Brivaracetam Teva: Uses, Dosage & Side Effects
A selective SV2A ligand antiepileptic drug for adjunctive treatment of partial-onset seizures in patients with epilepsy
Brivaracetam Teva is a prescription antiepileptic medicine containing brivaracetam, a highly selective synaptic vesicle protein 2A (SV2A) ligand. It is used as adjunctive therapy (add-on treatment) for partial-onset seizures (focal seizures) with or without secondary generalization in adults, adolescents, and children from 2 years of age who have epilepsy. Brivaracetam is chemically related to levetiracetam but demonstrates a 15–30 times higher affinity for SV2A, providing potent antiseizure activity at lower doses. Available as 10 mg film-coated tablets, Brivaracetam Teva is taken orally twice daily and has been shown in pivotal clinical trials to significantly reduce seizure frequency in treatment-resistant epilepsy patients.
Quick Facts: Brivaracetam Teva
Key Takeaways
- Brivaracetam Teva contains brivaracetam, a next-generation antiepileptic that selectively binds to synaptic vesicle protein 2A (SV2A) with 15–30 times greater affinity than levetiracetam, offering effective seizure control at lower doses.
- It is approved as adjunctive (add-on) therapy for partial-onset seizures with or without secondary generalization in patients aged 2 years and older, and has demonstrated significant seizure reduction in three pivotal phase III clinical trials.
- The recommended starting dose for adults is 50 mg twice daily (100 mg/day), which can be adjusted between 25 mg twice daily (50 mg/day) and 100 mg twice daily (200 mg/day) based on individual response and tolerability.
- The most common side effects are somnolence (drowsiness), dizziness, and fatigue, which are generally mild to moderate and tend to improve over the first weeks of treatment.
- Brivaracetam should never be discontinued abruptly; gradual dose reduction over at least one week is recommended to minimize the risk of rebound seizures or status epilepticus.
What Is Brivaracetam Teva and What Is It Used For?
Brivaracetam Teva contains the active substance brivaracetam, a member of the racetam family of chemical compounds. Brivaracetam is classified as a third-generation antiepileptic drug (AED) that was specifically designed and developed to target synaptic vesicle protein 2A (SV2A), a transmembrane glycoprotein located on synaptic vesicles in presynaptic nerve terminals throughout the central nervous system. SV2A plays a critical role in the process of neurotransmitter release, acting as a regulator of synaptic vesicle exocytosis—the mechanism by which neurons release chemical messengers into the synaptic cleft to communicate with other neurons.
The development of brivaracetam emerged from research into levetiracetam (marketed as Keppra), a well-established antiepileptic drug that was the first medication identified to exert its primary anticonvulsant effect through binding to SV2A. While levetiracetam proved to be a highly effective and widely prescribed antiepileptic, researchers at UCB Pharma undertook a systematic drug design program to create a compound with higher affinity and selectivity for the SV2A binding site. The result was brivaracetam, which demonstrates approximately 15 to 30 times higher binding affinity for SV2A compared with levetiracetam. This markedly enhanced affinity means that brivaracetam can achieve clinically meaningful antiseizure effects at substantially lower doses than levetiracetam, and it enters the brain more rapidly due to its higher lipophilicity.
By binding to SV2A with high selectivity, brivaracetam modulates the fusion of synaptic vesicles with the presynaptic membrane, thereby reducing the release of excitatory neurotransmitters (primarily glutamate) from overactive neurons. In epilepsy, certain populations of neurons fire excessively and synchronously, generating the abnormal electrical discharges that manifest clinically as seizures. By dampening this excessive neurotransmitter release without broadly suppressing normal neuronal function, brivaracetam helps restore the balance between excitatory and inhibitory signaling in the brain. Importantly, preclinical studies have shown that brivaracetam does not significantly affect normal synaptic transmission at therapeutic concentrations, which may contribute to its relatively favorable side effect profile.
