An antiepileptic medicine

Brivaracetam

An antiepileptic medicine used to help control certain types of seizure (focal/partial seizures), often alongside other epilepsy treatments.

What is Brivaracetam?

Brivaracetam is an antiepileptic (anti-seizure) medicine, closely related to levetiracetam, used to help control focal (partial) seizures — usually together with other epilepsy medicines. It is generally well tolerated, but it can cause drowsiness and, in some people, changes in mood or behaviour. It should not be stopped suddenly, as this can trigger seizures, and pregnancy plans should be discussed in advance.

Class: Antiepileptic medicines · Brands: Briviact

Education and reference only. This is a plain-language guide to Brivaracetam — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.

Brivaracetam (Antiepileptic medicines) — Meds Global Health reference card with 2D molecular structure
Brivaracetam — Antiepileptic medicines. The image shows the active ingredient's 2D molecular structure.

What it is

Brivaracetam is a relatively modern antiepileptic medicine used in the UK to help control epilepsy. It is chemically related to levetiracetam and is used mainly for focal (partial) seizures, often added on to other anti-seizure treatments. It is a long-term medicine that works to reduce how often seizures happen rather than to stop a seizure once it has started.

How it works

Brivaracetam attaches to a protein (SV2A) in the brain's nerve endings that is involved in releasing the chemical signals nerves use to communicate. By acting on this protein it helps calm the excessive, disorganised electrical activity that causes seizures. The overall effect is to make seizures less likely to start and spread. It does not cure epilepsy, so it needs to be taken regularly to keep working.

Company & origin

Originated / developed by: A modern antiepileptic medicine.

A newer antiepileptic medicine used in the UK, related to levetiracetam, for certain types of epilepsy.

Practical use

How to take Brivaracetam

General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.

  • Take it regularly as prescribed, at roughly the same times each day, to keep a steady level in your body.
  • It can be taken with or without food, and the tablet, liquid or injection forms are used depending on your situation.
  • Do not stop taking it suddenly, even if you feel well or have no seizures — stopping abruptly can trigger seizures.
  • Tell your team about any changes in mood, behaviour or alertness, and avoid driving until you know how it affects you.
  • If you miss a dose, take it as soon as you remember unless it is nearly time for the next one; never double up to catch up.

Weighing it up

Advantages & disadvantages of Brivaracetam

Advantages

  • Helps reduce how often focal seizures happen and can improve day-to-day seizure control.
  • Often well tolerated and can be used alongside other epilepsy medicines.
  • Available in different forms (including tablets, liquid and an injection), which is useful if swallowing is difficult.

Disadvantages

  • Can cause drowsiness, dizziness and tiredness, particularly when starting or increasing the dose.
  • May cause changes in mood or behaviour in some people, which need monitoring.
  • Must not be stopped abruptly, and ongoing prescriptions and reviews are needed.

Practical use

Good to know

Brivaracetam is taken regularly, with or without food, and it is important not to miss doses, as steady levels help keep seizures controlled. It can cause drowsiness or dizziness, especially at first, so be cautious with driving or operating machinery until you know how it affects you. Some people notice changes in mood or behaviour — such as low mood, irritability, anxiety or, rarely, thoughts of self-harm — and these should be reported promptly. It must not be stopped suddenly, because abrupt withdrawal can bring on seizures; any change is made gradually under medical guidance. If you are pregnant or planning a pregnancy, discuss this with your team early, as epilepsy treatment in pregnancy needs careful, individual planning.

Who should not take it / use with caution

  • People who have had a serious allergic reaction to brivaracetam or related medicines should not take it.
  • Used with caution in people with significant liver problems and in those with a history of depression or mood disorders.
  • In pregnancy and breastfeeding it is used only after careful, individual discussion, balancing seizure control against any risks.

Monitoring

  • Seizure frequency and how well symptoms are controlled.
  • Mood and behaviour, especially in the early weeks of treatment.
  • General tolerance, including drowsiness and dizziness, and any need for dose review.

Side effects

  • Drowsiness, dizziness and tiredness, which are among the most common effects.
  • Mood or behaviour changes — such as irritability, anxiety, low mood or, rarely, thoughts of self-harm — which should be reported.
  • Less commonly, nausea, unsteadiness or, rarely, a serious allergic reaction needing urgent medical help.

Key interactions

  • Other medicines that cause drowsiness — including some painkillers, sedatives and alcohol — can add to its sedating effect.
  • It interacts with some other epilepsy medicines, so doses may need adjusting when these are combined.
  • Always check with a pharmacist before starting new medicines, including ones bought over the counter.

Available as: Tablets and an oral liquid; an injection form is also used in hospital when tablets or liquid cannot be taken.

Answers

Brivaracetam: frequently asked questions

What is brivaracetam used for?

It is an antiepileptic medicine used to help control certain seizures, mainly focal (partial) seizures, often alongside other epilepsy medicines. It works to make seizures less likely rather than to stop one once it has started.

Can I stop brivaracetam if my seizures have settled?

No — do not stop it suddenly. Stopping abruptly can trigger seizures, sometimes severe ones. If it ever needs to change, your team will reduce it gradually and safely.

Does brivaracetam affect mood?

It can in some people, causing irritability, anxiety, low mood or, rarely, thoughts of self-harm. Tell your team promptly if you notice mood or behaviour changes so they can review your treatment.

Can I drive while taking brivaracetam?

It can cause drowsiness and dizziness, so be cautious until you know how it affects you. Driving with epilepsy also has DVLA rules linked to seizure control, so check what applies to you with your team.

Is brivaracetam the same as levetiracetam?

They are related and work in a similar way, but they are different medicines. Some people who do not get on with levetiracetam are switched to brivaracetam; your team will decide which is right for you.

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