perampanel
Fycompa (perampanel) is an antiseizure medication that's used to control certain types of seizures. It's available as a liquid and tablet that's taken by mouth. While it's convenient because the dosage is taken once per day, Fycompa (perampanel) is a schedule III controlled substance and can have a lot of side effects, including sleepiness, dizziness, and weight gain. This medication is not yet available as a lower-cost generic.
What is Fycompa (perampanel)?
What is Fycompa (perampanel) used for?
- Partial-onset seizures in people ages 4 years and older
- Generalized tonic-clonic seizures in people ages 12 years and older (add-on therapy to other seizure medications)
How Fycompa (perampanel) works
Fycompa (perampanel) is an antiepileptic (anti-seizure) medication. It's not exactly clear how the medication works. But it's thought to block glutamate from attaching to its receptors in the brain. Glutamate is a chemical in the brain that causes a lot of brain activity and plays a role in seizures. By stopping the actions of glutamate in the brain, Fycompa (perampanel) causes nerve cells to become less active, which helps prevent seizures.
Drug facts
Risks and warnings for Fycompa (perampanel)
Fycompa (perampanel) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Abnormal mood, thoughts, or behavior
- Risk factors: History of mental health problems | Alcohol | Taking higher doses of Fycompa (perampanel)
Fycompa (perampanel) can raise your risk of having abnormal mood, thoughts, or behavior. Changes in mood or behavior can include being aggressive, irritable, unfriendly, angry, or anxious. Sometimes, people might even have thoughts of hurting other people. Some people have also reported having hallucinations (seeing or hearing things that aren't real), delusions, and paranoia.
These changes in mood, thoughts, and behavior are more likely to happen when you're first starting Fycompa (perampanel) or after switching to a higher dose. Don't drink alcohol with this medication since it can make the effects worse. Let your provider know right away if you notice a change in your mood or thoughts or if your child is behaving abnormally while taking Fycompa (perampanel). Call your provider even if these changes happen a couple months after stopping the medication.
Suicidal thoughts or behavior
- Risk factors: Taking other anti-seizure medications
Fycompa (perampanel) can raise your risk of having thoughts of suicide or harming yourself. You can be at higher risk of having these thoughts as early as 1 week after you start taking Fycompa (perampanel). Get medical help right away if you or anyone around you notices that you have any worsening depression, suicidal thoughts, or unusual behavior (e.g., anxiety, panic attacks, trouble sleeping, feeling angry or irritated, restlessness) while you're taking Fycompa (perampanel).
Difficulty concentrating, extreme sleepiness, dizziness, and loss of balance
- Risk factors: Taking high doses of Fycompa (perampanel) | Taking other medications that can cause sleepiness | Drinking alcohol | People over 65 years of age
Fycompa (perampanel) can cause extreme dizziness and sleepiness, which can lower your ability to think, react, and focus. These effects can raise your risk for falls. You might also feel off balance or uncoordinated, which can also lead to falls. Your risk might be higher if you're taking other medications that can make you feel sleepy (e.g., benzodiazepines, muscle relaxants). Make sure you know how this medication affects you before driving a car or doing activities that require your concentration. Talk to your healthcare provider right away if you feel too sleepy from taking Fycompa (perampanel) or if you experience a fall during treatment.
Severe allergic and skin reactions
Severe allergic reactions to Fycompa (perampanel) are possible. These can include life-threatening reactions like facial swelling and anaphylaxis (e.g., closing of the throat). Fycompa (perampanel) can also cause rare, but serious skin reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Stop using Fycompa (perampanel) and get medical attention right away if you experience swelling in your face, trouble breathing, fever, or changes in your skin (e.g., rash, blisters, swollen lymph nodes, skin reddening, skin peeling).
Risk of seizures and withdrawal symptoms if stopped suddenly
Because Fycompa (perampanel) helps control your seizures, stopping the medication suddenly can cause more seizures to happen. Suddenly stopping the medication can also cause other withdrawal symptoms, such as anxiety, nervousness, and trouble sleeping. To help prevent these withdrawal symptoms, don't change your dose or stop taking Fycompa (perampanel) without talking to your provider first. They'll help you lower your dose slowly over time before stopping completely.
Side effects of Fycompa (perampanel)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (up to 43%)
- Sleepiness (up to 18%)
- Headache (up to 13%)
- Feeling irritable (up to 12%)
- Tiredness (up to 12%)
- Falls (up to 10%)
- Nausea or vomiting (up to 8%)
- Difficulty with movement or coordination (up to 8%)
Less Common Side Effects
- Muscle, joint, or back pain
- Constipation
- Weight gain
- Upper respiratory tract infection
- Numbness
- Slurred speech
- Vision changes
- Difficulty walking
- Spinning sensation
- Anxiety
Fycompa (perampanel) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behavior
- Serious allergic and skin reactions: fever, fatigue, rash, hives, peeling skin, swollen lymph nodes
The following Fycompa (perampanel) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Loss of balance or coordination
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Rash, fever, and swollen lymph nodes
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Dizziness
- Drowsiness
- Fatigue
- Headache
- Irritability
- Nausea
- Weight gain
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Pros and cons of Fycompa (perampanel)
Pros
- Works well for seizures
- Only taken once per day
- Available as a liquid and tablet
Cons
- Causes dizziness and raises your risk of falls
- Can cause dangerous changes in mood, thoughts, or behavior
- Might not be a safe choice for pregnant women
Pharmacist tips for Fycompa (perampanel)
- Take Fycompa (perampanel) once per day at bedtime with or without food. But if it upsets your stomach, try taking it with food to help.
- Side effects from Fycompa (perampanel) are more likely to happen if you're taking higher doses. These side effects might return if your dose is raised. Let your provider know if you experience bothersome side effects. They might lower your dose.