Brivaracetam Teva is specifically indicated for the adjunctive treatment of partial-onset seizures (also called focal seizures) with or without secondary generalization in adults, adolescents, and children from 2 years of age with epilepsy. Partial-onset seizures originate in one area (focus) of the brain and are the most common seizure type in adults with epilepsy, accounting for approximately 60% of all epilepsy cases. These seizures may remain localized (simple partial or focal aware seizures) or spread to involve larger brain areas (complex partial or focal impaired awareness seizures), and may sometimes generalize to involve both hemispheres of the brain (secondary generalized or focal to bilateral tonic-clonic seizures).
The clinical efficacy of brivaracetam was established in three pivotal phase III, randomized, double-blind, placebo-controlled clinical trials (designated N01252, N01253, and N01358) involving a total of over 1,550 adult patients with treatment-resistant partial-onset seizures. In these trials, patients were required to have at least 8 partial-onset seizures during an 8-week baseline period despite treatment with one or two concomitant antiepileptic drugs. The primary efficacy endpoint was the percentage reduction in seizure frequency per 28 days over the 12-week treatment period compared with placebo.
Across these three trials, brivaracetam at doses of 50 mg/day, 100 mg/day, and 200 mg/day demonstrated statistically significant and clinically meaningful reductions in partial-onset seizure frequency compared with placebo. In the pooled analysis, brivaracetam 100 mg/day achieved a median seizure frequency reduction of approximately 24% over placebo. The 50% responder rate (the proportion of patients experiencing at least a 50% reduction in seizure frequency from baseline) ranged from 27% to 38% across the treatment groups, compared with 16% to 22% for placebo. These results are particularly notable given that all patients had treatment-resistant epilepsy, meaning they had already failed to achieve adequate seizure control with other antiepileptic medications.
Brivaracetam was first approved in the European Union in January 2016 under the brand name Briviact (UCB Pharma). It was subsequently approved by the U.S. Food and Drug Administration (FDA) in February 2016. Brivaracetam Teva is a generic formulation manufactured by Teva Pharmaceuticals that contains the same active substance and meets the same quality, safety, and efficacy standards as the originator product through demonstrated bioequivalence. The availability of generic brivaracetam broadens patient access to this important antiepileptic medication.
Although both drugs target SV2A, brivaracetam has 15–30 times higher binding affinity, enters the brain more rapidly, and may be better tolerated in some patients. Notably, clinical evidence suggests that patients who experienced significant behavioral side effects (irritability, aggression, mood changes) with levetiracetam may tolerate brivaracetam better, as brivaracetam's more selective mechanism may produce fewer neuropsychiatric adverse effects. However, co-administration of the two drugs provides no additional clinical benefit because they compete for the same SV2A binding site.
What Should You Know Before Taking Brivaracetam Teva?
Contraindications
The primary contraindication to Brivaracetam Teva is hypersensitivity (allergy) to the active substance brivaracetam, to other pyrrolidone derivatives (such as levetiracetam or piracetam), or to any of the excipients (inactive ingredients) in the tablet formulation. Pyrrolidone derivatives share a common chemical backbone, and cross-sensitivity between members of this chemical class has been reported, although it is uncommon. If you have previously experienced a serious allergic reaction to levetiracetam or piracetam, inform your doctor before starting brivaracetam.
The excipients in Brivaracetam Teva 10 mg film-coated tablets typically include croscarmellose sodium, lactose monohydrate, and magnesium stearate in the tablet core, with a film coating containing polyvinyl alcohol, macrogol (polyethylene glycol), talc, titanium dioxide, and iron oxide yellow. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption should not take this medicine due to the lactose content.
Warnings and Precautions
Antiepileptic drugs, including brivaracetam, have been associated with an increased risk of suicidal thoughts and behavior. In a meta-analysis conducted by the FDA involving 199 placebo-controlled clinical trials of 11 antiepileptic drugs, patients receiving antiepileptics had approximately twice the risk of suicidal ideation or behavior compared with those receiving placebo (0.43% versus 0.24%). Patients, caregivers, and family members should be alert to the emergence of depression, mood changes, unusual behavior, or suicidal thoughts and should report these promptly to the treating physician.
