Bivara
Generic Name
Brivaracetam
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| bivara 25 mg tablet | ৳ 40.00 | ৳ 400.00 |
Description
Overview of the medicine
Brivaracetam is an antiepileptic drug used to treat partial-onset seizures in adults and children. It belongs to the class of SV2A ligands.
Uses & Indications
Dosage
Adults
Initial dose typically 50 mg/day (25 mg twice daily), adjusted based on response and tolerability up to 200 mg/day.
Elderly
No specific dose adjustment required based on age alone, but monitor for renal/hepatic impairment.
Renal_impairment
No dose adjustment for mild to moderate renal impairment. For severe renal impairment or end-stage renal disease (ESRD), a starting dose of 25 mg twice daily may be considered, with a maximum of 75 mg twice daily.
How to Take
Can be taken with or without food. Swallow tablets whole with water. Do not crush or chew.
Mechanism of Action
Brivaracetam selectively binds to synaptic vesicle glycoprotein 2A (SV2A) in the brain, which is believed to modulate neurotransmitter release and thus reduce seizure activity.
Pharmacokinetics
Onset
Rapid, often within hours of first dose.
Excretion
Primarily renal (95%), with about 70-80% as metabolites and 9-10% as unchanged drug.
Half life
Approximately 9 hours.
Absorption
Rapid and almost complete oral absorption; absolute bioavailability is 100%. Peak plasma concentrations achieved in 0.5-2 hours.
Metabolism
Primarily hydrolyzed by amidase, and to a lesser extent, by CYP2C19. No major active metabolites.
Side Effects
Contraindications
- Hypersensitivity to brivaracetam or any pyrrolidone derivative
Drug Interactions
Carbamazepine
No significant pharmacokinetic interaction but monitor for additive CNS effects.
Rifampin (strong enzyme inducer)
May decrease brivaracetam plasma concentrations. Monitor and adjust brivaracetam dose if needed.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include drowsiness, dizziness, nausea. Management is supportive and symptomatic, including gastric lavage or activated charcoal if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs the potential risk to the fetus. Excreted in breast milk; advise against breastfeeding or monitor infant for adverse effects.
Side Effects
Contraindications
- Hypersensitivity to brivaracetam or any pyrrolidone derivative
Drug Interactions
Carbamazepine
No significant pharmacokinetic interaction but monitor for additive CNS effects.
Rifampin (strong enzyme inducer)
May decrease brivaracetam plasma concentrations. Monitor and adjust brivaracetam dose if needed.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include drowsiness, dizziness, nausea. Management is supportive and symptomatic, including gastric lavage or activated charcoal if recent ingestion.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit outweighs the potential risk to the fetus. Excreted in breast milk; advise against breastfeeding or monitor infant for adverse effects.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Patent protected (original molecule), generic versions available
Clinical Trials
Extensive clinical trials have demonstrated efficacy and safety in partial-onset seizures, including phase II and III studies comparing brivaracetam to placebo and other antiepileptics.
Lab Monitoring
- Monitor for changes in mood or behavior, including suicidal thoughts.
- Routine blood tests generally not required unless clinically indicated.
- Monitor hepatic and renal function in patients with pre-existing impairment.
Doctor Notes
- Counsel patients on potential CNS side effects and behavioral changes.
- Emphasize gradual withdrawal if discontinuation is planned.
- Consider dose adjustment in severe renal or hepatic impairment.
- Monitor for seizure control and tolerability.
Patient Guidelines
- Take medicine as prescribed by your doctor.
- Do not stop taking this medicine suddenly, as it may worsen your seizures.
- Report any unusual mood changes or thoughts of self-harm to your doctor immediately.
- Avoid driving or operating heavy machinery until you know how this medicine affects you.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine may cause dizziness or drowsiness. Do not drive or operate machinery until you know how it affects you.
Lifestyle Advice
- Maintain a regular sleep schedule.
- Avoid alcohol, as it may increase side effects.
- Inform your doctor about all other medications you are taking.
- Carry an epilepsy identification card.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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