II. Indications

  1. Refractory partial-onset Seizures

III. Mechanism

  1. Antiepileptic
  2. Glutamate receptor antagonist (first in the class)
    1. Selective for AMPA receptors

IV. Precautions

  1. FDA Schedule III
    1. Abuse potential due to associated euphoria

V. Adverse Effects

  1. Mood changes
    1. Euphoria
    2. Anger
    3. Hostility
  2. Dizziness
  3. Sedation

VI. Dosing

  1. FDA approved for age over 12 years
  2. Initial: 2 mg orally at bedtime
  3. Titrate To: 4-8 mg orally at bedtime (increase by 2 mg/day on a weekly basis)
  4. Maximum: 12 mg/day

VII. Drug Interactions

  1. Levonorgestrel containing contraceptives
    1. Perampanel decreases the contraceptive efficacy
    2. Use alternative agents

IX. References

  1. (2014) Presc Lett 21(11): 65
  2. French (2012) Neurology 79(6):589-96 [PubMed]

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Cost: Medications

fycompa (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
FYCOMPA 2 MG TABLET $11.92 each
FYCOMPA 4 MG TABLET $24.19 each
FYCOMPA 6 MG TABLET $24.11 each
FYCOMPA 8 MG TABLET $23.84 each