Before and during treatment with Brivaracetam Teva, discuss the following with your healthcare provider:
- Central nervous system (CNS) depression: Brivaracetam can cause somnolence (drowsiness), fatigue, and dizziness, which may impair your ability to drive or operate machinery, particularly during the initial weeks of treatment or after dose increases. These effects are typically dose-related and tend to diminish over time. Concomitant use of other CNS depressants (including alcohol, benzodiazepines, opioids, and sedative antihistamines) may amplify these effects.
- Psychiatric symptoms: In clinical trials, psychiatric adverse events were reported in approximately 13% of patients receiving brivaracetam compared with 8% receiving placebo. These included irritability, anxiety, insomnia, depression, nervousness, and aggression. In most cases these were mild to moderate in severity, but some patients required dose reduction or discontinuation. Patients with a history of psychiatric disorders may be at greater risk.
- Hepatic impairment: Brivaracetam is extensively metabolized in the liver. Patients with hepatic (liver) disease may have increased exposure to brivaracetam. A lower starting dose of 25 mg twice daily (50 mg/day) is recommended for patients with chronic liver disease of any severity (Child-Pugh Class A, B, or C), with a maximum recommended dose of 75 mg twice daily (150 mg/day).
- Abrupt discontinuation: As with all antiepileptic drugs, brivaracetam should not be stopped suddenly. Abrupt withdrawal can trigger rebound seizures, seizure clusters, or potentially life-threatening status epilepticus. If discontinuation is necessary, the dose should be gradually reduced over a period of at least one week.
- Hypersensitivity reactions: Bronchospasm and angioedema have been reported in post-marketing experience with brivaracetam. If such reactions occur, treatment should be discontinued immediately and the patient should seek urgent medical attention.
Pregnancy and Breastfeeding
If you are pregnant, think you may be pregnant, or are planning to become pregnant, consult your neurologist or epileptologist before using Brivaracetam Teva. The management of epilepsy during pregnancy requires careful consideration by a specialist, as both uncontrolled seizures and antiepileptic drug exposure carry risks to the developing fetus. Generalized tonic-clonic seizures during pregnancy can cause trauma, hypoxia, and even death of the mother and/or unborn child, making adequate seizure control essential.
There are limited data from the use of brivaracetam in pregnant women. Animal reproductive toxicity studies have shown that brivaracetam produced developmental toxicity (increased embryofetal mortality and reduced pup body weight) at maternally toxic doses, but no teratogenicity (structural malformations) was observed. As a precaution, brivaracetam should preferably not be used during pregnancy unless the clinical condition of the mother requires treatment and the potential benefit justifies the potential risk to the fetus. Women of childbearing potential should use effective contraception and discuss pregnancy planning with their doctor well in advance.
It is not known whether brivaracetam is excreted in human breast milk. In animal studies, brivaracetam was excreted in the milk of lactating rats. A risk to the nursing infant cannot be excluded. The decision whether to discontinue breastfeeding or to discontinue brivaracetam therapy should be made in consultation with your doctor, taking into account the benefit of breastfeeding for the child and the benefit of therapy for the mother.
Driving and Operating Machinery
Brivaracetam has a moderate influence on the ability to drive and use machines. Due to possible central nervous system effects including somnolence, dizziness, and fatigue, patients should not drive, operate complex machinery, or engage in other potentially hazardous activities until they have gained sufficient experience with the medication to determine whether it affects their ability to perform these activities safely. This is particularly important during the initial treatment period and after dose adjustments. Patients should also be aware that their underlying epilepsy may itself affect driving eligibility, depending on local regulations.
Children and Adolescents
Brivaracetam Teva is approved for use in children and adolescents aged 2 years and older as adjunctive therapy for partial-onset seizures. The safety and efficacy in children below 2 years of age have not been established, and the use of brivaracetam in this age group is not recommended. Dosing in pediatric patients is weight-based and should be determined by a pediatric neurologist or epileptologist experienced in the management of childhood epilepsy. The 10 mg tablet strength may be particularly suitable for pediatric dose titration in younger children.