- Fycompa (perampanel) can raise the risk of suicidal thoughts. Contact your provider right away if you or your loved ones notice any new or worsening changes in your behavior or mood while taking the medication.
- Fycompa (perampanel) commonly causes sleepiness, tiredness, and dizziness. Don't drive or do anything requiring concentration until you know how this medication affects you. Also, avoid drinking alcohol because it can worsen these effects.
- Don't change your dose or stop taking Fycompa (perampanel) without talking to your provider first. Doing so can cause more seizures or other withdrawal symptoms like anxiety and sleeping problems. Follow your provider's instructions to lower your dose slowly over a period of time to stop the medication completely.
- If you use birth control, talk to your provider about which methods of birth control is right for you while you're taking Fycompa (perampanel). You'll need to use a backup method of protection during treatment until 1 month after you've stopped taking the medication if you're using hormonal birth control containing levonorgestrel (e.g., Vienva). This type of birth control might not work as well when taken with Fycompa (perampanel) and raise the risk for an unplanned pregnancy.
- Make sure to tell your provider and pharmacist about all of the medications you're taking or planning to take with Fycompa (perampanel). Fycompa (perampanel) can interact with some common medications, including other anti-seizure medications (e.g., carbamazepine (Tegretol), phenytoin (Dilantin)).
- If you miss a dose of Fycompa (perampanel), skip the missed dose. Wait to take your next dose at your next regularly scheduled time. Don't double-up to make up for the missed dose. Call your provider to see what to do next if you forget to take Fycompa (perampanel) for more than a day.
More tips for the oral suspension (liquid) only:
- Each 1 milliter (mL) of liquid contains 0.5 mg of Fycompa (perampanel). Ask your pharmacist or provider if you're not sure how many mL of the suspension you need to take.
- Shake the bottle well for a few seconds before each dose. Make sure to only use a medication dose cup or syringe from the package or from the pharmacy to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
- Keep the oral suspension at room temperature. Once the bottle is opened, it's good for 3 months before the medication expires. Throw out any remaining medication after this time.
Common questions about Fycompa (perampanel)
In clinical studies, some people with partial-onset seizures who took Fycompa (perampanel) had about 20% to 34% fewer seizures per month during about 4 months of treatment; 36% of people became seizure-free during treatment. In a different set of studies, people with generalized tonic-clonic seizures who took Fycompa (perampanel) had 76% fewer seizures per month during about 4 months of treatment; 31% of people taking the medication became seizure-free during the study. Keep in mind that most people in these clinical studies were using other seizure medications with Fycompa (perampanel). Talk to your provider if you're concerned with how well Fycompa (perampanel) is working for you.
Yes, Fycompa (perampanel) is a schedule III controlled substance. The active ingredient perampanel has risks for misuse and physical and mental dependence. Make sure you use this medication only as prescribed by your provider. Talk with your provider if you have any questions or concerns about the risks for misuse and dependence.
No, you shouldn't cut, crush, chew, or cut the Fycompa (perampanel) tablets. Swallow the tablets whole. Ask your provider about switching you to the liquid (suspension) form of the medication if you're having trouble swallowing the tablets.
Weight gain is a known side effect of Fycompa (perampanel). In clinical studies, 4% of people with partial-onset seizures and 7% of people with generalized tonic-clonic seizures who took Fycompa (perampanel) for a few months gained an average of 2.5 pounds. Make sure to have a healthy diet and exercise routine while you're taking Fycompa (perampanel). Let your provider know if you've had significant weight changes after starting this medication.
It takes about 22 days for most of Fycompa (perampanel) to leave your body. This timeframe is estimated based on the half-life of Fycompa (perampanel). It can differ from person to person depending on your age and your liver and kidney function. It can also differ if you take other medications at the same time that affect how well your body removes Fycompa (perampanel) from your system. Side effects that you might have from Fycompa (perampanel) might last up until the time it takes for the medication to clear out of your system. Let your provider know if any side effects are bothering you.
It's recommended to avoid alcohol while you're taking Fycompa (perampanel) because both can make you feel sleepy and dizzy. Mixing alcohol with Fycompa (perampanel) can make these effects worse and also cause mood changes. Additionally, alcohol can potentially make your seizures come back. Speak with your provider if you have concerns about your alcohol intake while you're taking Fycompa (perampanel). They can work with you to lower how much you drink and stop drinking alcohol during treatment.
There aren't enough studies to say whether taking Fycompa (perampanel) during pregnancy is safe for you and your baby. In animal studies, babies born to mothers exposed to the medication were harmed, which means there could be a chance that it can harm human babies too. Discuss the risks and benefits of taking Fycompa (perampanel) with your provider if you're pregnant or thinking of getting pregnant. Tell them right away if you become pregnant during treatment. It's encouraged that you enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry so that researchers can monitor for safety and learn more about the risks if you're taking Fycompa (perampanel) while pregnant. Enroll by visiting the registry's website or by calling 1-888-233-2334.
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Fycompa (perampanel) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2mg of | 30 tablets | $168.86 | $5.63 |
| 4mg of | 30 tablets | $326.37 | $10.88 |
| 6mg of | 30 tablets | $326.37 | $10.88 |
| 8mg of | 30 tablets | $326.37 | $10.88 |
| 10mg of | 30 tablets | $326.37 | $10.88 |
| 12mg of | 30 tablets | $326.37 | $10.88 |
Typical dosage for Fycompa (perampanel)
The typical starting dose is 2 mg by mouth once daily at bedtime. The maintenance dose ranges from 8 mg to 12 mg once daily.
Your dose might differ if you have liver problems or if you take other medications that interact with Fycompa (perampanel).
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