Perampanel: Uses, Dosage and Side Effects

Perampanel is used for treating certain kinds of partial-onset seizures in adults and children who are 4 years of age and older. It is also used in conjunction with other medications to treat certain types of primary generalized tonic-clonic seizures in adults and children aged 12 and up.

What Is Perampanel?

Perampanel is a prescription medication used to manage epilepsy. It is available in oral forms like perampanel tablets and is classified as an antiepileptic drug (AED). Perampanel helps control seizures by acting on specific receptors in the brain to reduce abnormal electrical activity.

Perampanel Uses

The main benefit of perampanel is its ability to reduce the frequency and intensity of seizures. It is especially useful for patients who do not respond well to other seizure medications. Perampanel uses include managing both focal onset seizures and generalized tonic-clonic seizures, either alone or in combination with other treatments.

Conditions Perampanel Treats

• Focal onset seizures with or without secondary generalization
• Primary generalized tonic-clonic seizures (GTCS) in patients 12 years and older

Secondary Uses of Perampanel

• May be considered for certain off-label uses in patients with difficult-to-treat epilepsy
• Used in combination with other anti-seizure drugs when monotherapy is not effective

A commonly prescribed dose is perampanel 4 mg, which can be adjusted based on the patient's response. While effective, it may lead to some perampanel side effects like dizziness, sleepiness, irritability, or balance issues. Regular follow-up with a neurologist is important for safe use.

How Does Perampanel Work?

Perampanel works by blocking AMPA receptors in the brain. These receptors play a key role in sending signals between nerve cells. By stopping these receptors from over-firing, perampanel helps calm abnormal electrical activity, which is the main cause of seizures.

This medicine acts directly on the nervous system but does not involve hormones. It slows down certain brain signals without affecting hormone levels. The goal is to restore balance in the brain and prevent seizures from starting or spreading.

Perampanel Dosage

Perampanel is usually started at a low dose, often perampanel 2 mg or perampanel 4 mg once daily at bedtime. The dosage is gradually increased by your doctor based on how well your body responds and the severity of your seizures. Perampanel tablets should be swallowed whole with water and taken at the same time each day.

What Should I Do If I Miss a Dose?

If you forget to take a dose of Perampanel, take it as soon as you remember. If it's close to your next dose, skip the missed one. Do not take two doses at once to make up for the missed one.

What Happens If There's an Overdose?

An overdose of perampanel can lead to serious side effects such as severe drowsiness, agitation, confusion, or even loss of consciousness. Seek emergency medical help right away if an overdose is suspected.

Perampanel Side Effects

Perampanel side effects occur because it blocks AMPA receptors in the brain, which reduces seizures but may also interfere with normal brain signalling. This can lead to dizziness, aggression, irritability, sleepiness, or coordination problems.

• Dizziness
• Sense of spinning
• Drowsiness
• Constipation
• Nausea
• Vomiting
• Headache
• Tiredness
• Weight gain
• Irritability
• Weakness
• Problems with coordination
• Muscle pain or joint pain
• Back pain
• Decreased sense of touch or sensation
• Blurred vision

Precautions for Perampanel

• Allergies: Inform your doctor if you are allergic to Perampanel or have any other allergies.
• Medical Conditions: Inform your doctor if you have liver problems, kidney problems, mental/mood disorders, or galactose intolerance.
• Pregnancy: This medication'should not be taken during pregnancy as it can harm the unborn child. However, untreated seizures can also harm both the mother and the child. Consult your doctor about the benefits and risks.
• Breastfeeding: This drug does not appear to pass through breast milk. Consult your doctor before breastfeeding.

Possible Interactions with Other Medications (Drug Interactions)

Perampanel may interact with other medications that affect liver enzymes, especially those that speed up drug metabolism. These include:

• Carbamazepine
• Phenytoin
• Oxcarbazepine

These drugs can reduce the effectiveness of perampanel tablets, so that dosage adjustments may be needed.

Supplements and Herbal Products

Some herbal products and supplements, such as St. Johns Wort, may interfere with how perampanel works. Always inform your doctor about any over-the-counter products or supplements you take to avoid reduced effectiveness or unexpected side effects.

How Should Perampanel Be Stored?

Store perampanel tablets at room temperature between 20°C and 25°C (68°F and 77°F). Keep the medicine in its original container, tightly closed, and away from light and moisture.

What Happens If Perampanel Is Not Stored Properly?

Exposure to extreme temperatures, sunlight, or moisture may reduce the effectiveness of perampanel. Improper storage can also alter its chemical stability, potentially leading to safety issues. Always keep it out of reach of children and do not use expired medication.

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