How Does Brivaracetam Teva Interact with Other Drugs?
Brivaracetam is primarily metabolized in the liver through three main pathways: hydrolysis of the acetamide group (the primary route, mediated by amidase enzymes), hydroxylation mediated by cytochrome P450 enzyme CYP2C19, and a combination of both pathways. Understanding these metabolic pathways is important for predicting and managing potential drug interactions. Brivaracetam is considered a moderate inhibitor of CYP2C19 and does not significantly induce or inhibit other major CYP enzymes at therapeutic concentrations.
In clinical practice, brivaracetam has a more favorable drug interaction profile than many traditional antiepileptic drugs (such as carbamazepine, phenytoin, or valproate), which are potent inducers or inhibitors of hepatic enzymes and interact extensively with other medications. However, several clinically important interactions have been identified:
| Drug | Effect on Brivaracetam | Effect on Co-administered Drug | Clinical Significance |
|---|---|---|---|
| Carbamazepine | Decreases brivaracetam plasma levels by ~26% | No significant change in carbamazepine levels; carbamazepine-epoxide may increase slightly | Dose adjustment of brivaracetam may be needed |
| Phenytoin | Decreases brivaracetam plasma levels by ~21% | Increases phenytoin levels by ~20–30% | Monitor phenytoin levels; dose adjustment of phenytoin may be required |
| Rifampicin | Decreases brivaracetam exposure by ~45% | No significant effect | Consider increasing brivaracetam dose during co-administration |
| Levetiracetam | No pharmacokinetic interaction | No pharmacokinetic interaction | No additional clinical benefit; both compete for same SV2A binding site |
| Valproate | No clinically significant effect | No clinically significant effect | No dose adjustment needed |
| Oral Contraceptives | No effect | No clinically meaningful change | No dose adjustment needed; contraceptive efficacy maintained |
| Lamotrigine | No clinically significant effect | No clinically significant effect | No dose adjustment needed |
Major Interactions
The most clinically significant interactions involve strong enzyme inducers. Rifampicin, a potent inducer of multiple metabolic enzymes, reduces brivaracetam plasma exposure by approximately 45%. If co-administration with rifampicin or other strong enzyme inducers is necessary, the prescribing physician should consider increasing the brivaracetam dose to maintain therapeutic efficacy, guided by clinical response and seizure control.
Carbamazepine is a moderate enzyme inducer that reduces brivaracetam plasma concentrations by approximately 26%. While this interaction does not always require dose adjustment, patients should be monitored for changes in seizure control when carbamazepine is added, removed, or dose-adjusted. Of note, brivaracetam may cause a small increase in carbamazepine-epoxide (the active metabolite of carbamazepine), although the clinical significance of this increase is generally considered minor.
The interaction with phenytoin is bidirectional and clinically important. Phenytoin induces the metabolism of brivaracetam, reducing its plasma levels by approximately 21%. Conversely, brivaracetam inhibits CYP2C19-mediated metabolism of phenytoin, leading to increases in phenytoin plasma concentrations of 20–30%. Since phenytoin has a narrow therapeutic index (small margin between therapeutic and toxic levels), monitoring of phenytoin plasma levels is recommended when brivaracetam is started, stopped, or dose-adjusted in patients taking phenytoin.
Minor Interactions
Brivaracetam does not significantly affect the pharmacokinetics of commonly used antiepileptic drugs such as lamotrigine, lacosamide, topiramate, oxcarbazepine (active metabolite monohydroxy derivative), or valproate. Similarly, these drugs do not significantly affect brivaracetam exposure. This favorable interaction profile makes brivaracetam a practical choice as add-on therapy in patients already taking multiple antiepileptic drugs.
Brivaracetam does not significantly affect the efficacy of combined oral contraceptives. In a dedicated interaction study, co-administration of brivaracetam 100 mg twice daily with an oral contraceptive containing ethinylestradiol and levonorgestrel did not result in clinically meaningful changes in the pharmacokinetics of either contraceptive component. This is an important advantage over enzyme-inducing antiepileptic drugs (such as carbamazepine, phenytoin, and oxcarbazepine), which can reduce contraceptive efficacy.
