changes can raise the risk of side effects or, more importantly, they can raise the risk of seizures. Follow the recommended dosage for your medication carefully, and talk with your prescriber before making any changes.
5. Briviact may be less likely to cause mood changes than Keppra
Briviact and Keppra have similar side effects to consider, such as:
Fatigue
Drowsiness
Dizziness
Nausea
Some people may also experience mood or behavior changes with these medications. This includes depression, anxiety, and irritable or aggressive behavior. But Briviact may be less likely to cause these side effects than Keppra. In fact, studies show that switching from Keppra to Briviact may improve mood and behavior-related side effects for some people.
If you have a history of mental health problems, Briviact may be a better option for you. Your prescriber can help determine the risks and benefits of both medications based on your personal history.
6. Keppra has fewer possible drug interactions than Briviact
The other medications you take may determine whether Keppra or Briviact is a better option for you.
Keppra isn’t known to interact with most medications. This makes it a popular choice for those taking more than one prescription, especially other anti-epilepsy medications.
Briviact doesn’t have many drug interactions, either. But it can interact with some other anti-epileptic medications. Briviact interactions include:
Carbamazepine (Tegretol)
Phenytoin (Dilantin, Phenytek)
Rifampin (Rifadin)
Your prescriber may need to adjust your dosage if you take Briviact with these medications. Be sure to share a complete list of all your medications and supplements with your healthcare team so they can alert you of any issues before they occur.
How to save on the cost of your Briviact or Keppra prescription
Cost may also be a factor when choosing between Briviact and Keppra. Both are available as brand-name medications. But you can also find Keppra as a lower-cost generic. GoodRx can help you navigate ways to save on your prescription.
Save with GoodRx. GoodRx can help you save over 90% off the average retail price of the generic version of Keppra. The price of generic Keppra tablets at certain pharmacies is as low as $9.00 with a free GoodRx discount.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, you may pay as little as $10 per month for Briviact using a savings card from the manufacturer.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Briviact’s patient assistance program, which offers the medication free of cost.
The bottom line
Briviact (brivaracetam) and Keppra (levetiracetam) are both considered safe and effective medications for certain types of epilepsy. But there are some differences to consider when it comes to Briviact versus Keppra.
Keppra is FDA approved for more types of epilepsy and has fewer drug interactions than Briviact. But it requires a slow increase in dose when you first start taking it. Briviact doesn’t require a gradual dosage increase, and it may cause fewer mood-related side effects than Keppra. But Briviact is a controlled substance, so it may not be the best choice for those with a history of substance misuse. Your healthcare team can help you find the best fit for your needs based on your personal history.
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