Alcohol can increase the CNS depressant effects of brivaracetam, intensifying somnolence, dizziness, and impaired coordination. Patients should avoid or minimize alcohol consumption during treatment. Similarly, caution is advised when combining brivaracetam with other CNS depressants including benzodiazepines, opioid analgesics, barbiturates, and sedating antihistamines.
What Is the Correct Dosage of Brivaracetam Teva?
Brivaracetam Teva should always be used exactly as prescribed by your doctor. The tablets are taken orally (by mouth), swallowed whole with a glass of water, and can be taken with or without food. Food does not significantly affect the rate or extent of absorption. The daily dose should be divided into two equal doses, taken approximately 12 hours apart (e.g., morning and evening) to maintain stable drug levels in the blood throughout the day.
Adults and Adolescents Weighing 50 kg or More
| Parameter | Starting Dose | Therapeutic Range | Maximum Dose |
|---|---|---|---|
| Daily dose | 100 mg/day | 50–200 mg/day | 200 mg/day |
| Single dose | 50 mg twice daily | 25–100 mg twice daily | 100 mg twice daily |
| Titration needed | No (can start at full dose) | Based on response | — |
One of the notable advantages of brivaracetam is that dose titration is generally not required. Unlike many antiepileptic drugs that must be started at a low dose and gradually increased over weeks to minimize side effects, brivaracetam can be initiated at the full therapeutic dose of 50 mg twice daily (100 mg/day). This allows for a more rapid onset of antiseizure protection. However, if side effects are a concern (particularly CNS effects such as somnolence and dizziness), the doctor may choose to start at a lower dose of 25 mg twice daily (50 mg/day) and increase as tolerated.
Based on individual patient response and tolerability, the dose can be adjusted within the therapeutic range of 50 to 200 mg/day. Clinical trials showed that doses of 50 mg/day, 100 mg/day, and 200 mg/day all demonstrated statistically significant efficacy compared with placebo. The 100 mg/day dose is considered the optimal balance between efficacy and tolerability for most patients. The maximum recommended dose is 200 mg/day (100 mg twice daily).
Children (2 Years and Older)
Dosing in pediatric patients is based on body weight. The prescribing physician, typically a pediatric neurologist, will calculate the appropriate dose based on the child's weight and clinical response. For children and adolescents weighing less than 50 kg, the recommended starting dose is 1 mg/kg twice daily (2 mg/kg/day), with a therapeutic range of 0.5–2 mg/kg twice daily (1–4 mg/kg/day). The 10 mg tablet strength of Brivaracetam Teva is particularly useful for precise weight-based dosing in smaller children.
Pediatric Dosing Example
A child weighing 20 kg would typically start at 20 mg twice daily (40 mg/day = 2 mg/kg/day), which could be adjusted to between 10 mg twice daily (20 mg/day) and 40 mg twice daily (80 mg/day) based on response and tolerability. The 10 mg tablets can be used to achieve precise dosing adjustments.
Elderly Patients
No dose adjustment is required for elderly patients (aged 65 and older) based solely on age. However, as older patients are more likely to have reduced renal and/or hepatic function, comorbidities, and concomitant medications, careful dose selection is advisable. Elderly patients may also be more susceptible to CNS depressant effects, so starting at the lower end of the dosing range and titrating slowly may be prudent in this population.
Hepatic Impairment
For patients with liver disease of any severity (Child-Pugh Class A, B, or C), a lower starting dose of 25 mg twice daily (50 mg/day) is recommended. The maximum recommended dose in patients with hepatic impairment is 75 mg twice daily (150 mg/day). Hepatic impairment increases brivaracetam plasma exposure because the drug is extensively metabolized in the liver, and impaired liver function slows this metabolic clearance.
Missed Dose
If you forget to take a dose of Brivaracetam Teva, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and take the next dose at the regular time. Do not take a double dose to make up for a forgotten dose. Consistent twice-daily dosing is important for maintaining stable blood levels and optimal seizure control. Consider using a pill organizer or setting a phone alarm to help you remember.
Overdose
If you have taken more Brivaracetam Teva than prescribed, contact your doctor, pharmacist, or local poison control center immediately. There is limited clinical experience with brivaracetam overdose. In clinical trials, doses up to 1,400 mg/day have been administered, and the adverse effects observed were primarily exaggerations of the known CNS side effects: somnolence, dizziness, fatigue, and nausea. There is no specific antidote for brivaracetam overdose. Treatment is supportive and may include symptomatic management. Hemodialysis is not expected to be effective in removing brivaracetam from the body because the drug is highly protein-bound in plasma at only about 20%—however, both brivaracetam and its metabolites can technically be removed by dialysis, although this is generally not clinically necessary.
What Are the Side Effects of Brivaracetam Teva?
Like all medicines, Brivaracetam Teva can cause side effects, although not everybody gets them. The side effect profile of brivaracetam has been characterized in clinical trials involving over 3,000 patients with epilepsy, including both placebo-controlled studies and long-term open-label extension studies lasting up to 8 years. The safety database provides a comprehensive understanding of the frequency, severity, and time course of adverse effects associated with this medication.
The side effects of brivaracetam are predominantly related to the central nervous system, which is expected given the drug's mechanism of action in the brain. The majority of adverse effects are dose-dependent (more likely to occur at higher doses) and tend to occur within the first few weeks of treatment initiation, diminishing in frequency and severity as the body adjusts to the medication. In clinical trials, the overall discontinuation rate due to adverse events was approximately 8% for patients receiving brivaracetam compared with 4% for placebo.
Very Common (may affect more than 1 in 10 people)
- Somnolence (drowsiness, sleepiness) — reported in approximately 12–16% of patients
- Dizziness — reported in approximately 11% of patients
Common (may affect 1 in 10 to 1 in 100 people)
- Fatigue (tiredness, lack of energy)
- Nausea
- Insomnia (difficulty sleeping)
- Decreased appetite
- Irritability
- Depression
- Anxiety
- Influenza-like symptoms
- Upper respiratory tract infection
- Vertigo (spinning sensation)
- Constipation
- Vomiting
Uncommon (may affect 1 in 100 to 1 in 1,000 people)
- Aggression
- Agitation
- Psychotic disorder
- Suicidal ideation
- Neutropenia (low white blood cell count)
- Abnormal behavior
Rare (may affect fewer than 1 in 1,000 people)
- Suicidal attempt
- Bronchospasm (breathing difficulty due to airway spasm)
- Angioedema (swelling of face, lips, tongue, or throat)
Neuropsychiatric Effects
Neuropsychiatric adverse effects deserve special attention with all antiepileptic drugs, including brivaracetam. In clinical trials, psychiatric adverse events were reported in approximately 13% of patients receiving brivaracetam versus 8% receiving placebo. The most common psychiatric effects were insomnia, irritability, depression, and anxiety. These effects were generally mild to moderate in severity and led to treatment discontinuation in approximately 1.5% of patients. Importantly, clinical evidence suggests that brivaracetam may have a more favorable neuropsychiatric profile than its close relative levetiracetam, with lower rates of behavioral side effects such as aggression and irritability. A retrospective analysis found that a proportion of patients who had discontinued levetiracetam due to behavioral side effects were able to tolerate brivaracetam successfully.
However, all patients starting brivaracetam should be monitored for mood changes, depression, anxiety, irritability, aggression, or suicidal thoughts, particularly during the first months of treatment and after dose changes. Patients and caregivers should be informed about the risk and instructed to seek medical advice immediately if concerning symptoms emerge.
When to Seek Immediate Medical Attention
Signs of a severe allergic reaction (angioedema, bronchospasm): swelling of face, lips, tongue, or throat; difficulty breathing or wheezing; severe skin rash or hives. Symptoms of suicidal thoughts or self-harm: persistent thoughts of death, worsening depression, or plans to hurt yourself. Signs of severe CNS depression: extreme drowsiness with difficulty being awakened, confusion, or significantly impaired coordination. Contact your healthcare provider or local emergency services immediately.
If you experience any side effect that is bothersome, persistent, or that you are unsure about, contact your doctor or pharmacist. You can also report side effects to your national pharmacovigilance authority (e.g., the Yellow Card Scheme in the UK, MedWatch in the US, or the EMA's EudraVigilance system in the EU). Reporting side effects helps improve the understanding of drug safety for all patients.
How Should You Store Brivaracetam Teva?
Proper storage of medication is essential to maintain its quality, safety, and effectiveness throughout its shelf life. Brivaracetam Teva 10 mg film-coated tablets should be stored at room temperature, typically defined as not above 25°C (77°F). The tablets should be kept in their original packaging (blister packs within the outer carton) to protect them from light and moisture. Do not remove tablets from the blister pack until you are ready to take them.
Store the medication in a secure location out of the sight and reach of children. Brivaracetam is a potent antiepileptic drug, and accidental ingestion by a child could cause serious adverse effects including excessive drowsiness, respiratory depression, and other CNS effects requiring urgent medical attention.
Do not use Brivaracetam Teva after the expiry date (EXP) stated on the carton and blister. The expiry date refers to the last day of that month. Do not use the medicine if you notice any visible signs of deterioration, such as discoloration, crumbling, or an unusual odor.
Do not dispose of medications via wastewater or household waste. Return any unused or expired medicine to your pharmacy for proper disposal according to local regulations. Proper disposal helps protect the environment and prevents accidental exposure to others.
What Does Brivaracetam Teva Contain?
Active Ingredient
Each film-coated tablet contains 10 mg of brivaracetam. Brivaracetam is a white to off-white crystalline powder with the chemical formula C11H18N2O2 and a molecular weight of 212.3 g/mol. It is a 4n-propyl analogue of the cyclic γ-aminobutyric acid (GABA) derivative levetiracetam. Despite its structural relationship to GABA, brivaracetam does not directly modulate GABA receptors or GABAergic neurotransmission; instead, its primary pharmacological target is SV2A.
Inactive Ingredients (Excipients)
The tablet core of Brivaracetam Teva 10 mg typically contains the following excipients:
- Lactose monohydrate — a filler/diluent that provides bulk to the tablet. Patients with rare hereditary galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should not take this medicine.
- Croscarmellose sodium — a disintegrant that helps the tablet break apart in the gastrointestinal tract for absorption.
- Magnesium stearate — a lubricant used in tablet manufacturing to prevent the tablet material from sticking to machinery.
The film coating typically contains polyvinyl alcohol (partially hydrolyzed), macrogol (polyethylene glycol), talc, titanium dioxide (E171), and iron oxide yellow (E172). These coating ingredients give the tablet its smooth appearance, protect the core from moisture, and facilitate swallowing. The film coating also provides the characteristic appearance that helps identify the tablet.
Brivaracetam Teva 10 mg tablets are typically round, film-coated, white to off-white tablets that may be debossed with identifying markings. The exact appearance, including size, color, and markings, should match the description in the patient information leaflet included in the medication packaging. If the tablets you receive look different from what is described, consult your pharmacist before taking them.
Frequently Asked Questions About Brivaracetam Teva
Brivaracetam Teva is used as adjunctive therapy (add-on treatment) for partial-onset seizures (focal seizures) with or without secondary generalization in patients aged 2 years and older with epilepsy. It is not intended for use as a sole antiepileptic treatment (monotherapy). It works by selectively binding to SV2A protein in the brain, which helps reduce excessive neuronal firing that causes seizures.
Both drugs target the same protein (SV2A) in the brain, but brivaracetam binds to it with 15–30 times greater affinity. Brivaracetam also reaches the brain faster and may cause fewer neuropsychiatric side effects (such as irritability and aggression) in some patients. However, because they target the same site, taking both drugs together provides no additional benefit. If you are switching from levetiracetam to brivaracetam, your doctor will guide you through the transition safely.
No, you should never stop taking brivaracetam suddenly without medical supervision. Abrupt withdrawal of any antiepileptic drug can lead to a dangerous increase in seizure frequency (rebound seizures) or even status epilepticus, a prolonged seizure that is a medical emergency. If you need to stop taking brivaracetam, your doctor will gradually reduce your dose over a period of at least one week.
It is strongly recommended to avoid or significantly limit alcohol consumption while taking brivaracetam. Alcohol is a central nervous system depressant that can intensify the drowsiness, dizziness, and cognitive effects caused by brivaracetam. Additionally, alcohol can lower the seizure threshold in people with epilepsy, potentially triggering seizures and counteracting the protective effect of the medication.
Brivaracetam Teva and Briviact both contain the same active substance (brivaracetam) and are therapeutically equivalent. Briviact is the original brand-name product manufactured by UCB Pharma, while Brivaracetam Teva is a generic version manufactured by Teva Pharmaceuticals. Generic medicines are required to demonstrate bioequivalence to the originator product, meaning they deliver the same amount of active drug into the bloodstream at the same rate. The inactive ingredients may differ slightly between the two products, but this does not affect clinical efficacy or safety for the vast majority of patients.
No, brivaracetam does not reduce the effectiveness of oral contraceptive pills. Unlike several other antiepileptic drugs (such as carbamazepine, phenytoin, and oxcarbazepine) that are potent enzyme inducers and can interfere with hormonal contraception, brivaracetam does not significantly affect the metabolism of combined oral contraceptives. This has been confirmed in a dedicated drug interaction study. Women taking brivaracetam can continue to rely on their hormonal contraception for pregnancy prevention.
References
- European Medicines Agency (EMA). Briviact (brivaracetam) — Summary of Product Characteristics. Last updated 2025. Available at: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Briviact (brivaracetam) — Prescribing Information. Revised 2024. Available at: www.accessdata.fda.gov
- Klein P, Schiemann J, Sperling MR, et al. A randomized, double-blind, placebo-controlled, multicenter, parallel-group study of adjunctive brivaracetam in adult patients with uncontrolled partial-onset seizures. Epilepsia. 2015;56(12):1890–1898. doi:10.1111/epi.13212
- Ryvlin P, Werhahn KJ, Blaszczyk B, Johnson ME, Lu S. Adjunctive brivaracetam in adults with uncontrolled focal epilepsy: results from a double-blind, randomized, placebo-controlled trial. Epilepsia. 2014;55(1):47–56. doi:10.1111/epi.12432
- Kwan P, Trinka E, Van Paesschen W, Rektor I, Johnson ME, Lu S. Adjunctive brivaracetam for uncontrolled focal and generalized epilepsies: results of a phase III, double-blind, randomized, placebo-controlled, flexible-dose trial. Epilepsia. 2014;55(1):38–46. doi:10.1111/epi.12391
- Lattanzi S, Cagnetti C, Foschi N, Provinciali L, Silvestrini M. Brivaracetam add-on for refractory focal epilepsy: a systematic review and meta-analysis. Neurology. 2016;86(14):1344–1352. doi:10.1212/WNL.0000000000002545
- Yates SL, Fakhoury T, Liang W, Eckhardt K, Borghs S, D'Souza J. An open-label, prospective, exploratory study of patients with epilepsy switching from levetiracetam to brivaracetam. Epilepsy Behav. 2015;52:165–168. doi:10.1016/j.yebeh.2015.09.005
- International League Against Epilepsy (ILAE). Treatment guidelines: antiseizure medication selection for focal epilepsy. Updated 2022. Available at: www.ilae.org
- National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults. NICE guideline [NG217]. Updated 2024. Available at: www.nice.org.uk
- World Health Organization (WHO). Epilepsy: a public health imperative. Geneva: World Health Organization; 2019. Available at: www.who.int
Medical Editorial Team
Medical Content
Written by licensed physicians specializing in neurology, epileptology, and clinical pharmacology with documented academic background and clinical experience in seizure management.
Medical Review
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